UnderstandingPain and Needle Phobia -

Comfort and Coping Strategies

Angela Mackenzie

Department of Anaesthesia and Pain Management

Social EnvironmentSocial Environment

Pain BehaviourPain Behaviour

Suffering

Attitudes /Attitudes /BeliefsBeliefs

NociNoci--ceptionception

Understanding Pain

Change the way you think about pain

Reduce threat value for you/your child

Improve management

Prevent needle phobia

Surveys

1 in 4 adults avoid medical contexts

1 in 10 adults have needle phobia

70% had bad experience < 10 years of age

Health professional

Child Parent

Respect

Leadership

Confidence

Trust

Parent focused training

Stimulus

Thoughts

Alarm Signal

DampensAlarm Signal

Alarm Signal

FearsSeparation

Strangers

Bodily mutilation

Loss of control

“Words are the most powerful drugs used by

mankind”

Rudyard Kipling

“This is going to hurt like hell”

Reassuring comments EmpathyApologiesCriticismToo much control to child

WarningSympathising with language that refers to

negative experiences

Blount 1989, Chambers 2002

Can words hurt? Lang EV Pain 114 (2005) 303-309

Mother / Child

Patient / Provider

Techniques for babies

Swaddling

Rocking / Patting

Dummy

Sucrose

Breast feeding

Psychological techniques

Information/preparation

Parent positioning

Distraction

Hypnosis

Combined cognitive-behavioural interventions

Psychological interventions for needle-related procedural pain and distress in childrenand adolescents (Review) Cochrane Library 2007, Issue 1. Uman LS et al.

Self-hypnosis

“I am convinced that the need to dream is critical, to visit the private country in your head is an essential part of thinking, a natural problem-solving gift we are all given if we choose to use it.”Bryce Courtenay April Fool’s Day p.59

You

are your

child’s voice

Themes

Transformative experience

Role of Parents

Power of Music

Perception of Hospital

Pain Management

Treatment of Phobia

Psycho-education

Recognise response of body

Check and challenge thinking

Use of distraction/imaginal situations

Exposure to a hierarchy of feared situations