The relationship between past medical experience and children's response to preparation for medical examinations was investigated in 79 pediatric outpatients aged 3 to 12 years. Children were randomly assigned to one of five preparation conditions prior to receiving a medical examination and a throat culture: sensory information about the exam, training in coping skills (deep breathing and positive self-talk), combined sensory information and coping skills training, attention control, and no-treatment control. The results indicated that children with previous negative medical experiences demonstrated more behavioral distress during a throat culture examination that did children with previous positive or neutral medical experiences. In addition, the attention control condition appeared to increase the distress of children with previous negative medical experiences. Amount of past exposure to the specific medical procedure was not related to observed distress. The implications of these findings for the preparation of children for medical procedures are discussed.
"We investigated the neural impact of IAA practices on the spinal cord by comparing the spinal cord neural activity of expert with novice practitioners using MRI. Such investigation may provide further evidence related to the belief that these practices are beneficial for physical health [11–14] as the spinal cord is directly connected to the body in that it innervates each part via various spinal nerve segments (e.g., the cervical cord innervates the hands and arms, and the lumbar segment innervates the feet and legs). The spinal cord was once considered as a mere relay that executes pregenerated plans originating in supraspinal structures or delivers sensory afferent signals from the periphery, but this view has been challenged in various studies and thus no more holds to be true. "
[Show abstract][Hide abstract] ABSTRACT: Many disciplines/traditions that promote interoceptive (inner sensation of body parts) attention/awareness (IAA) train practitioners to both attend to and be aware of interoceptive sensory experiences in body parts. The effect of such practices has been investigated in previous imaging studies but limited to cerebral neural activity. Here, for the first time, we studied the impact of these practices on the spinal neural activity of experts and novices. We also attempted to clarify the effect of constant and deep breathing, a paradigm utilized in concentration practices to avoid mind wandering, on IAA-related spinal neural activity. Subjects performed IAA tasks with and without a deep and constant breathing pattern in two sessions. Results showed that neural activity in the spinal segment innervating the attended-to body area increased in experts (P = 0.04) when they performed IAA and that this increase was significantly larger for experts versus novices in each of the sessions (P = 0.024). The significant effects of IAA and expertise on spinal neural activity are consistent with and elaborate on previous reports showing similar effects on cerebral neural activity. As the spinal cord directly innervates body parts, the results might indicate that IAA has an instantaneous (possibly beneficial) effect on the physical body after extended training.
"For example, the degree of social support provided by interviewers (Quas, Wallin, Papini, Lench, & Scullin, 2005) and interviewing techniques (Lamb, Orbach, Hershkowitz, Horowitz, & Abbott, 2007) affect children's reports. Furthermore, there could be moderating factors that influence child distress that were not explored here, such as attachment or narrative skills (Laible & Panfile, 2009; Sales, 2009), the quality of children's previous experiences (Dalquist et al., 1986) and adult behaviours during the painful event (Chambers, Craig, & Bennett, 2002). Additionally, differences in self report of crying may reflect not only differences in children's ability to express the extent to which they cried but also their general ability to express their emotions. "
"Young patients in fact often refer to lumbar puncture and bone marrow aspiration (procedures repeatedly conducted as part of diagnostic and therapeutic protocols) as the most painful experiences relating to their malignancy. This experience is associated not only with the invasiveness of the procedures, but also with the children's fear of needles and memories of previous procedures, which influence their reaction to subsequent procedures[4-6]. The child's life-long quality of life may be affected by these painful experiences. "
[Show abstract][Hide abstract] ABSTRACT: Beliefs of caregivers about patient's pain have been shown to influence assessment and treatment of children's pain, now considered an essential part of cancer treatment. Painful procedures in hematology-oncology are frequently referred by children as the most painful experiences during illness. Aim of this study was to evaluate professionals' beliefs about painfulness of invasive procedures repeatedly performed in Pediatric Hemato-Oncology Units.
Physicians, nurses, psychologists and directors working in Hemato-Oncology Units of the Italian Association of Pediatric Hematology-Oncology (AIEOP) were involved in a wide-nation survey. The survey was based on an anonymous questionnaire investigating beliefs of operators about painfulness of invasive procedures (lumbar puncture, bone marrow aspirate and bone marrow biopsy) and level of pain management.
Twenty-four directors, 120 physicians, 248 nurses and 22 psychologists responded to the questionnaire. The score assigned to the procedural pain on a 0-10 scale was higher than 5 in 77% of the operators for lumbar puncture, 97.5% for bone marrow aspiration, and 99.5% for bone marrow biopsy. The scores assigned by nurses differed statistically from those of the physicians and directors for the pain caused by lumbar puncture and bone marrow aspiration. Measures adopted for procedural pain control were generally considered good.
Invasive diagnostic-therapeutic procedures performed in Italian Pediatric Hemato-Oncology Units are considered painful by all the caregivers involved. Pain management is generally considered good. Aprioristically opinions about pain depend on invasiveness of the procedure and on the professional role.
Italian Journal of Pediatrics 06/2011; 37(1):27. DOI:10.1186/1824-7288-37-27 · 1.52 Impact Factor
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