C Meghan Mcmurtry

C Meghan Mcmurtry
University of Guelph | UOGuelph · Department of Psychology

Ph.D. (Clinical Psychology)

About

120
Publications
25,733
Reads
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2,498
Citations
Citations since 2017
74 Research Items
1710 Citations
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Education
July 2009 - July 2010
Brown University
Field of study
  • Clinical Psychology, Predoctoral Residency
September 2003 - October 2010
Dalhousie University
Field of study
  • Clinical Psychology
September 1998 - May 2002
Wilfrid Laurier University
Field of study
  • Psychology

Publications

Publications (120)
Article
Introduction Community pharmacists report that providing vaccinations can be challenging, particularly if the vaccine recipient is a child, because of heightened levels of fear. The objective of this study was to determine acceptability and feasibility of the CARD (Comfort Ask Relax Distract) system as a vaccination delivery framework for children...
Article
Full-text available
Background: Routine needle procedures can be distressing for parents and children. Mindfulness interventions may be helpful for parents and children but have not been examined for pediatric needle procedures despite showing benefits in the context of pediatric chronic pain and in lab-based pain tasks. Methods: This preregistered (NCT03941717) tw...
Article
Full-text available
Introduction CARD (Comfort Ask Relax Distract) is a vaccine delivery program demonstrated to reduce pain, fear and associated immunization stress-related responses (ISRR) in children undergoing vaccinations at school. This study evaluated CARD’s clinical impact when integrated into community pharmacy–based pediatric vaccinations. Methods This was...
Article
This study examined perceptions of children and parents about a new web-based CARD (Comfort, Ask, Relax, Distract) game that teaches children how to cope with needle-related pain and fear. A convenience sample of 15 child-parent dyads (children, 6–12 years) participated. Children played the game on a handheld device while being virtually monitored....
Article
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This qualitative study explored children’s perceptions of their dental experiences and their acceptability of the CARD™ (Comfort, Ask, Relax, Distract) system, adapted for the dental setting as a means to mitigate dental fear and anxiety (DFA). A purposive sample of 12 participants (7 males) aged 8-12 years receiving dental care at the Paediatric D...
Article
The purpose of this study was to further our understanding of early childhood pain-related distress regulation. Concurrent and predictive relations between child-led emotion regulation (ER) behaviors and pain-related distress during vaccination were examined at 2 different ages using autoregressive cross-lagged path analyses. Toddlers were video-re...
Article
Background Injection-related pain and fear are common adverse reactions in children undergoing vaccination and influence vaccine acceptance. Despite the large body of literature on sources of vaccine non-compliance, there is no estimate of the prevalence of pain and fear as contributing factors. The objective was to estimate the prevalence of injec...
Article
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Children’s needle-related distress is strongly related to parental verbal behaviors. Yet, empirical data supporting theorized contributors to parent behaviors in this context remain limited. This is the first study to collectively measure biological (heart rate variability; HRV), psychological (catastrophizing, anxiety), and social (child behaviors...
Article
Needle procedures are common throughout childhood and often elicit distress in children and parents. Heart rate variability (HRV), as an index of emotion regulation, can inform both self‐regulatory and co‐regulatory processes. Mindfulness may serve to regulate distress; however, no research has studied mindfulness or parent and child regulatory res...
Article
Objectives: Medical needle procedures are a common source of pain, distress, and fear for children, which can worsen over time and lead to needle noncompliance and avoidance, if unaddressed. Children's pain experience is multiply determined by external (e.g., parent behaviors) and internal (e.g., cognitive and affective) factors. Some parent behav...
Article
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The goal of the current study was to review and meta-analyze the literature on relationships between child distress expression behaviors (e.g., cry) and three clusters of child distress regulation behaviors (disengagement of attention, parent-focused behaviors, and self-soothing) in the first three years of life. This review was registered with PRO...
Article
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Background: Pediatric chronic pain is a prevalent condition that requires significant coping to encourage optimal functioning; however, relevant research is vast, heterogeneous, and difficult to interpret. To date, no attempt has been made to map and summarize the measurement and conceptualization of coping responses in the context of pediatric chr...
Article
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Exploring factors related to resilience in youth with inflammatory bowel disease may elucidate modifiable risk factors and inform interventions. Yet, how resilience factors may impact positive adaptation for youth with inflammatory bowel disease is not clear. We conducted an exploratory qualitative study on specific factors that bolster resilience...
Article
Objective: Parents are integral to their youth's chronic pain experiences and intervening with parents may improve parent and youth functioning. Existing systematic reviews are not specific to pain, or do not systematically report critical aspects to facilitate implementation of parent interventions in diverse settings. Thus, this scoping review a...
Article
This special issue focusing on pediatric psychology research in young children highlights 15 papers that focus on infants through preschoolers. Studies selected for inclusion cover a range of pediatric health conditions such as food allergy, medical trauma, injuries/traumatic brain injury, cancer, inflammatory bowel disease, pain, and sleep. The in...
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Background Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typic...
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Background The social context is critical to children’s pain, and parents frequently form a major aspect of this context. We addressed several gaps in our understanding of parent-child interactions during painful procedures and identified intrapersonal contributions to parental affective responses and behaviors. We used the Pain Empathy Model frame...
Article
Within a parallel-group randomized control trial, pain training's impact on Respite Workers' (RW) care approaches and training evaluations was explored. RW (n = 158) from 14 organizations received pain or control training following randomization. Researchers were blind until randomization; allocations were not shared explicitly with organizations/p...
Article
This parallel group randomized controlled trial tested effectiveness of the Let's Talk About Pain training on respite workers' (RW) pain-related knowledge and feasibility-confidence-skill ratings using between-group and within-group analyses. Fourteen children's respite organizations were randomized to pain or control training. Participants (ninter...
Article
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are i...
Article
Our understanding of how pain in early life differs to that in maturity is continuing to increase and develop, using a mixture of approaches from basic science, clinical science, and implementation science. The new edition of the Oxford Textbook of Pediatric Pain brings together an international team of experts to provide an authoritative and compr...
Article
Objectives Abdominal pain adversely impacts children with functional gastrointestinal disorders (FGIDs) or organic gastrointestinal disorders (OGIDs); findings are inconsistent regarding diagnosis and health-related quality of life (HRQoL). This study utilizes a positive psychology framework to understand the experience of youth with abdominal pain...
Article
Full-text available
Background Vaccination is a common painful procedure for children. Parents’ concern regarding vaccination pain is a significant driver of vaccine hesitancy. Despite the wealth of evidence-based practices available for managing vaccination pain, parents lack knowledge of, and access to, these strategies. Knowledge translation (KT) tools can communic...
Article
Parent behaviors strongly predict child responses to acute pain; less studied are the factors shaping parent behaviors. Heart rate variability (HRV) is considered a physiological correlate of emotional responding. Resting or “trait” HRV is indicative of the capacity for emotion regulation, while momentary changes or “state” HRV is reflective of cur...
Article
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Introduction: Although several evidence-based strategies for managing children's vaccination pain exist, many parents report being unaware of them. Knowledge translation (KT) tools present evidence-based information in plain language. Objectives: This two-phase study assessed parents/caregivers' uptake of evidence-based pain management strategie...
Article
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Background Negative experiences with school-based immunizations can contribute to vaccine hesitancy in youth and adulthood. We developed an evidence-based, multifaceted and customizable intervention to improve the immunization experience at school called the CARD™ (C-Comfort, A-Ask, R-Relax, D-Distract) system. We evaluated the feasibility of CARD™...
Article
Full-text available
Most vaccinations are administered with a needle, which can cause pain and pain-related symptoms such as fear and fainting. At present, interventions aimed at preventing pain and associated symptoms are not systematically integrated in the vaccination delivery process even though they contribute to negative experiences with vaccination and vaccinat...
Article
La plupart des vaccins sont administrés avec une aiguille, ce qui peut provoquer des douleurs et des réactions liées à la douleur, tels que la peur et l’évanouissement. À l’heure actuelle, les interventions visant à prévenir la douleur et les réactions connexes ne sont pas systématiquement intégrées dans le processus d’administration de vaccins, bi...
Article
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Actively involving children in their healthcare is a core value of patient-centered care. This is the first study to directly obtain children’s detailed perspectives on positive and negative aspects of outpatient physician visits in a primary care setting (e.g., checkups) and their preferred level of participation. Individual interviews were conduc...
Article
Objective Map the current literature investigating autonomy development, identity development, and peer relationships in young people aged 10–24 years with chronic pain. Methods A scoping review method was used to systematically search four databases (APA PsycNET, PubMed, Web of Science, and Cinahl) for peer-reviewed articles. Search results were...
Article
Full-text available
Increasing the comfort of vaccine delivery at school is needed to improve the immunization experience for students. We created the CARD™ (C-Comfort, A-Ask, R-Relax and D-Distract) system to address this clinical care gap. Originally designed for grade 7 students, this study examined the perceptions of grade 9 students of CARD™. Grade 9 students who...
Article
Full-text available
Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain manageme...
Article
Full-text available
Adverse events following immunizations (AEFI) are important to identify and manage effectively so as to sustain trust in vaccines and optimize health. The AEFI category related to "anxiety about the immunization" was considered problematic as it did not adequately capture the range of stress responses that can occur. The currently used term for thi...
Article
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Aim: Fully illuminating mechanisms relating parent behaviors to child pain require examining both verbal and nonverbal communication. We conducted a multimethod investigation into parent nonverbal communication and physiology, and investigated the psychometric properties of the Scheme for Understanding Parent Emotive Responses Scale to assess paren...
Article
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Objective Pain is common for children with intellectual and developmental disabilities. It is critical that caregivers have adequate pain assessment and management knowledge. The Let’s Talk About Pain program has shown promise to provide pain‐related knowledge and skills to respite workers; however, more systematic evaluation of the program is need...
Article
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Objective Pain is common and complex for children with intellectual and developmental disabilities (I/DD). Secondary caregivers such as respite workers are lacking important pain‐related information which can impact care. Here, we outline a randomized controlled trial (RCT) protocol testing the effectiveness of a pain training for respite workers s...
Article
The Council for the International Organizations of Medical Sciences (CIOMS) and WHO working group on pharmacovigilance defines five cause specific AEFI which includes an immunization anxiety-related reaction. Historically this term has been used to describe a range of symptoms and signs that may arise after immunization that are related to “anxiety...
Article
Objectives: Pediatric chronic pain has often been examined from a risk perspective, and relatively less is known about the individual and family-level resilience factors that help youth with chronic pain maintain their quality of life. This cross-sectional study: (a) examined the relations among purported youth and parent resilience (youth pain ac...
Article
Background: For children with cancer in palliative care, pain and worry are common and frequently under-managed, which negatively impacts quality of life (QOL). Massage therapy (MT) can lead to reduced pain in children with chronic illnesses. Children with cancer have experienced lower anxiety after MT. No studies have examined the effects of MT i...
Article
Horseback riding and related activities bring risks for serious injury. Extant literature focuses largely on moderate to severe horse-related injuries resulting in a need for medical care. Yet incidents deemed as less severe are also important, with potential to impact subsequent safety precautions and behaviors of parents and children. The study o...
Article
Full-text available
Background Students experience fear, pain, and fainting during vaccinations at school. While evidence-based interventions exist, no Knowledge Translation (KT) interventions have been developed to mitigate these symptoms. A multidisciplinary team—the Pain Pain Go Away Team—was assembled to address this knowledge-to-care gap. This manuscript provides...
Article
Objective Many students are fearful of vaccine injection-associated pain. In prior research, we created Knowledge Translation (KT) tools to address school vaccinations and associated pain, fear, and fainting. The objectives of this pilot implementation project were to determine the acceptability and impact of these KT tools on student knowledge, at...
Article
Background Many students are afraid of receiving vaccinations at school. We implemented a novel, multifaceted knowledge translation intervention incorporating evidence-based vaccination coping strategies—The CARD™ System (C-Comfort, A-Ask, R-Relax, D-Distract)—and evaluated impact on student attitudes, knowledge, coping strategies used, and symptom...
Article
Objective We conducted a small-scale implementation study that integrated The CARD™ System (C-Comfort, A-Ask, R-Relax, D-Distract)—a multifaceted knowledge translation intervention designed to improve the vaccination experience at school—within the school vaccination program. Methods Mixed methods design, including a controlled clinical trial and...
Article
Objective Pain, fear, and fainting management during school-based vaccinations is suboptimal. The objective was to examine stakeholder perceptions of barriers and facilitators to better practices. Method: Six semi-structured focus groups were conducted in Niagara Region, Ontario: two parent groups (n=7); one grade 7 to 8 student group (n=9); two nu...
Article
Objective School-based vaccination programs can be a source of distress for many students due to the pain from the needle injection and related fears. We created a multifaceted Knowledge Translation (KT) intervention to address vaccination and pain, fear, and fainting called The CARD™ System. The objectives were to document acceptability of key too...
Article
Full-text available
Background: Low levels of agreement between caregiver and child reports of acute pain are well documented. Aims: This study builds on prior research through exploring factors that may contribute to low caregiver-child concordance. Specifically, the study examined the influence of adult and child sex on adult judgments of children's pain and fear...
Chapter
Pain experience and expression are complex and multiply determined by numerous biological, psychological, and social factors. However, the interpersonal context in which pain occurs has been largely understudied compared to intrapersonal factors. This chapter aims to review existing literature on nonverbal features of caregiving behavior occurring...
Conference Paper
BACKGROUND Parenting a youth with chronic pain can be challenging and have a significant impact relationally, emotionally and financially on caregivers (Palermo, 2000; Lewandowski et al., 2010). There is a growing literature indicating that parent emotions (e.g., anxiety, depression), cognitions (e.g., coping, pain catastrophizing), and behaviours...
Article
BACKGROUND “…The field of paediatric pain medicine has demonstrated the benefits of interdisciplinary collaboration more than any other endeavour” (Law, Palermo, & Walco, 2013). Recently, the Ontario Ministry of Health and Long-term Care announced the funding of specialty paediatric chronic pain programs in several children’s hospitals across the p...
Article
Background: Clinicians commonly advise patients to look away from the needle during vaccinations; however, this recommendation is not evidence based. Aim: To determine whether looking at the needle versus looking away affects pain and fear during vaccinations in adults. Methods: This was a pilot randomized 2-group parallel trial with university stu...
Article
Full-text available
Parents’ ability to regulate their emotions is essential to providing supportive caregiving behaviours when their child is in pain. Extant research focuses on parent self-reported experience or observable behavioural responses. Physiological responding, such as heart rate (HR) and heart rate variability (HRV), is critical to the experience and regu...
Article
Introduction: Pain in children with intellectual disabilities (ID) is common and complex, yet there is no standard pain training for their secondary caregivers. Objectives: Determine perceived pain training needs/preferences of children's respite staff (Phase One) and, use this information combined with extant research and guidelines to develop...
Article
Aim: Develop and evaluate pain knowledge measures and accompanying self-report ratings; determine their sensitivity to change. Materials & methods: Young adults (n = 77; Mage = 18.89; standard deviation = 2.29; 67 females) were randomly assigned to one of two 'caring for children with intellectual disabilities' training programs (pain and visual...
Article
Objectives: (1) compare disability and pain-related beliefs between RW and a sample with little experience in ID; (2) determine whether individuals' beliefs and personal characteristics are related to pain assessment and management decisions. Participants: Fifty-six RW (aged: 18-67 years, Mage=33.37, 46 female) and 141 emerging adults (aged: 18-...
Article
Objective: Children's pain memories play a powerful role in shaping future pain experiences. Interventions aiming to reframe children's memories of painful medical procedures hold promise for altering pain memories and improving subsequent pain experience; however, this evidence has not been synthesized. This brief clinical report includes a syste...
Article
Objectives: To describe/determine the following in response to a series of pain-related scenarios (e.g., headache, falling): (1) factors considered important by RW when assessing children with ID's pain; (2) whether children's verbal ability impacts pain assessment factors considered; (3) RW assessment and management approach. Participants: Fift...
Article
Pain is a highly prevalent experience in pediatric medical populations, both in an acute form (e.g., iatrogenic pain from needle procedures) as well as in more chronic forms (e.g., as a result of arthritis, inflammatory bowel disease, or as a disease/disorder in and of itself). Guided by the biopsychosocial model, the overarching objective of this...
Article
Although there are existing guidelines for teaching and learning skillful client communication, there remains a need to integrate a developmental focus into veterinary medical curricula to prepare students for interactions with children who accompany their companion animals. The objectives of this Teaching Tip are (1) to describe the use of a Teddy...
Article
Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a...
Article
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. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up). Objective . To determine whether an evidence-based educational program reduced children’s ratin...
Article
Aim: Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses. Method: For six vignettes, 76 undergraduate students (38 females, mean age = 19...
Article
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Background: This systematic review evaluated the effectiveness of physical and procedural interventions for reducing pain and related outcomes during vaccination. Design/methods: Databases were searched using a broad search strategy to identify relevant randomized and quasi-randomized controlled trials. Data were extracted according to procedure...
Article
Full-text available
Background: A knowledge synthesis was undertaken to inform the development of a revised and expanded clinical practice guideline about managing vaccination pain in children to include the management of pain across the lifespan and the management of fear in individuals with high levels of needle fear. This manuscript describes the methodological de...