Paper
Thursday, 20 July 2006
This presentation is part of : Evidence-Based Practice for Children with Diabetes
Evidence of Needle Anxiety in Children with Diabetes: Foundation for Developing Practice Guidelines
Carol Howe, RN, MSN1, Kenneth J. A. Lown, RN, MSN, CPNP1, Alan Tuttle, MSW2, and Terri Lipman, PhD, CRNP, FAAN3. (1) Endocrinology, The Children's Hospital of Philadelphia, Philadlephia, PA, USA, (2) Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA, (3) School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
  Background: Needle anxiety has been shown to be a problem for children with diabetes and may contribute to omission of blood tests or insulin injections.
Aims: To describe 1) parents’ self report of their fear and distress with intrusive procedures; 2) children’s self report of pain with injections and fingersticks; 3) parents' use of distraction/relaxation techniques.
Methods: Parents and children completed the Perceptions of Insulin Shots and Fingersticks Survey at diagnosis and at the first 3 clinic visits post discharge. The survey asks parents to rate their fear, distress, and their perception of child's pain, cooperation, verbal protest, physical protest for both injections and fingersticks on a visual analog scale (VAS). Children rated pain and fear for injections and fingersticks on a VAS or on Wong Baker Faces Scale (for <9 yr).
Results: 23 parents and children aged 9.9 ± 3.5 yr (4.9-16.2 yr, 21 white, 2 AA) completed the survey.   Parents' and childrens' ratings of > 4 was used to indicate a problem that would warrant intervention.  26% of children < 9 yr reported fear of injections at diagnosis. Parents reported a high degree of fear with injections (44%) and fingersticks (21%) at diagnosis. Children’s pain, and parents’ distress decreased over time, but at 6 mos, 9% of children still reported fear of injections, 13% of parents reported distress with administering injections and 17.3% of parents reported very poor cooperation with injections. Only 8.7% of parents were using distraction techniques at 6 mos.
Conclusions: Needle anxiety is a significant problem for children with diabetes and their parents at diagnosis and persists over time.  When insulin or blood testing omission is suspected, an assessment of needle anxiety is essential.  In response to these data, we are developing a program of distraction techniques for all children with diabetes and their families

See more of Evidence-Based Practice for Children with Diabetes
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)