1. Lipman, Terri H. PhD, CRNP, FAAN

Article Content

Lacey, C. M., Finkelstien, M., Thygeson, M. V. (2008).Journal of Pediatric Nursing, 23, 195-200.


Children are quite fearful of injections. Multiple studies have attempted to identify interventions that will decrease the anxiety associated with painful procedures. Pediatric nurses know that children tend to resist lying down during a healthcare visit. Would a child feel less fearful if given an injection while sitting up? The purpose of this study was to answer that question.


One hundred children were randomized into being placed into a supine or sitting position prior to receiving an injection. Tools were used to measure children's fear, level of pain, and occurrence of crying. Children who were sitting up while receiving an immunization reported less fear and cried for a shorter interval than children who were supine.


This study provides data for an evidence-based practice approach to positioning children during painful procedures. Allowing children to remain seated gives them a greater sense of control. In addition, when children display less distress, parental anxiety also decreases. Low immunization rates have been partially explained by parents not wanting to see their children cry. If children do not associate being supine with a painful procedure, they may be less fearful when they are asked to lie down for a physical examination. They also may have more positive views of their healthcare visits. Incorporating the data from this study into practice may require a shift from usual procedure. Nurses may need additional education related to immobilizing a child in a sitting position to feel more comfortable with a change in customary practice.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.