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Nonpharmacologic Methods of Pain Management in Children
Although little research has focused on the use of cognitive-behavioral methods for children with cancer, they have a potentially important role in relieving pain, and the methods used by adults can be adapted for children. For example, distraction techniques might involve reading or telling a favorite story, talking about the story's characters, or playing video games. Preparation for painful events could involve the use of a puppet, a favorite cartoon character, or an animal. Stuffed animals with inserted audiotapes of stories or music may help to induce a state of relaxation. Something familiar to the child may facilitate participation in these nonpharmacologic strategies.
When a child is in pain, the presence of a parent is usually helpful. Other methods of psychological support include holding someone's hand, a stuffed toy, or favorite blanket; asking questions;- using distraction; sleeping and resting; relaxing or using imagery; changing positions; and engaging in humor; these seemingly simple interventions can have powerful effects. Facilitating the child's usual strategies for decreasing pain is important. Although not well researched in child populations, measures such as physical therapy, TENS,129 splinting a painful extremity, positioning, the application of heat or ice, and massage may help relieve pain.
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