Children's Coping with Needle-Related Procedures: Parent and Child Concurrent and Longitudinal Predictors

Coping with needle-related procedures during childhood is a complex and dynamic process that must be viewed in the context of the parent as well as the childs stage of development. This dissertation consists of three studies that present a comprehensive and in-depth investigation of childrens coping with needle-related procedures. Study 1 is a published systematic review that synthesizes the literature on childrens coping during needle-related procedures in the context of the parent. Studies 2 and 3 were published within one extended manuscript based on an ongoing longitudinal cohort (OUCH Cohort) of caregiver-child dyads followed over vaccination appointments during the first five years of life (12-month vaccination [n=548], preschool vaccination [n=302], preschool psychological assessment [n=172]). Study 2 employed a cross-lagged path analysis to investigate the dynamic and reciprocal relationships between childrens coping responses and coping outcomes at the preschool vaccination. Study 3 used four longitudinal path models to examine the prediction of preschool childrens coping responses and coping outcomes during vaccination (using an array of caregiver and child variables from the 12-month and preschool stage). Study 1 found that combinations of childrens coping responses were more predictive of coping outcomes than individual coping responses alone and, similarly, that combinations of parent behaviours were more predictive of childrens coping responses and outcomes than any individual parent behaviour. Study 2 demonstrated that coping responses and coping outcomes during the preschool vaccination are separate, but interrelated, aspects of the coping process and that the relationships between them are dynamic. Study 3 showed that parents play an important role in preschool childrens coping during vaccination and that this role is both longitudinal and concurrent. It was also found that parent behaviours during the 12-month vaccination predicted broader child cognitive abilities at preschool. Clinical implications and suggestions for future research are discussed.