Distress in pediatric hematology - Oncology patients undergoing intravenous procedures: Evaluation of a CD-ROM intervention

This study assessed the influence of a developmentally specific CD-ROM intervention on cognitive appraisals, fear, behavioral distress, and pain in pediatric hematology-oncology patients scheduled for intravenous (IV) procedures. Thirty children, 7 to 18 years of age, were randomly assigned either to a standard medical care group or a standard medical care plus CD-ROM intervention group. It was hypothesized that using the CD-ROM would decrease threat appraisals of the IV procedure, causing decreased fear of the IV, less behavioral distress, and less pain during the IV. It was also hypothesized that intervention-enhanced secondary appraisal would be seen in children in the CD-ROM intervention group and that they would cope more effectively with the IV procedure. Self-report and observational ratings were used to assess the following dependent variables: primary and secondary appraisal, fear, behavioral distress, and pain. Results indicated significant effects for the reduction of threat appraisals following CD-ROM intervention (p < .05). Children in the CD-ROM intervention group used cognitive restructuring coping more effectively than did the control group (p < .05). No significant effects were found for fear, behavioral distress, or pain.