Distraction Is Not Effective at Reducing Procedural Pain in Children

I was allocated to topic 2 ‘distraction is not effective at reducing procedural pain in children’ and I decided to argue against this statement. This topic is based on strong evidence based practice and critical analysis of studies which were used to support my debate. Both qualitative and quantitative approaches were used for the purpose of investigation and analysis of non-pharmacological interventions

Quantitative research is generally a systematic approach used to quantify variables, which are numerically quantifiable. Also, a quantitative research is defined as a formal and structured process that uses statistical approach in the analysis, interpretation, collection, and presentation of data.

Quantitative research is used to quantify opinions, behaviours, attitudes, and generalises result from a larger sample population. Furthermore, quantitative research uncover patterns in research and uses measurable data to formulate facts. Methods of quantitative data collection are much more structured than methods of qualitative data collection. Quantitative data collection approach highlights objective calculations which consists of accurate mathematical investigations of information include various forms of paper surveys, online surveys, kiosk surveys, mobile surveys, telephone interviews, longitudinal studies, face-to-face interviews, online polls, website interceptors, and systematic observations.

Contrarily, defined a qualitative research as a systematic approach but unstructured technique that uses descriptive approach in the analysis, interpretation, collection and presentation of data. Qualitative research is used to analyse and gain understanding of an underlying reasons, opinion, perceptions and ideas, which sets a hypothesis for a potential quantitative theory.

Qualitative Research is also very useful to uncover trends in opinions and thoughts and dive deeper into the problems.

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Qualitative data collection techniques vary using semi-structured or unstructured methods. Some common methods include group discussions (focus group), individual interviews, and observations or participation.

There are four components of the research strategies which should be implemented when qualitative and quantitative research investigations have been completed. These research strategies are theoretical perspectives, epistemology, methods and methodology.

Qualitative and quantitative approaches are associated with subjectivity (qualitative) and objectivity (quantitative). For social behaviour, quantitative approach is associated with objectivist epistemology and try to expand on an instructive universal law by establishing the concepts and norms statically. Whereas, qualitative approach assess social spectacle and individual perspectives and opinions which have unbiased bearing on the investigation subject.

Irrespective of the difference in the meaning of a qualitative research and quantitative research, they are both research techniques that follow a step by step process which considers all the main components of any research such as the methodology and design systematically (Kaplain, 2015).

A qualitative research helps to develop a theory for a quantitative research to experiment on, while a qualitative research is more suitable to validate this theory hence they work simultaneously to improve practice (Barrett, 2012).

Nursing research method is a systematic research process that is designed to build knowledge about issue of importance to the healthcare profession including education, nursing practice and administration. It can also provides evidence based care that support high quality health outcomes and nursing practice.

Critical analysis of the quantitative and qualitative literature shed light on how the research was conducted. Both qualitative and quantitative techniques plays an important role in systematic review of the investigation and contributes to the quality of evidence-based practice. These studies were also helpful with analysis of the topic that ‘distraction is not effective at reducing procedural pain in children.’

The pain associated with any medical procedure is reported as the most distressing and significant cause of pain for children. The cumulative effects of these medical and painful procedures may result in adverse psychological outcomes for children and their family, including anxiety and fear. These negative experiences can have a lifelong impact on children and their parents/caregivers. It may also contribute to sleeping and eating disorders, increase fears, diminish social disorder or provoke post-traumatic stress disorder.

The randomised and controlled trial was conducted and evaluated at the phlebotomy station of the Karaman Maternity and Children’s hospital. This study was designed as a prospective randomised trial that compared and evaluated the effects of the visual distraction cards on procedural pain and anxiety levels of children during medical treatment. Quantitative research approach to this trial provided exact percentage for participants/patients (parents and children) participated in the randomised and controlled trial.

This randomised control trial included one hundred and eighty eight children, consisted of 7 to 11 year old children who required blood tests. They were randomised into two groups- the control group and the distraction cards group. Data were collected by interviewing the pediatric patient with their parents and the observer before, during and after the procedure by using PICO (Patient/Problem/Population, Intervention, Comparison and Outcome) format.

Children’s pain and anxiety levels were assessed by the parent, observer and self report using the Wong Baker Faces Pain Rating Scale and Children Fear Scale. Qualitative research showed the participants/patients’ (parents and children) opinions and reactions toward the distraction methods which were used during phlebotomy collection.

A randomised controlled trial using distraction method showed that the anxiety and pain levels of the distraction card group were significantly lower than those of the control group. A meta analysis of the trial showed strong support for distraction techniques for reducing pain and distress from medical procedures.

The main issue addressed was how distraction is effective at reducing procedural pain in children. The effective management of medical procedural pain is a fundamental human right and distraction method is one of the non pharmacological intervention which is found to be the most effective in reducing distress and pain in children.

Qualitative research has established that distraction interventions are helpful to take children’s attention away from pain stimuli, by redirecting their attention from clinical procedures. Distraction inhibits the transmission of pain impulses so that these pain impulses are not transferred to the brain. As a result, the sensations of pain are not experienced.

A meta analysis of trial also showed that non-pharmacological interventions for procedural pain may exclude pharmacological pain interventions or reduce dosage of pain medication. Moreover, most non-pharmacological treatment techniques are easily accessible, cheap, and safe to use. This systematic review of this randomised controlled trial demonstrates that distraction is a promising intervention for medical procedural pain.

I argued against the allocated topic means that I do not agree that distraction is not effective at reducing procedural pain in children. It was a challenging assignment for me. Oral part (first part) of this assignment was so confusing for me which drove me crazy. But I found my workshop very informative and useful and everything about our assignment was clearly and brilliantly explained by our tutor. I initially thought this subject is straight forward but after researching I realised that there is huge amounts of information on the internet about my allocated topic that distraction is not effective at reducing procedural pain in children.

I spent a long time on researching. I was on the opinions that distraction is effective at reducing procedural pain in children and I had to find relevant data to support my debate. When I started researching about my topic, I only searched the internet using the everyday browser but it was so hard to find anything related to my topic with good examples. However, workshops, lectures and computer lab helped me to find relevant information about my topic and I also learned about randomised control trials and systematic reviews with good examples using Cochran and Cinahl library database. It took few days to get familiar with these databases but I managed to find relevant information about my topic in the end. This assessment also gives me an advanced overview of the skills necessary to evaluate and critique research evidence. I was introduced to quantitative and qualitative methodologies related to evaluating and conducting semi-structured interviews (qualitative research methodology) and survey questionnaires based research (quantitative research methodology).

Quantitative and qualitative research has an important role in healthcare systems. It helps nurses to understand patients’ experience of health and health issues. My research on assessment have allowed me to understand the importance of evidence based practice in nursing. Furthermore, as I reflect on the relevance of this assessment on my current and future work as a registered nurse, I understand the importance of distraction techniques by conducting both qualitative and quantitative research. This assessment has made me consider how distraction is effective at reducing procedural pain in children. I have learned about many different methods of distraction therapy

In my future nursing practice, by using evidence based practice, I will ensure that the best care is given to the patients and to their families. As a registered nurse, I will utilise qualitative and quantitative research methods in order to evaluate the best outcomes and interventions for my patients. By performing qualitative and quantitative research I will gather patient’s information, which will further help me to determine how to proceed with the care of patients. Findings from qualitative and quantitative studies can guide me in planning treatments and approaches to patient’s care that meet their needs. These research methods will help me to explore new directions in healthcare environment to improve patient’s health outcomes.