The relationship between adults' behavior and child coping and distress during BMA/LP procedures: A sequential analysis

The influence of the immediate social environment on the child's ability to cope during painful medical procedures was examined. Transcriptions and audiotapes of verbal interactions among residents, nurses, mothers, fathers, and children that occurred during bone marrow aspirations and lumbar puncture procedures were scored using the Child-Adult Medical Procedure Interaction Scale (CAMPIS). Using Sackett's lag analysis to determine conditional probabilities, during the medical procedure it was found that adults' reassuring comments, apologies to the child, giving control to the child, and criticism of the child typically preceded child distress. Also, when the child emitted any one of eight distress behaviors, adults generally attempted to reassure the child. Child coping typically was preceded and followed by adult commands to the child to engage in coping procedures, by nonprocedural talk to the child, and by humor directed to the child. Implications for future research are discussed.