{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:40:21Z","timestamp":1790073621047,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Negative experiences of needle procedures in childhood can lead to medical avoidance and vaccine hesitancy into adulthood. We evaluated the feasibility of two new interventions provided by clinical nurses to reduce the negative impact of vaccinations: divided attention (DA) and positive memory reframing (PMR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children (8\u201312\u2009years) were randomized into four groups: usual care (UC), DA, PMR or combined (DA\u2009+\u2009PMR). To evaluate feasibility, we undertook in\u2010depth analysis of video\u2010recorded interventions, nurse experiences (phone interviews) and child\/parent memory recall of interventions (phone interviews at 2\u2009weeks post\u2010vaccination). Key clinical outcomes included child and parent ratings of needle\u2010related pain intensity and fear assessed at baseline, immediately post\u2010vaccination and 2\u2009weeks post\u2010vaccination (recalled).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 54 child\u2013parent dyads were screened, with 41 included (10\/group, except PMR [<jats:italic>n<\/jats:italic>\u00a0=\u200911]). The interventions were not always completed as intended: 10%\u201322% of participants received complete interventions and two had adverse events related to protocol breach. Preliminary within\u2010group analyses showed no effects on child\/parent pain ratings. However, children in DA\u2009+\u2009PMR had reduced recalled fear (<jats:italic>p<\/jats:italic>\u00a0=\u20090.008), and PMR (<jats:italic>p<\/jats:italic>\u00a0=\u20090.025) and DA\u2009+\u2009PMR (<jats:italic>p<\/jats:italic>\u00a0=\u20090.003) had reduced fear of future needles. Parent ratings of child fear were also reduced immediately post\u2010vaccination for UC (<jats:italic>p<\/jats:italic>\u00a0=\u20090.035) and PMR (<jats:italic>p<\/jats:italic>\u00a0=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The interventions were feasible, although enhanced nurse training is required to improve fidelity. Preliminary clinical results appear promising, particularly for reducing needle\u2010related fear. Protocol registration: Protocol number ACTRN12618000687291 at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/anzctr.org.au\">ANZCTR.org.au<\/jats:ext-link><\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Two new nurse\u2010led interventions to reduce negative impacts of vaccinations in children, divided attention and positive memory reframing, were feasible and may reduce needle\u2010related fear. Nurses were able to deliver the interventions in various environments including non\u2010clinical settings (schools). These interventions have potential to facilitate broader dissemination of vaccinations for children in a manner that minimizes distress.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1992","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T16:05:15Z","timestamp":1654617915000},"page":"1702-1722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Reframe the pain: Divided attention and positive memory reframing to reduce needle pain and distress in children\u2014A feasibility randomized controlled trial"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6676-026X","authenticated-orcid":false,"given":"Felicity A.","family":"Braithwaite","sequence":"first","affiliation":[{"name":"IIMPACT in Health The University of South Australia  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3752-8055","authenticated-orcid":false,"given":"Melanie","family":"Noel","sequence":"additional","affiliation":[{"name":"Department of Psychology The University of Calgary  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah G.","family":"Jones","sequence":"additional","affiliation":[{"name":"IIMPACT in Health The University of South Australia  Adelaide South Australia Australia"},{"name":"Department of Psychology The University of Bath  Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3255-9242","authenticated-orcid":false,"given":"Michael D.","family":"Wiese","sequence":"additional","affiliation":[{"name":"Clinical &amp; Health Sciences The University of South Australia  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara G.","family":"Nania","sequence":"additional","affiliation":[{"name":"School and Applied Child Psychology The University of Calgary  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3139-2946","authenticated-orcid":false,"given":"Emily","family":"Watson","sequence":"additional","affiliation":[{"name":"IIMPACT in Health The University of South Australia  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7106-4456","authenticated-orcid":false,"given":"Tasha R.","family":"Stanton","sequence":"additional","affiliation":[{"name":"IIMPACT in Health The University of South Australia  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(90)90052-K"},{"key":"e_1_2_9_3_1","unstructured":"Australian Government Department of Health. 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