Original ArticlesPhysiologic correlates of comfort in healthy children*,**
Section snippets
Design and methods
A one-group, repeated measures, randomized crossover design guided this study. Chosen from a convenience sample, subjects served as their own controls while undergoing two levels of intervention: cold pressor pain and guided imagery. Measurement of physiologic and self-report variables occurred across baseline, intervention, and recovery periods for the interventions.
The University's institutional review board approved the study. Parents and children signed informed consent and assent
Sample
A convenience sample of 100 children and adolescents was recruited from posted flyers and word of mouth. Inclusion criteria specified that children were ages 8 through 17 years, English-speaking, healthy, and free of pain at the time of the study. Excluded were children with significant developmental delays, Raynaud's phenomenon or disease, attention deficit disorder, and coexisting conditions or taking medications known to affect autonomic nervous system response.
Data collection occurred in a
Results
Children who received the cold pressor test first (cold pressor group) were not demographically different from those who received imagery first (imagery group). Data examined for group differences included age, sex, ethnicity, whether a parent elected to stay in the room during data collection, worst previous pain the child could recall, room temperature at start of data collection, and parent's estimate of pain tolerance. The last 59 children in the sample were asked if they expected the water
Discussion
This study examined the ability of selected physiologic variables (peripheral skin temperature, heart rate, SCA, respiratory rate, EMG of the frontalis and right forearm muscles, and systolic and diastolic BP) to detect changes from baseline in children experiencing arousing and relaxing stimuli. When examined descriptively, physiologic responses generally reflected decreased arousal during imagery and increased arousal during cold pressor.
Exceptions were noted for forearm EMG and SCA, which
Conclusion
Physiologic responses to cold pressor and imagery were largely unaffected by age, sex, or treatment order. Responses could reasonably be expected to vary most between the imagery and cold pressor measures. Five variables were able to detect this response: SCA, forehead EMG, respiratory rate, and systolic and diastolic BP. Only two variables, forehead EMG and systolic BP, showed mean differences between the baseline and imagery periods. The relatively weak cold pressor test in this study (13° C
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2015, Pain Management NursingCitation Excerpt :In a single-group, randomized crossover study with 100 healthy children (aged 8-17 years) in a laboratory setting the ERC demonstrated a significant difference across the five measurement periods (χ2 = 72.8; p < .001). The measurement periods comprised a baseline period, two interventions (cold pressor and guided imagery) and washout periods between the interventions (Foster, Yucha, Zuk, & Vojir, 2003). ERC responses were less positive during the cold pressor stimulus and more positive following relaxation, providing support for construct validity.
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2011, Pain Management NursingCitation Excerpt :Physiologic indicators, such as heart rate, respiratory rate, and oxygen saturation, have been reported to provide information about the neonatal response to noxious stimuli and are associated with acute pain (Stevens, Johnston, Petryshen, & Taddio, 1996). Physiologic indicators, however, are also affected by disease, medications, and changes in physiologic status and are therefore not specific to the presence or absence of pain in children (Foster et al., 2003). Although no single behavioral tool has been shown to be superior to others, several have been recommended for use in clinical settings (Crellin, Sullivan, Babl, O'Sullivan, & Hutchinson, 2007; von Baeyer & Spagrud, 2007), and clinicians should select a tool that is appropriate to the patient and types of pain on which it has been tested.
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This research was funded by a grant from National Institutes of Health, National Institute for Nursing Research NINR (R15 NR04762).
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1524-9042/03/0401-0000$30.00/0