Every kid knows getting a shot can be painful, but there are many effective methods to help them cope. With a variety of tricks and techniques available //— from blowing soap bubbles to teaching self-hypnosis — it doesn’t matter what health professionals do so much as that they do something, suggests a new review.

The goal of the review was to identify the best psychological interventions for reducing pain and distress in children and teenagers undergoing a needle procedure. "This way, health care professionals, parents and even the children themselves, can have options to help make their experience less painful and distressing," said lead reviewer Lindsay Uman, of Dalhousie University in Halifax, Nova Scotia.

The review looked at 28 randomized controlled studies that excluded children with known needle phobias. The procedures studied included vaccinations, lumbar punctures and bone marrow aspirations. Nearly 2,000 children and teenagers participated.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Techniques included cognitive interventions — such as distraction, hypnosis or having the child repeat positive thoughts such as "I can do this." Also analyzed were behavioral interventions such as breathing exercises or muscle relaxation, or combinations of cognitive and behavioral interventions. Some techniques were quite simple, while others involved video games, television or virtual reality headsets that provided both audio and visual stimulation.

The techniques with the most evidence for their effectiveness in reducing pain and distress during needle procedures include distraction, combined cognitive and behavioral
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