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Investigated the validity of the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R) using multiple concurrent objective and subjective measures of child distress, approach-avoidance behavior, fear, pain, child cooperation, and parents' perceived ability to help their preschool children during routine immunizations. Parents', staffs', and children's behaviors in the treatment room were videotaped and coded. Results indicate that the validity of the CAMPIS-R codes of Child Coping and Distress, Parent Distress Promoting and Coping Promoting, and Staff Distress Promoting and Coping Promoting behavior were supported, with all significant correlations being in the predicted direction. An unanticipated finding was that the child, parent, and staff Neutral behaviors were inversely related to some measures of distress and positively related to some measures of coping. Interobserver reliability was high for each CAMPIS-R code.

Assessed the influence of adult in-session behavior and psychological variables on 77 preschool children's coping and distress during routine immunizations. Maternal anxiety was not related to the behavior of the parent, staff, or child. However, in-session behavior by one person was highly correlated with in-session behavior by the other people in the treatment room. The effects of parent and staff in-session behaviors, previous child medical experience, and maternal anxiety on child distress and coping was examined using hierarchical multiple regression procedures. Child coping was predicted by parent and staff behavior whereas child distress was predicted by parent behavior and by the level of the child's distress during previous medical and dental experiences. Implications for intervention and future research are discussed.