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Trajectories of Distress Regulation During Preschool Vaccinations: Child and Caregiver Predictors.

Pain 2021 July 6
ABSTRACT: Recent research has highlighted the need for a deeper understanding of the heterogeneity in trajectories of children's distress following acute pain exposure, moving beyond group means of behavioural pain scores at a single timepoint. During preschool vaccinations, three distinct trajectories of post-vaccination pain regulation have been elucidated, with approximately 75% of children displaying trajectories characterized by down-regulation to no distress by two minutes post-needle and 25% concerningly failing to down-regulate by two-minutes. The objective of the present study was to examine child and caregiver predictors of preschool children's post-vaccination regulatory patterns. Our results indicated that higher child baseline distress, more caregiver coping-promoting verbalizations in the first minute following the needle, less coping -promoting verbalizations in the second minute, and more caregiver distress-promoting verbalizations in the second minute following the needle were associated with membership in the trajectories characterized by high distress. Further, while all children's pain-related distress at various timepoints throughout the appointment was most strongly predicted by prior pain scores, different patterns of associations emerged depending on the trajectory exhibited. This research highlights both the need to minimize distress prior to the needle in order to avoid the highly distressed trajectory as well as the importance of considering the heterogeneity of trajectories of preschool pain responding when examining the factors that are associated with children's pain-related distress.

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