The child's perspective on discomfort during medical research procedures: a descriptive study

• Published in: BMJ open 2017-07, Vol.7 (7), p.e016077
• Main Authors: Staphorst, Mira S, Benninga, Marc A, Bisschoff, Margriet, Bon, Irma, Busschbach, Jan J V, Diederen, Kay, van Goudoever, Johannes B, Haarman, Eric G, Hunfeld, Joke A M, Jaddoe, Vincent V W, de Jong, Karin J M, de Jongste, Johan C, Kindermann, Angelika, Königs, Marsh, Oosterlaan, Jaap, Passchier, Jan, Pijnenburg, Mariëlle W, Reneman, Liesbeth, Ridder, Lissy de, Tamminga, Hyke G, Tiemeier, Henning W, Timman, Reinier, van de Vathorst, Suzanne
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety; Attention; Attitude; Biomedical Research; Boredom; Child; Child & adolescent psychiatry; Children & youth; Cross-Sectional Studies; Descriptive research; Diagnostic Techniques and Procedures - psychology; Fatigue; Fear; Female; Humans; Male; Medical ethics; Paediatrics; Pain; Pediatrics; Personality; Research Design; Review boards; Self Report; Stress, Psychological; Teenagers
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-016077

ObjectiveThe evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a ‘minimal discomfort’ medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort.DesignCross-sectional descriptive study.SettingPaediatric research at three academic hospitals.Patients357 children with and without illnesses (8–18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care.Main outcome measuresWe measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures.ResultsMost children reported limited discomfort during the research procedures (means: 1–2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort.ConclusionsThe findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research.