Amy Pulsipher and Dr. Beth Luthy, Nursing

The development and widespread use of vaccinations is one of the most important public health achievements of the 20th century (Schechter, Zempsky, Cohen, McGrath & McMurtry, 2007). Despite the immeasurable benefits of vaccinations, many parents are still reluctant to vaccinate their children. Multiple studies have reported that the perceived pain and anxiety associated with the administration of vaccines is a significant reason why parents are reluctant to vaccinate their children in a timely manner (Luthy, Beckstrand & Peterson, 2009; Luthy, Sperhac, Faux & Miner, 2010).

Therefore, it is necessary to identify ways to reduce a parent’s perception of their child’s pain and anxiety during vaccinations. Interventions that have been utilized to reduce the pain and anxiety associated with vaccinations, including distraction, topical anesthetics, or a combination of treatments, have been researched and proven effective. The purpose of our research was to determine if distraction (DVD) or a vapocoolant spray (ethyl chloride) effectively reduced a parent’s perception of their child’s vaccine-related pain and anxiety as compared to the control.

Prior to our ORCA research project, the study was conducted. A convenience sample of 68 parents with children ranging from 2-12 years was selected. Parents and children were randomized to one of three groups: control, DVD distraction, or vapocoolant spray. Following the vaccination and appropriate intervention, parents were asked to rate their perception of the child’s pain and anxiety on the survey provided.

Responses from each survey were entered into an SPSS database. Frequencies and measures of central tendency and dispersion were calculated for all quantitative items. Qualitative items were coded and analyzed independently by two separate researchers. Final themes were then identified.

Following completion of the study and a careful analysis of the quantitative and qualitative data collected, it was determined that there was no significant difference in parent perception of the child’s pain or anxiety between the two treatment groups as compared to the control. However, 38 (58.5%) of parents reported that they would like the same intervention at future vaccination visits. Parents commented that the DVD distraction method seemed helpful before and after the vaccination, but not during. Also, although parents appreciated the distraction, they would prefer to choose the intervention rather than being randomized to a group. Following this pilot study, it is apparent that the effectiveness of interventions in regard to parental perceptions of pain and anxiety warrants further study.

We hope that, with the publication of our pilot study on immunizations, other researchers will also take interest in methods and interventions to reduce the pain and anxiety associated with vaccinations, thus improving the vaccination compliance rate across the nation. Due to the limitations of our research, we recommend that others utilize a larger sample size, allow parents to choose their child’s intervention rather than randomization, and consider other possible interventions to yield significant results.

Despite insignificant findings, we believed it was still important to disseminate our research findings and methods. I worked with Beth Luthy and Renea Beckstrand to draft and submit a manuscript for publication to The Journal of Pediatric Health Care. Our first attempt was unsuccessful. Upon review of the manuscript, they recommended making the necessary changes and resubmitting the research again at a later date.

After consulting with the appropriate statisticians and professors, we made the necessary changes. After submitting again, revisions were suggested again, but it was accepted. The manuscript has greatly improved with each set of revisions and with each person who has helped edit and proof read the manuscript. We have recently submitted our last set of revisions and hope to hear that it will be published in the near future. We have also had the opportunity to present our research at conferences across the nation. Professor Luthy and I attended and prepared a poster presentation at a national immunization conference in Washington D.C. and at a WIN Conference in Las Vegas, Nevada. To share our findings and associate with other researchers who are passionate about immunizations, as well as so many other areas of nursing was an incredible experience.

Locally, I prepared a podium presentation to be presented to my peers at the 34th Annual Brigham Young University College of Nursing Research Conference. Local media has also taken interest in our research, including The Daily Universe and The College of Nursing’s “The Pulse”.

Personally, ORCA has been a great learning experience and I have appreciated the opportunity to work so closely with professors that have a passion for learning and continually seek to improve and expand upon research in their field of interest. I appreciate ORCA donors that made my participation in this research possible, as well as all of the professors who have worked with me on this project. I have learned so much and had so many unique opportunities throughout this research experience that I would have not received in my standard nursing curriculum.

References

• Luthy, K. E., Beckstrand, R. L., & Peterson, N. E. (2009). Parental hesitation as a factor in delayed childhood immunization. Journal of Pediatric Health Care, 23(6), 388- 393.
• Luthy, K. E., Sperhac, A. M., Faux, S. A., & Miner, J. K. (2010). Improving immunization rates in the clinic and in the community. Contemporary Pediatrics, 27(9), 54-60.
• Schechter, N. L., Zempsky, W. T., Cohen, L. L., McGrath, P. J., & McMurtry, C. M. (2007). Pain reduction during pediatric immunizations: Evidence-based review and recommendations. Pediatrics, 119(5), e1184-e1198.