Study designs of evaluations included in the review
Randomised clinical trials (RCT) and repeated measure trials that assessed self-reported pain or observed distress in children undergoing medical procedures, were included if means and standard deviations were available for outcomes in both treatment arms.
Specific interventions included in the review
Distraction methods, defined as any intervention intended to focus the subject's attention away from the pain or discomfort, included simple methods and packages of distraction techniques. Simple techniques included the following: music or story via headphones; party blower; non procedural talk by parent or professional; cartoon; toy; kaleidoscope; story and poster. Packages included imagery alone; imagery and reinforcement; imagery, breathing and rehearsal; distraction, relaxing images, reinforcement; distraction and breathing; and imagery, breathing, nonprocedural talk and concentrating.
Participants included in the review
Children aged 3 to 15 years (mean 6.6 years) undergoing the following procedures were studied: intravenous before surgery; injection; bone marrow aspiration; lumbar puncture; venipuncture; burn treatment; and dentistry procedure.
Outcomes assessed in the review
Pain and distress were assessed. Pain scales included the following: FACES; OUCHER; Childs Global Rating Scale; and Visual Analogue Scale. Distress scales included the following: Global Distress Scale; Observation Scale of Behavioural Distress; Procedural Behaviour Rating Scale; Children's Hospital of Eastern Ontario Pain Scale; Burn Treatment Distress Scale; Child Behaviour Observation Code; Behaviour Rating Profile Scale; Anxiety and Disruptive Behaviour Code; and Total Disruptive Behaviour.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.