以护士为主导的新技术有望减少儿童对针头的恐惧

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Tears, tantrums, and distress – when it comes to needles, many children struggle with anxiety. But with vaccinations becoming more regular, finding ways to help reduce needle-related fear and pain is high on the agenda.

Now, new research from the University of South Australia shows that children's vaccination and needle fear can be lessened when nurses spend additional time supporting children in the vaccination process.

Working with children aged 8-12 years, the preliminary study found that two new nurse-led techniques show promise in reducing needle fear in primary-aged children:

Divided Attention – where a child's attention and expectations are drawn away from the needle.

Positive Memory Reframing – where a child's exaggerations about the distress and discomfort of needles are redressed through discussion about the positive elements of the experience so that the form more realistic memories of the event.

Lead researcher, UniSA's Dr Felicity Braithwaite, says helping children reduce fear and distress around vaccinations is a critical research priority given the current COVID-19 pandemic.

For many children, undergoing a needle procedure can be painful and distressing.

Negative experiences of vaccinations in childhood can often lead to medical avoidance and vaccine hesitancy into adulthood, which can have devastating consequences when it comes to outbreaks of preventable diseases.

By investing more time into techniques to help children manage their fears about needles, we hope to change these outcomes and deliver better health outcomes for the next generation."

Dr Felicity Braithwaite, Lead Researcher, UniSA

The study involved 41 children and their parents, with participants randomly allocated to one of four groups – usual care, divided attention, positive memory reframing, or a combination of the latter two interventions. Clinical outcomes were assessed at baseline, immediately post-vaccination and at two-weeks post-vaccination.

The Divided Attention technique involved a one-two minute distraction game where a nurse tapped the child's arm above and below the vaccination spot in a random order, with the child focussing their attention on guessing which spot was touched each time. This game takes advantage of the potential analgesic effects of distraction.

The Positive Memory Reframing technique involved talking to children about a past injection and emphasizing positive aspects, such as how brave the child was and praising specific strategies they used to reduce their own distress, for example, deep breathing and looking away. The aim is to foster a sense of self-efficacy to help children better cope.

Both strategies were tested in non-clinical settings (such as schools) to maximize the potential of broad vaccination programs that deliver minimal distress for children.

全文翻译（仅供参考）

眼泪、发脾气和痛苦——当谈到针头时，许多孩子都在与焦虑作斗争。但随着疫苗接种变得越来越频繁，寻找有助于减少与针头相关的恐惧和疼痛的方法已成为议程的重中之重。

现在，南澳大利亚大学的新研究表明，当护士在疫苗接种过程中花更多时间支持儿童时，可以减少儿童的疫苗接种和对针头的恐惧。

初步研究与 8-12 岁的儿童一起工作，发现两种由护士主导的新技术有望减少小学生对针头的恐惧：

分散注意力——孩子的注意力和期望从针头上移开。

积极记忆重构——通过讨论体验的积极因素，纠正孩子对针头痛苦和不适的夸大，从而形成更真实的事件记忆。

UniSA 的首席研究员 Felicity Braithwaite 博士说，鉴于当前的 COVID-19 大流行，帮助儿童减少对疫苗接种的恐惧和痛苦是一项关键的研究重点。

对于许多孩子来说，接受针头手术可能是痛苦和痛苦的。

儿童时期接种疫苗的负面经历往往会导致成年后的医疗回避和疫苗犹豫，这在涉及可预防疾病的爆发时可能产生毁灭性后果。

通过在技术上投入更多时间来帮助儿童管理他们对针头的恐惧，我们希望改变这些结果并为下一代带来更好的健康结果。”

南澳大学首席研究员 Felicity Braithwaite 博士

该研究涉及 41 名儿童及其父母，参与者被随机分配到四组之一——常规护理、注意力分散、积极记忆重构或后两种干预措施的组合。在基线、疫苗接种后立即和疫苗接种后两周评估临床结果。

分散注意力技术涉及一两分钟的分心游戏，护士以随机顺序在疫苗接种点上方和下方敲击孩子的手臂，孩子将注意力集中在猜测每次触摸到哪个点。该游戏利用了分心的潜在镇痛作用。

积极记忆重构技术涉及与孩子谈论过去的注射并强调积极的方面，例如孩子有多勇敢，并赞扬他们用来减轻自己痛苦的特定策略，例如深呼吸和移开视线。目的是培养自我效能感，帮助孩子更好地应对。

这两种策略都在非临床环境（例如学校）中进行了测试，以最大限度地发挥广泛疫苗接种计划的潜力，为儿童带来最小的痛苦。

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