P.A.C.E.® Approved COURSE DESCRIPTION - National Center for ...

Desensitization techniques generally have the following steps. The healthcare
providers must watch the patient carefully through these steps as a vasovagal reaction
may occur. Steps may be started and stopped as many times as necessary for the
patient to become comfortable with the equipment.
Step 1: Recognition and relaxation. Using an anxiety scale of 0-10 (10 being severe
anxiety), the psychologist/psychiatrist evaluates patients at risk. If an anxiety score of 3
is identified, they discuss the needlestick procedure in detail to assist in alleviating the
fear of the unknown. Distraction and relaxation methods are discussed and practiced.
The healthcare provider may recommend hypnosis.
Step 2: Control and Preparation. The healthcare provider encourages patients to
participate in decision-making and to optimize ways to relieve anxiety. Patients are
encouraged to talk about their concerns and ask questions related to the procedure.
Patients can choose their own environment and have a support person to stay by their
side. Developing a sense of control assists patients in minimizing their anxiety.
Step 3: Graded Exposure. In this step, patients are gradually exposed to the
equipment used for the needlestick procedure. At first, toys, videos, and pictures may
be used to illustrate the procedural steps. Next, patients look at and handle the
actual equipment to be used such as an alcohol wipe, local anesthetic gel, syringe
needle, syringe, vaccine vial, etc. Eventually the healthcare provider performs the steps
in the needle procedure without actually performing the needlestick. The capped
needle can be placed on the skin and a puncture mimicked. When the patients become
comfortable with this, they are ready to move on to the actual procedure.
The Virtual Reality Medical Center (www.vrphobia.com/) has a virtual doctor’s office
where the patient is gradually exposed to experiences that cause anxiety in carefully
controlled stages.
Prevention of Needle Phobia
Due to the genetic component, not all needle phobias can be prevented. However,
inappropriate care provided by healthcare providers that can result in needle phobia in 1
out of every 10 patients can be prevented. Improved care can even assist as many as
50-70% of needle phobics in dealing with their anxiety. The following suggestions are
recommended for the prevention of needle phobia.
Healthcare personnel should identify individuals at risk for needle phobia at the
time of scheduling an invasive/painful procedure and not at the time of the actual
procedure.
Healthcare providers should ask the patient (or the parents of a child) if he/she
has unusual sensitivity to pain and if he/she has exhibited needle phobic
reactions during previous procedures.
Page 12 of 19