ArticleChildren (Basel, Switzerland)2026
Trauma-Informed Care Approach During Pediatric Venipuncture: Pre-Post Associations with Fear and Heart Rate.
Article in Children (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeedle-related procedures such as venipuncture can be distressing for children and may trigger severe fear and behavioral dysregulation, particularly in those with previous traumatic experiences. Trauma-informed care (TIC) is a framework that recognizes the widespread impact of trauma and integrates this knowledge into clinical practice to prevent re-traumatization and support emotional regulation during medical procedures.
methodsThis before-and-after study included 135 children aged 4-8 years who had previously shown severe distress during venipuncture, including escape attempts, shouting, or self/other-directed aggressive behaviors. Before venipuncture, children and their families received a TIC-based intervention delivered by a psychological counselor in a dedicated preparation room. Fear, behavioral responses during venipuncture, procedural pain, and heart rate were evaluated before and after the intervention using parent reports, the Children's Fear Scale, the Wong-Baker FACES Pain Rating Scale, and pulse oximetry.
resultsFollowing the TIC intervention, significant pre-post reduction were observed in distress-related behaviors during venipuncture, including escape attempts, shouting/crying, and self-/other-directed harmful behaviors. The proportion of children rated as experiencing high levels of fear decreased from 96.2% before the intervention to 15.5% after. Among the 85 children with complete heart-rate measurements available, mean heart rate decreased from 113.6 ± 10.1 beats/min to 87.3 ± 8.43 beats/min. Many families reported a more positive venipuncture experience compared with previous procedures.
conclusionsA trauma-informed care intervention delivered before venipuncture is associated with meaningful reductions in behavioral distress, fear, and physiological arousal in children with prior needle-related traumatic experiences. These pre-post associations support the feasibility and potential value of the TIC model, though controlled studies are needed to confirm these findings without confounding clinical effects.
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