While the majority of school-aged children associate immunizations with low levels of anxiety, fear, and pain, there is a small subset for whom needles are highly distressing (Humphrey, et al., 1992). Poorly managed, these individuals may come to avoid medical treatment (Ollendick, King, & Muris, 2002). Using Lazarus and Folkmans (1984) transactional theory of coping and Reid and colleagues (1998) development and validation of the Pain Coping Questionnaire as frameworks, the present program of research elaborated on existing knowledge about how children cope with needles. As part of Studies 1 (N = 176) and 2 (N = 302), a Coping with Needles Questionnaire (CNQ) was developed and validated; both two- and three-subscale versions of the questionnaire were examined. The resulting CNQ was composed of and scored as two separate subscales: problem-focused and emotion-focused coping. Construct validity testing demonstrated that emotion-focused coping was robustly associated with more negative experience with needles (i.e., higher anxiety, fear, pain, and lower self-efficacy). There was no main effect of problem-focused coping but it tended to moderate the negative effect of emotion-focused coping when the two interacted. Study 3 (N = 78) was designed to investigate (1) the percentage of participants who are high on only one type of coping (i.e., dominant copers) and (2) how coping responses change over time in response to repeated presentations of the same stressor. Presently there are gaps in the existing literature regarding these two targeted areas of investigation. Results of this investigation indicated that most children engage in high amounts of both problem- and emotion-focused coping when initially queried about their experience with an immunization, with approximately 30% showing a pattern of coping dominance. When participants were followed and queried about a second experience with immunization, it was found that most of them engaged in low amounts of both types of coping. This pattern of change in the distribution of coping over time was not consistent with learning effects. In other words, participants did not seem to improve their coping with experience. However, lack of a clearly positive type of coping and a six-month time-lag may have inhibited the potential for learning to occur. The utility of the CNQ for screening purposes and implications of these findings for interventions are discussed.
| Identifer | oai:union.ndltd.org:USASK/oai:usask.ca:etd-07302008-212809 |
| Date | 14 August 2008 |
| Creators | Spagrud, Lara Jennifer |
| Contributors | Teucher, Ulrich, Reid, Graham J., Nicol, Jennifer A. J., Marche, Tammy, Johnston, Celeste, von Baeyer, Carl |
| Publisher | University of Saskatchewan |
| Source Sets | University of Saskatchewan Library |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://library.usask.ca/theses/available/etd-07302008-212809/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Saskatchewan or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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