DVD-Based Training Program in Self-Hypnosis for Children (VCUG)

• Distress: Child Self-Report [ Time Frame: Same day - one week after procedure ] [ Designated as safety issue: No ]
  Crying will be assessed by having the child point to a picture on a continuous visual analog scale of 6 different faces representing increasing levels of distress, ranging from a smiling face to a face crying intensely.
  
  
• Distress: Parent Report [ Time Frame: Same day - one week after procedure ] [ Designated as safety issue: No ]
  Parent assessments of child distress (fear, pain, and crying)and overall trauma will be completed on 5-point scales, ranging from "not at all" to "extremely". Parents will also rate of how traumatic the present VCUG procedure was compared with the previous one was completed on a 6-point scale ranging from "much less traumatic" to "much more traumatic."
  
  
• Distress: Observational Ratings [ Time Frame: Same day - while the child is undergoing the VCUG procedure. Time can range from minutes - hours of observation. ] [ Designated as safety issue: No ]
  A research associate will rate the child's distress from the time he or she enters the procedure room until the procedure is completed. A modified 8-point version of the Torrance Global Mood Scale will be used.
  
  

• Difficulty of Procedure: Medical Staff Ratings [ Time Frame: Directly following procedure - up to 30 minutes following the end of procedure. ] [ Designated as safety issue: No ]
  Immediately after the procedure, the attending radiologist and the technician each will be asked to rate the degree of difficulty of conducting the procedure. Staff will be asked to make the ratings with respect to children of similar ages on a 7-point scale ranging from "far easier" to "far more difficult."
  
  
• Anxiety: Parent Self-Report [ Time Frame: Directly following procedure - up to 30 minutes following the end of procedure. ] [ Designated as safety issue: No ]
  Parents will complete the State-Trait Anxiety Inventory (Spielberger, 1970) immediately following the procedure.
  
  
• Parent Confidence [ Time Frame: Directly following procedure - 1 week ] [ Designated as safety issue: No ]
  Parent confidence in helping their child through the VCUG procedure will be assessed immediately following the procedure up to 1 week.
  
  
• DVD Evaluation [ Time Frame: Same day - 3 months following procedure ] [ Designated as safety issue: No ]
  The DVD Evaluation form will ask parents to evaluate the DVD-based training program.
  
  
• Duration of Procedure [ Time Frame: Same day - Time can range from minutes - hours of observation. ] [ Designated as safety issue: No ]
  Time in minutes of the VCUG procedure will be recorded from when the child first enters the room to when the child is told the procedure is over.
  
  

Pediatric care professionals and parents seek safe ways to make invasive medical procedures less stressful and traumatic for children. However, for unpleasant procedures that require child cooperation, this task becomes difficult. Home-training in self-hypnotic relaxation may provide an inexpensive, yet systematic method for improving the overall medical care of children undergoing invasive medical procedures. The proposed study is designed to utilize a self-hypnosis DVD home-training program for parents to use with their children to teach self-hypnosis techniques for inducing relaxation and hypnotic analgesia. The study will examine the efficacy of this intervention for children undergoing urethral catheterization for VCUG procedures. Parents will be instructed to watch the DVD and practice the self-hypnosis exercises every day for a week with their child prior to the upcoming procedure. Parents are encouraged to practice self-hypnosis during their child's VCUG procedure. Both parents and children will be asked to complete a series of questionnaires before and following the procedure.