Children's expectations and memories of acute distress: Short- and long-term efficacy of pain management interventions

Objective: To examine the effect of psychologic and pharmacologic intervent ions on children's expectations and 6-month recollections of painful proced ures. Methods: A repeated measures design allowed examination of 22 fourth grader s' expectations, experiences, and memories of distress across three conditi ons (typical care, distraction, topical anesthetic) for a three-injection v accination series. All participants were African American and from urban, l ow-income families. Results: Across conditions, children's expectations of distress were signif icantly higher than their experience of distress. Distress ratings did not differ among conditions prior to or immediately following the injections; h owever, children later recalled that the treatment conditions were superior to control for distress relief. Analyses of recall accuracy suggest that t he interventions buffered the children from forming negative recollections that occurred with typical care. Conclusions: Children have negative expectations prior to a procedure despi te knowing that a distress management intervention will be employed. Howeve r, interventions may thwart the development of negative memories of distres s.