Easier said than done: What parents say they do and what they do during children's immunizations

In this study we evaluated the relation between parents' reports of their u sual procedural behavior, their observed behavior, and children's coping an d distress during immunization procedures. Fifty-five children, 4 to 6 year s old, and their parents participated in the study. Prior to the children's immunizations, the parents provided reports of the therapeutic behaviors t hey typically engage in during their children's painful medical procedures. The immunization procedure was videotaped, and parent and child behaviors were later coded with the Child-Adult Medical Procedure Interaction Scale. Results indicated that parents overestimate the quantity of their therapeut ic behaviors and that no relation exists between parents' reports of their behavior and their actual behavior during children's immunizations. Further , parents' reports of their behavior were unrelated to their children's dis tress or coping. However, parents' behaviors were significantly related to children's distress. These findings suggest that preoperative parent self-r eport is not a valid index of actual behavior during children's acute painf ul procedures. Therefore, parent behavior, rather than parent report, shoul d be used to determine their need for training in how to help their childre n cope with painful medical treatments.