Research Article| Volume 14, ISSUE 5, P296-303, October 1999

Reducing children's immunization distress in a primary care setting

      This paper is only available as a PDF. To read, Please Download here.
      The purpose of this study was to compare two brief, inexpensive distraction techniques for children receiving immunizations during a county-sponsored immunization clinic. Preschool children (n=80) were assigned to a party blower intervention, a pinwheel intervention, or a control group. Nurses were instructed to use “standard instructions” for the control group, and to simply provide the distracter and encourage use, but not to spend time trying to train the child or force them to use it, for the other groups. Results of planned comparisons indicated significant party blower results in the children's ratings of reduced distress (P<.01) and the parents' ratings of having to hold their child less strongly (P=.04), and showed it to be more distracting than the pinwheel (P<.02). The overall pattern of results on all rating scales supports the efficacy of using a party blower for reducing children's immunization distress, with minimal staff training and no procedural delay.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Abbot K.
        • Fowler-Kerry S.
        The use of a topical refrigerant anesthetic to reduce injection pain in children.
        Journal of Pain and Symptom Management. 1995; 10: 584-590
        • Agras S.
        • Sylvester D.
        • Oliveau D.
        The epidemiology of common fears and phobias.
        Comprehensive Psychiatry. 1969; 10: 1511-1556
        • Bandura A.
        Principles of behavior.
        Holt, Rinehart, & Winston, New York1969
        • Blount R.L.
        • Bachanas P.J.
        • Powers S.W.
        • Cotter M.C.
        • Franklin A.
        • Chaplin W.
        • Mayfield J.
        • Henderson M.
        • Blount S.D.
        Training children to cope and parents to coach them during routine immunizations: Effects on child, parent & staff behaviors.
        Behavior Therapy. 1992; 23: 689-705
        • Campbell D.T.
        • Stanley J.C.
        Experimental and quasi-experimental designs for research.
        Rand Mc-Nally, Chicago1963
        • Cohen L.L.
        • Blount R.L.
        • Panopoulos G.
        Nurse coaching and cartoon distraction: An effective and practical intervention to reduce child, parent, and nurse distress during immunizations.
        Journal of Pediatric Psychology. 1997; 22: 355-370
        • Costello C.G.
        Fears and phobias in women.
        Journal of Abnormal Psychology. 1982; 91: 280-286
        • Eland J.M.
        Minimizing pain associated with prekin-dergarten intramuscular injections.
        Issues in Comprehensive Pediatric Nursing. 1981; 5: 361-372
        • French G.M.
        • Painter E.C.
        • Coury D.L.
        Blowing away shot pain: A technique for pain management during immunization.
        Pediatrics. 1994; 93: 384-388
        • Fowler-Kerry S.
        • Lander J.R.
        Management of injection pain in children.
        Pain. 1987; 30: 169-175
        • Gonzalez J.C.
        • Routh D.K.
        • Armstrong F.D.
        Effects of maternal distraction versus reassurance on children's reactions to injections.
        Journal of Pediatric Psychology. 1993; 18: 593-604
        • Hamilton J.G.
        Needle phobia: A neglected diagnosis.
        Journal of Family Practice. 1995; 41: 169-175
        • Manne S.L.
        • Redd W.H.
        • Jacobsen P.B.
        • Gorfinkle K.
        • Schorr O.
        Behavioral intervention to reduce child and parent distress during venipuncture.
        Journal of Consulting and Clinical Psychology. 1990; 58: 565-572
        • Ost L.G.
        Acquisition of blood and injection phobia and anxiety response patterns in clinical patients.
        Behavior Research and Therapy. 1991; 29: 323-332
        • Oswalt R.M.
        • Napoliello M.
        Motivations of blood donors and non-donors.
        Journal of Applied Psychology. 1974; 59: 122-124
        • Piaget J.
        Piaget's theory.
        in: Mussen P.E. Charmichael's manual of child psychology. vol 1. Wiley, NY1970: 703-732
        • Reissland N.
        Cognitive maturity and the experience of fear and pain in hospital.
        Social Science and Medicine. 1983; 17: 1389-1395
        • Whalen C.K.
        • Hanker B.
        • Granger D.A.
        Rating of medication effects in hyperactive children: viable or vulnerable?.
        Behavioral Assessment. 1989; 11: 179-199