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UBC Theses and Dissertations

Acceptability of psychological interventions for pediatric pain associated with invasive medical procedures Calvert, Susan Cross


Differences in perceived acceptability of treatments has been proposed as a means for explaining why recommended treatments are often not implemented or poorly utilized. Although treatment acceptability research has identified the acceptability of numerous psychological interventions and the variables influencing these evaluations, the construct of acceptability, its theoretical basis, and extent of generalizability has had minimal attention. To address these concerns, a series of four studies examined the acceptability of psychological and pharmacological interventions for the alleviation of pediatric pain and distress associated with invasive medical procedures. A conceptual model of treatment acceptability, adopted from a model of health beliefs, provided a framework for conceptualizing acceptability attitudes and how these attitudes may be formed and changed. In Studies 1 and 2, an acceptability measure (AQ) appropriate for the evaluation of interventions for pediatric pain and distress was developed. Undergraduate students, presented with written descriptions of six different pain management interventions as applied to a child having difficulty coping with a painful medical procedure, rated the acceptability, predicted effectiveness, and general evaluation of these interventions as well as anticipated choice and predicted self-efficacy in implementing the interventions. In Study 3, 63 mothers evaluated the acceptability of one pharmacological and two psychological interventions designed to reduce pediatric pain and distress. Study 4 investigated how acceptability attitudes are influenced by experience with the effectiveness of an intervention. Acceptability attitudes of 90 mothers were assessed before and after exposure to an effective or ineffective implementation of a pain management intervention or a no effectiveness information exposure. Across the studies, results indicated that the AQ differentiates among interventions and is an internally consistent and reliable instrument. Accelerative interventions (imagery, attention-distraction, deep breathing) were evaluated as more acceptable than reductive interventions (reprimands, ignoring), and a pharmacological intervention (oral Valium) fell in the middle range. Providing construct validity, acceptability attitudes were highly correlated with effectiveness predictions, general evaluation of the intervention, and anticipated treatment selection; and modestly correlated with predicted self-efficacy in implementing the intervention. Study 4 demonstrated that exposure to an effective implementation of an intervention improved acceptability attitudes and exposure to an ineffective implementation resulted in less positive acceptability attitudes. Acceptability attitudes did not change after exposure to an implementation of the intervention without effectiveness information. Suggestions for future research directions and potential implications for educating potential consumers about psychological interventions and their effectiveness are discussed.

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