Development of the Distraction Coaching Index

Abstract

Children's distress during medical procedures can be decreased when professionals or parents provide distraction coaching, but the quality of distraction may contribute to the variation in the results. This article describes the development of the Distraction Coaching Index (DCI), a tool for measuring the quality and frequency of distraction coaching. Nominal group technique and consensus agreement were used for concept clarification and development of behavioral indicators and descriptors. Videotapes of untrained parents, trained parents, and expert professional coaches, who provided distraction to children (4-10 years old) undergoing peripheral intravenous catheter insertion, were used to assess interrater reliability and construct validity. DCI scores were significantly higher for the experts versus untrained parents and trained parents versus untrained parents. The DCI can be used by researchers to evaluate treatment fidelity of distraction coaching and by clinicians for teaching health professionals and parents how to perform distractions.