Distraction for Pediatric Immunization Pain: A Critical Review

The paper provides a critical review of distraction for pediatric immunizations in order to determine clinical practicality and efficacy of this commonly employed intervention. The MEDLINE and PsycINFO databases were searched to identify papers that included an evaluation of a distraction intervention as a method of pediatric immunization pain management. Fifteen papers were included in this review. Effect sizes were calculated to estimate the clinical significance of findings. In order to examine possible differences in effect sizes related to distraction characteristics, chi square analyses were conducted. Results indicate that distraction is clinically effective in the reduction of pain during pediatric immunizations. Support is found for behavioral and cognitive explanations of distraction mechanisms. Further, various distraction stimulus characteristics were found to be associated with the clinical significance of findings. This article is based on the preliminary examination paper of the first author under the direction of the second, at West Virginia University.