针头恐惧通常始于童年,代表着整个生命周期中与健康相关的重要问题。非常害怕针头的人经常避免医疗保健。尽管在手术过程中存在管理针头疼痛和恐惧的指导,最害怕的人可能会拒绝或放弃这样的程序。临床实践指南(CPG)的目的是为特定健康问题的管理提供可操作的指导;本指南来自系统过程。利用专家小组解释的严格系统审查的证据,本CPG提供了针对儿童和成人高度针头恐惧的基于暴露的干预措施的建议.AGREE-II,等级,并使用了Cochrane方法。包括基于暴露的干预措施。纳入的证据平均质量很低。强有力的建议包括以下内容。推荐体内(活/人)基于暴露的治疗(与不治疗)适用于7岁及以上的儿童和患有高度针头恐惧的成年人。非体内(想象,基于计算机的)暴露(vs.对于不愿意进行体内暴露的个体(7岁以上),建议不进行治疗。虽然没有纳入研究7岁以下儿童的试验,基于暴露的干预措施被讨论为良好的临床实践。讨论了实施考虑因素并提供了临床工具。使用这些推荐的做法可能会由于更好的医疗保健依从性而导致改善的健康结果。迫切需要对高水平的针头恐惧的理解和治疗进行研究;提供了具体建议。
Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing
needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice
guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of
needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children < 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of
needle fear is urgently needed; specific recommendations are provided.