2.5.1. Groningen Distress Scale

The Groningen Distress Scale is an observational scale developed by Humphrey et al. in 1992 [30] and designed to measure anxiety during a brief medical procedure. It is a scale based on the Behavioural Approach-Avoidance and Distress Scale (BAADS) and in the original article this scale was used to measure anxiety levels during venipuncture in a child-adolescent population aged between 2½ and 19 years.

The scale rates distress or anxiety in the child on 5 levels from low to high (1–5). Crying and muscle tension, both of which are relatively easy to define operationally, are the two most frequently presented behaviours and thus are the two main variables taken into account. Distress is classified into 5 degrees: 1- Calm, 2- Shy/nervous, 3- Moderate anxiety but still under control, 4- Continuous tension and crying, 5- Panic.