Non-Pharmacological Management of Acute Pain Symptoms in Pediatric Patients

Acute pain is a complex experience of physiological and psychological symptoms. Pediatric acute pain is often undertreated and undermanaged due to a lack of fast acting and cost effective pain management interventions. The aims of this study were to demonstrate the feasibility of implementing a fast acting non-pharmacological pain management intervention in a clinical pediatric setting, and to measure the physiological, behavioral, and psychological outcomes of the interventions. The physiological and psychological outcome measures are the primary components of the "acute pain phenomenon" established by Humprey et al. in 1992. Forty outpatients from a major metropolitan pediatric hospital participated in this study. Study participants were referred to the Laboratory Medicine Clinic for a routine blood draw from various outpatient clinics in the hospital. Participants in the treatment group completed a non-pharmacological pain management intervention: a mandala art therapy intervention. Participants in the control group received standard of care treatment during needle stick procedures. The physiological outcomes of heart rate and blood oxygen saturation were measured with a pulse oximeter machine. The stress behaviors recorded through observation were fidgeting, crying, screaming, and the need for physical restraint. Subjective anxiety and subjective pain were recorded through self-report surveys as outcome measures for psychological indicators of stress. Results indicated high feasibility in both the treatment and control groups. Participants in the treatment group experienced less physiological stress and psychological stress in the time leading up to the needle stick and during the needle stick procedure, including a decrease in anxiety during the procedure. There was no significant difference in subjective pain between the two groups, though self-reported pain was low for the majority of the participants.