It doesn’t have to hurt – Cochrane author finds great success with YouTube pain management video

Christine Chambers, Professor  Christine Chambers 
Professor of Pediatrics and Psychology at Dalhousie University 
Halifax, Nova Scotia 

It’s difficult to believe that as recently as the 1980s physicians were performing complex, painful procedures such as heart surgery on babies without using anesthesia.

While Christine Chambers agrees pain management in babies and children has come a long way since then, she argues, “We still have a long way to go.”

Chambers, a Professor of Pediatrics and Psychology at Dalhousie University and former Canada Research Chair in Pain and Child Health, wants to do more to lessen the pain children experience during medical procedures. That’s why she developed the YouTube video, It Doesn’t Have to Hurt: Strategies for Helping Children with Shots and Needles.

The two-minute video explores approaches parents can use to help make getting a needle a less traumatic experience for their child. The strategies include applying over-the-counter numbing cream to the injection site, having the child blow bubbles to encourage deep breathing, or simple psychological distraction interventions like playing a game on a parent’s phone.

Aware of the fact that parents don’t typically study research papers to find health information for their children or themselves, Chambers looked to the internet to help get her message out. “We want to do a good job making evidence-based information available to parents in a way they can understand,” says Chambers of the video.

Chambers, a mother of four, shares that parents and the public often think everything possible is already being done when it comes to pain management: “Especially when it comes to routine needles.”

Parents generally want to help their children manage getting needles, but they often don’t know what to do. “When you ask parents what they’ve tried when it comes to pain management, they say, ‘I don’t know, my doctor hasn’t recommended anything,’” explains Chambers.

While most health professionals are aware of pain management strategies, many say their patients aren’t asking for this. Other health professionals aren’t interested in the strategies at all. When asked about these strategies some say, “I don’t want patients asking about pain management. It takes too much time,” according to Chambers.

She says the main goal of the video was simply to get people interested in the topic so they would talk about it. This is certainly the case as the video has garnered over 46,000 views to date, with 26,000 views in the first two weeks alone.

While Chambers wanted parents to see and talk about the video, there are more significant outcomes to employing pain management strategies. “Poorly managed painful experiences in childhood can lead kids to develop needle phobias. One in 10 children and adults have needle phobias,” explains Chambers. “We don’t want kids to become so afraid of needles and doctors that they avoid medical care when they are older. When you are little, your parent will make sure you go to the doctor. No one is there to make you once you are an adult.”

These phobias can stand in the way of children seeking adequate medical care for the rest of their lives.

Chambers goes on to say, “We’re seeing a lot of media coverage around vaccinations. But one of the issues people don’t talk about so much is that being afraid of needles is another reason why children and adults are not being vaccinated.”

Further to this psychological implications are physical effects. Research shows that early, poorly managed pain experiences in childhood changes the nervous system and leads to individuals being more likely to experience pain later in life.

According to Chambers, fewer than five per cent of Canadian children receive any sort of pain management for vaccinations. “We do a terrible job at educating health professionals about pain,” states Chambers, which is highlighted by the fact that veterinarians receive five times the pain training doctors do, pointing to a systematic problem.

Chambers has always had an interest in child health and well-being. The catalyst to this YouTube video dates back to 2001 when she discovered there were many study trials in the area of psychological interventions for procedure pain management in children, but no systematic reviews, which would synthesize all of the available evidence into one report. Chambers then connected with the Cochrane Pain, Palliative and Supportive Care Review Group in hopes of completely a review on this subject.

The review, Psychological interventions for needle-related procedural pain and distress in children and adolescents, was published in 2006 with Chambers and her team updating the review in 2013.

Knowing parents are unlikely to find this type of information themselves, Chambers looked to a more non-traditional way of sharing her research findings through the video and got a knowledge sharing grant from the Nova Scotia Health Research Foundation to help pay for it. Response to the video has been positive all around with media coverage throughout the year and compliments from parents and physicians alike.

This work also lead to collaborations with researchers at the University of Toronto and SickKids, 
Toronto’s children’s hospital, to examine vaccine pain, specifically. This group has developed clinical practice guidelines which were published in the Canadian Medical Association Journal.

Despite all of her success, it’s clear that Chambers’ work in this area is not finished: “We need to continue to make sure we use the research evidence we have to reduce suffering and improve children’s lives.”

Please explore these links for more information about Chambers’ research: