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Available from: Rebecca R Pillai Riddell, Oct 14, 2014
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    ABSTRACT: Educating parents about ways to minimize pain during routine infant vaccine injections at the point of care may positively impact on pain management practices. The objective of this cluster randomized trial was to determine the impact of educating parents about pain in outpatient pediatric clinics on their use of pain treatments during routine infant vaccinations. Four hospital-based pediatric clinics were randomized to intervention or control groups. Parents of 2- to 4-month-old infants attending the intervention clinics reviewed a pamphlet and a video about vaccination pain management on the day of vaccination, whereas those in the control clinics did not. Parent use of specific pain treatments (breastfeeding, sugar water, topical anesthetics, and/or holding of infants) on the education day and at subsequent routine vaccinations 2 months later was the primary outcome. Altogether, 160 parent-infant dyads (80 per group) participated between November 2012 and February 2014; follow-up data were available for 126 (79%). Demographics did not differ between groups (P > 0.05). On the education day and at follow-up vaccinations, use of pain interventions during vaccinations was higher in the intervention group (80% vs 26% and 68% vs 32%, respectively; P < 0.001 for both analyses). Educating parents about pain management in a hospital outpatient setting leads to higher use of pain interventions during routine infant vaccinations.
    Pain 01/2015; 156(1):185-91. DOI:10.1016/j.pain.0000000000000021 · 5.84 Impact Factor
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    ABSTRACT: Analgesic interventions are not routinely used during vaccine injections in infants. Parents report a desire to mitigate injection pain but lack the knowledge about how to do so. The objective of this cluster randomized trial was to evaluate the effect of a parent-directed prenatal education teaching module about vaccination pain management on analgesic utilization at future infant vaccinations. Expectant mothers enrolled in prenatal classes at Mount Sinai Hospital, Toronto were randomized to a 30-minute interactive presentation about vaccination pain management (experimental group) or general vaccination information (control group). Both presentations included a Powerpoint™ and video presentation, take-home pamphlet, and 'Question and Answer' period. The primary outcome was self-reported utilization of breastfeeding, sugar water or topical anesthetics at routine 2-month infant vaccinations. Between October, 2012 and July, 2013, 197 expectant mothers from 28 prenatal classes participated; follow-up was obtained in 174 (88%). Maternal characteristics did not differ (p>0.05) between groups. Utilization of one or more pre-specified pain interventions occurred in 34% of participants in the experimental group compared to 17% in the control group (p=0.01). Inclusion of a pain management module in prenatal classes led to increased utilization of evidence-based pain management interventions by parents at the 2-month infant vaccination appointment. Educating parents offers a novel and effective way of improving the quality of pain care delivered to infants during vaccination. Additional research is needed to determine if utilization can be bolstered further using techniques such as; postnatal hospital reinforcement, reminder cards, and clinician education.
    Pain 04/2014; 155(7). DOI:10.1016/j.pain.2014.03.024 · 5.84 Impact Factor
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    Pain 05/2013; 154(9). DOI:10.1016/j.pain.2013.05.027 · 5.84 Impact Factor