Abstract
Background
The effect of reassurance in managing distress among children who receive procedures of a less aversive nature has not been fully investigated.
Purpose
This study aimed to investigate the relationship between reassurance by dental staff and distress behavior of preschool children receiving preventive procedures in a community setting.
Methods
Nurse–child interactions (n = 270) during fluoride varnish application were video recorded and coded. Multilevel logistic regression modeled the probability of the occurrence of child distress behavior as a function of reassurance provision, controlling for child-level and nurse-level variables.
Results
Child distress behavior was positively related to nurse verbal reassurance but negatively linked to the time that this reassurance occurred. Both child initial anxiety and nurse nonprocedural training increased the probability of observable distress behavior.
Conclusions
The use of verbal reassurance to promote reception of mild invasive procedures was counterindicated, especially when offered early in the intervention (ClinicalTrials.gov number: NCT00881790).
Similar content being viewed by others
References
Blount RL, Corbin SM, Sturges JW, Wolfe VV, Prater JM, James LD. The relationship between adults’ behavior and child coping and distress during BMA/LP procedures: A sequential analysis. Behav Ther. 1989; 20: 585-601.
Bush JP, Melamed BG, Sheras PL, Greenbaum PE. Mother–child patterns of coping with anticipatory medical stress. Health Psychol. 1986; 5: 137-157.
Chambers CT, Craig KD, Bennett SM. The impact of maternal behavior on children’s pain experiences: An experimental analysis. J Pediatr Psychol. 2002; 27: 293-301.
Manimala MR, Blount RL, Cohen LL. The effects of parental reassurance versus distraction on child distress and coping during immunizations. Child Health Care. 2000; 29: 161-177.
Blount RL, Bunke V, Cohen LL, Forbes CJ. The Child–Adult Medical Procedure Interaction Scale—Short Form (CAMPIS-SF): Validation of a rating scale for children’s and adults’ behaviors during painful medical procedures. J Pain Symptom Manag. 2001; 22: 591-599.
Dahlquist LM, Power TG, Carlson L. Physician and parent behavior during invasive pediatric cancer procedures: Relationships to child behavioral distress. J Pediatr Psychol. 1995; 20: 477-490.
Dahlquist LM, Power TG, Cox CN, Fernbach DJ. Parenting and child distress during cancer procedures: A multidimensional assessment. Child Health Care. 1994; 23: 149-166.
Blount RL, Sturges JW, Powers SW. Analysis of child and adult behavioral variations by phase of medical procedure. Behav Ther. 1990; 21: 33-48.
Weinstein P, Getz P, Ratener P, Domoto P. Behavior of dental assistants managing young children in the operatory. Pediatr Dent. 1983; 5: 115-120.
Greenbaum PE, Lumley MA, Turner C, Melamed BG. Dentist’s reassuring touch: Effects on children’s behaviour. Pediatr Dent. 1993; 15: 20-24.
Zhou Y, Forbes G, Macpherson LMD, Ball GE, Humphris GM. The behaviour of extended duties dental nurses and the acceptance of fluoride varnish application in preschool children. Br Dent J. 2012; 213: 603-609.
Gonzalez JC, Routh DK, Armstrong FD. Effects of maternal distraction versus reassurance on children’s reactions to injections. J Pediatr Psychol. 1993; 18: 593-604.
Razavi D, Merckaert I, Marchal S, et al. How to optimize physicians’ communication skills in cancer care: Results of a randomized study assessing the usefulness of posttraining consolidation workshops. J Clin Oncol. 2003; 21: 3141-3149.
Faulkner A, Maguire P. Talking to cancer patients and their relatives. Oxford: Oxford University Press; 1994.
Maguire P, Faulkner A, Booth K, Elliott C, Hillier V. Helping cancer patients disclose their concerns. Eur J Cancer. 1996; 32: 78-81.
Stewart MA. Effective physician–patient communication and health outcomes: A review. CMAJ. 1995; 152: 1423-1433.
Mead N, Bower P. Patient-centred consultations and outcomes in primary care: A review of the literature. Patient Educ Couns. 2002; 48: 51-61.
Sweet SD, McGrath PJ. Relative importance of mothers’ versus medical staffs’ behavior in the prediction of infant immunization pain behavior. J Pediatr Psychol. 1998; 23: 249-256.
Jay SM, Ozolins M, Elliott CH, Caldwell S. Assessment of children’s distress during painful medical procedures. Health Psychol. 1983; 2: 133-147.
Kleiber C, Schutte DL, McCarthy A, Floria-Santos M, Murray JC, Hanrahan K. Predictors of topical anesthetic effectiveness in children. J Pain. 2007; 8: 168-174.
Piira T, Taplin JE, Goodenough B, von Baeyer CL. Cognitive–behavioural predictors of children’s tolerance of laboratory-induced pain: Implications for clinical assessment and future directions. Behav Res Ther. 2002; 40: 571-584.
Chen E, Craske MG, Katz ER, Schwartz E, Zeltzer LK. Pain-sensitive temperament: Does it predict procedural distress and response to psychological treatment among children with cancer? J Pediatr Psychol. 2000; 25: 269-278.
Frank NC, Blount RL, Smith AJ, Manimala MR, Martin JK. Parent and staff behavior, previous child medical experience, and maternal anxiety as they relate to child distress and coping. J Pediatr Psychol. 1995; 20: 277-289.
Zhou Y, Cameron E, Forbes G, Humphris GM. Systematic review of the effect of dental staff behaviour on child dental patient anxiety and behaviour. Patient Educ Couns. 2010; 85(1): 4-13.
Prins P, Veerkamp J, Horst G, De Jorgh A, Tan L. Behavior of dentists and child patients during treatment. Community Dent Oral Epidemiol. 1987; 16: 253-257.
Folayan MO, Idehen EE, Ojo OO. Identified factors in child–dentist relationship important for the management of dental anxiety in Nigerian children. Eur J Paediatr Dent. 2004; 5: 225-232.
Childsmile Nursery. http://www.child-smile.org.uk/parents-and-carers/childsmile-at-nursery-and-school.aspx. Accessed June 14, 2013.
Zhou Y, Forbes G, Humphris GM. Camera-related behaviours of female dental nurses and nursery school children during fluoride application interactions in nursery school settings. Int J Paediatr Dent. 2010; 20(5): 374-381.
Penner LA, Orom H, Albrecht TL, Franks MM, Foster TS, Ruckdesckel JC. Camera-related behaviours during video recorded medical interactions. J Nonverbal Behav. 2007; 31: 99-117.
Zhou Y, Cameron E, Forbes G, Humphris GM. Development of a novel coding scheme (SABICS) to record nurse–child interactive behaviours in a community dental preventive intervention. Patient Educ Couns. 2012; 88: 268-276.
The Observer XT. http://www.noldus.com/animal-behavior-research/products/the-observer-xt. Accessed June 15, 2013.
Cohen JA. Coefficient of agreement for nominal scale. Educ Psychol Meas. 1960; 20: 37-46.
Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1991.
Dahlquist LM, Gil KM, Armstrong FD, DeLawyer DD, Greene P, Wuori D. Preparing children for medical examinations: The importance of previous medical experience. Health Psychol. 1986; 5: 249-259.
Horst G, Prins P, Veerkamp J, Verhey J. Interactions between dentists and anxious child patients: A behavioural analysis. Community Dent Oral Epidemiol. 1987; 15: 249-252.
Connor M, Fletcher I, Salmon P. The analysis of verbal interaction sequences in dyadic clinical communications: A review of methods. Patient Educ Couns. 2009; 75: 169-177.
Blount RL, Cohen LL, Frank NC, et al. The Child–Adult Medical Procedure Interaction Scale—Revised: An assessment of validity. J Pediatr Psychol. 1997; 22: 73-88.
Acknowledgments
We would like to acknowledge the National Health Service (NHS) Fife health board who funded the 1-year pilot study (2007–2008) and the Scottish government who provided financial support for the 3-year main study (2008–2011). In addition, we would like to acknowledge the support from the University Court of the University of St Andrews, who kindly acted as the sponsor for this study. We would also like to acknowledge the support from the Childsmile Evaluation Board, the Childsmile Evaluation and Research Team, and the Childsmile Directors Lorna Macpherson and Graham Ball. We thank all participants including the schools, dental nurses, parents, and children for their enthusiastic participation. We are grateful to Gillian Forbes for helping with collection and coding of the video data and to Jonathan Davidson for preparing the data file. We also gratefully acknowledge the valuable statistical advice provided by Dorothy Currie.
Conflict of Interest
The authors have no conflict of interest to disclose.
Disclaimer
The views expressed in this article are those of the authors and not necessarily those of the funders.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Zhou, Y., Humphris, G.M. Reassurance and Distress Behavior in Preschool Children Undergoing Dental Preventive Care Procedures in a Community Setting: a Multilevel Observational Study. ann. behav. med. 48, 100–111 (2014). https://doi.org/10.1007/s12160-013-9566-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12160-013-9566-7