title: Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents.
abstract: OBJECTIVE
  To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy.
  
  
  METHODS
  26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias.
  
  
  RESULTS
  Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy.
  
  
  CONCLUSIONS
  Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved.
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland kbirnie@dal.ca.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Birnie
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Melanie
authors.initials: M
authors.lastname: Noel
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Parker
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Christine T
authors.initials: CT
authors.lastname: Chambers
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Lindsay S
authors.initials: LS
authors.lastname: Uman
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Steve R
authors.initials: SR
authors.lastname: Kisely
authors.affiliation: Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland Department of Psychology and Neuroscience, Dalhousie University, Centre for Pediatric Pain Research, IWK Health Centre, Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Department of Pediatrics, Dalhousie University, Mental Health and Addiction Services, IWK Health Centre, and School of Population Health, The University of Queensland.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
mesh_terms: D000293:Adolescent; D001288:Attention; D002648:Child; D006801:Humans; D006990:Hypnosis; D009339:Needles / Q000009:adverse effects*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D059408:Pain Management / Q000379:methods*; D016896:Treatment Outcome
keywords: distraction; distress; empirically supported treatments; hypnosis; needles; pain; randomized controlled trials