Positive Emotions in Pediatric Communication During Needle Procedures: An Observational Study

Kari Sørensen; Hilde Wøien; Lena Heyn

doi:10.1016/j.pmn.2026.05.017

Positive Emotions in Pediatric Communication During Needle Procedures: An Observational Study

Pain Manag Nurs. 2026 Jun 11:S1524-9042(26)00187-6. doi: 10.1016/j.pmn.2026.05.017. Online ahead of print.

Authors

Kari Sørensen¹, Hilde Wøien², Lena Heyn³

Affiliations

¹ Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway; Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway. Electronic address: kari.sorensen@ldh.no.
² Department of Public Health Sciences, University of Oslo, Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
³ Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Campus Drammen, Drammen, Norway.

PMID: 42276928
DOI: 10.1016/j.pmn.2026.05.017

Abstract

Purpose: Fear of pain and anxiety are common among children undergoing needle procedures. Actively involving the child in communication can help reduce their distress and foster a stronger nurse-child relationship. Positive emotions have the potential to strengthen the patient-nurse connection and may also play an important role in managing children's distress, though further research is needed to fully understand their impact. This study aimed to identify expressions of positive emotions in procedural communication between children, parents, and nurses, using the seven categories of the Positive Emotion Communication (PEC) coding system.

Design: A secondary analysis of nine previously collected video recordings exploring fear and pain during needle injections among children recently diagnosed with rheumatic diseases. Positive emotions were identified using the PEC coding system, and the findings were analyzed using descriptive statistics.

Results: We identified 328 expressions of positive emotions (60% from nurses, 30.5% from parents and 9.5% from children). All participants widely used the category Positive Focus, while nurses and parents favored the category Praise or Support. Children used the category Humor more frequently than other participants. Communication was mainly directed at children, with parents also receiving encouragement.

Conclusion: Nurses frequently used positive utterances in their communication with children and parents during this challenging healthcare procedure. The PEC coding system proved useful for identifying positive emotions in pediatric communication research; however, it lacks the ability to capture nonverbal communication and responses.

Clinical implications: Using positive emotions in medical conversations with children has significant potential to enhance their healthcare experience. However, further research is needed to refine the PEC coding system to better capture nonverbal communication and responses, ensuring a more comprehensive understanding of positive communication in pediatric care.

Keywords: Children; Communication; Needle procedures; Positive emotion coding system.