1
|
Taspinar F, Turkmen AS. The impact of kaleidoscope on children's pain and fear during sutures. Int Emerg Nurs 2024; 77:101521. [PMID: 39342773 DOI: 10.1016/j.ienj.2024.101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 09/05/2024] [Accepted: 09/21/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION The pediatric emergency department can be a place of fear and pain during treatment. This study was to determine the effect of the kaleidoscope on the fear and pain levels of children aged 4-12 years admitted to the pediatric emergency department for suturing. METHOD This study was conducted as a randomized controlled experimental study. The sample size was calculated by taking into account the known score in the GPower 3.1.5 program. The sample size was calculated as 112 in total. Children with head or limb injuries were randomly assigned to their groups. Data were collected using "Information form", "Children's Fear Scale (CFS), Wong Baker Pain Scale, Kaleidoscope and Stopwatch". The data were evaluated by percentage, mean, standard deviation, chi-square, t test, correlation analysis and Krusskal Wallis test in computerized environment. RESULTS The majority of children were male (60.7 %) and the mean age was 7.75 ± 2.79 years. Demographic variables, fear and pain scores of the children were similar before the procedure. After the procedure, the mean fear score was 1.71 ± 1.27 for the kaleidoscope group and 3.23 ± 0.89 for the control group, and the difference between the groups was found to be significant (p < 0.01). When the difference between the groups was examined in terms of the pain status of the children after the procedure, it was observed that the pain level of the children in the kaleidoscope group (1.77 ± 1.12) was significantly lower than the pain level of the children in the control group (3.30 ± 0.91) (p < 0.05). In conclusion, it was found that the use of kaleidoscope during suturing procedure decreased children's fear and pain levels. Therefore, it is recommended that the use of kaleidoscope during suturing should be widespread.
Collapse
Affiliation(s)
| | - Ayşe Sonay Turkmen
- Karamanoglu Mehmetbey University, Health Science Faculty Nursing Department, Karaman, Turkey.
| |
Collapse
|
2
|
Ates Besirik S, Canbulat Sahiner N. Comparison of the effectiveness of three different distraction methods in reducing pain and anxiety during blood drawing in children: A randomized controlled study. J Pediatr Nurs 2024; 79:225-233. [PMID: 39303378 DOI: 10.1016/j.pedn.2024.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/20/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Healthcare professionals need to use effective pain and anxiety-relieving methods during blood drawing in children. AIM This study aimed to compare the effects of three different distraction methods (Virtual Reality Glasses, Kaleidoscope, and Distraction Cards) in reducing pain and anxiety during blood drawing in children. METHODS This study was a randomized controlled study. The research was conducted on 400 children between the ages of 7 and 11 years who required blood for routine check-ups upon the doctor's request and who met the sample selection criteria. Children were randomized into four groups: Virtual Reality Glasses, Kaleidoscope, Distraction Cards, and Control Group. Data were collected using the Interview and Observation Form, Wong-Baker FACES Pain Rating Scale, and Children's Fear Scale. Wong-Baker FACES and Children's Fear Scale were assessed and reported by children, parent, and observer. FINDINGS Pain assessments of the child, parent, and observer after the procedure, and anxiety assessments of the parent, and observer after the procedure in the Virtual Reality Glasses, Kaleidoscope, and Distraction Cards Group were significantly lower than the Control Group (p < 0.001). CONCLUSIONS All three methods applied to the child during blood drawing were effective in reducing the child's pain and anxiety level. However, it was found that the most effective method to relieve pain and anxiety is virtual reality glasses. PRACTICE IMPLICATIONS These results contribute to the pain and anxiety management of children during blood drawing. CLINICAL TRIAL REGISTRATION NUMBER NCT06192498.
Collapse
Affiliation(s)
- Selda Ates Besirik
- Burdur Mehmet Akif Ersoy University, Bucak School of Health, Department of Nursing, Department of Pediatric Nursing, Burdur, Turkey.
| | - Nejla Canbulat Sahiner
- Karamanoglu Mehmetbey University Health Science Faculty, Nursing Department, Karaman, Turkey
| |
Collapse
|
3
|
Buchanan C, Burt A, Moureau N, Murray D, Nizum N. Registered Nurses' Association of Ontario (RNAO) best practice guideline on the assessment and management of vascular access devices. J Vasc Access 2024; 25:1389-1402. [PMID: 37125815 DOI: 10.1177/11297298231169468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION Vascular access is the most common invasive procedure performed in health care. This fundamental procedure must be performed in a safe and effective manner. Vascular access devices (VADs) are often the source of infections and other complications, yet there is a lack of clear guidance on VADs for health providers across different settings. A Best Practice Guideline (BPG) was developed by the Registered Nurses' Association of Ontario (RNAO) to provide evidence-based recommendations on the assessment and management of VADs. METHODS RNAO BPGs are based on systematic reviews of the literature following the GRADE approach. Experts on the topic of vascular access were selected to form a panel. Systematic reviews were conducted on six research areas: education, vascular access specialists, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. A search for relevant research studies published in English limited to January 2013 was applied to eight databases. All studies were independently assessed for eligibility and risk of bias by two reviewers based on predetermined inclusion and exclusion criteria. The GRADE approach was used to determine certainty of the evidence. RESULTS Over 65,000 articles were screened related to the six priority research questions. Of these, 876 full-text publications were examined for relevance, with 174 articles designated to inform nine recommendations in the BPG on the subject areas of: comprehensive health teaching, practical education for health providers, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. In June 2021, the RNAO published the BPG on vascular access, which included the recommendations and other supporting resources. CONCLUSION The vascular access BPG provides high quality guidance and updated recommendations, and can serve as a primary resource for health providers assessing and managing VADs.
Collapse
Affiliation(s)
| | - Amy Burt
- Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Nancy Moureau
- PICC Excellence, Hartwell, GA, USA; Griffith University, Brisbane, QLD
| | | | - Nafsin Nizum
- Registered Nurses' Association of Ontario, Toronto, ON, Canada
| |
Collapse
|
4
|
Wei Q, Sun R, Liang Y, Chen D. Virtual reality technology reduces the pain and anxiety of children undergoing vein puncture: a meta-analysis. BMC Nurs 2024; 23:541. [PMID: 39112987 PMCID: PMC11304930 DOI: 10.1186/s12912-024-02184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 07/15/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Pain management is an important part of nursing care for children. The objective of this study was to systematically assess the impact of virtual reality (VR) technology on alleviating the pain and anxiety experienced by children during venipuncture procedures. METHODS This study searched Pubmed, Web of Sciences, Scopus, The Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu and China biomedical databases on the randomized controlled trials (RCTs) of virtual reality technology for relieving pain and anxiety associated with venous puncture for children up to July 6, 2024. Risk of bias tool recommended by Cochrane library was used to evaluate the RCT quality. RevMan 5.3 software was used for statistical analysis. RESULTS A total of 10 RCTs involving 874 children were included. 429 children received VR intervention during vein puncture. VR was beneficial to reduce the children's self-reported pain scores [SMD=-0.48, 95% CI (- 0.61, - 0.35)], children's caregivers reported needle-related pain level [SMD=-0.93, 95% CI (-1.45, - 0.42)], children's self-reported anxiety scores [SMD=-0.45, 95% CI (- 0.65, - 0.25)], children's caregivers reported needle-related anxiety level [SMD=-0.47, 95% CI (- 0.73, - 0.21)]. Egger regression tests indicated that there were no publication biases in the synthesized outcomes (all P > 0.05). CONCLUSIONS VR technology has been shown to effectively mitigate the pain and anxiety experienced by children during venipuncture. Despite the positive findings, more research is needed to better understand the role of VR in children undergoing venipuncture.
Collapse
Affiliation(s)
- Qin Wei
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Rong Sun
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Yan Liang
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Dan Chen
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China.
| |
Collapse
|
5
|
Pattabi A, Nazarene A, Varghese S, Hassan SM, Nashwan AJ, Patil SK, Singh K. Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar. Front Pediatr 2024; 12:1279033. [PMID: 38774295 PMCID: PMC11106397 DOI: 10.3389/fped.2024.1279033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/24/2024] Open
Abstract
Background "Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. Aim This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. Methods This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. Results A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. Conclusion The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.
Collapse
Affiliation(s)
- Amudha Pattabi
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Ananth Nazarene
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | - Sejo Varghese
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdulqadir J. Nashwan
- Department of Nursing Education and Practice Development, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Surekha Kiran Patil
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
6
|
Uzsen H, Tural Buyuk E, Odabasoglu E, Koyun M. The effects of vibration and pressure interventions on children's pain, fear and anxiety: A randomized controlled trial. J Pediatr Nurs 2024; 75:196-204. [PMID: 38171061 DOI: 10.1016/j.pedn.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
AIM The effects of vibration and pressure methods on the level of fear, anxiety, and pain of pediatric patients who were admitted to the emergency department for intramuscular injection were evaluated. METHODS This was a parallel group and a randomized controlled study conducted in Turkey. The study sample consisted of 114 children aged between 5 and 10 years who presented to the emergency department to receive intramuscular ceftriaxone injection as part of their treatment. The children were randomized into three groups: Vibration Intervention Group (n = 38), Pressure Intervention Group (n = 38) and Control Group (n = 38). Before the procedure, the level of anxiety and fear of the children were evaluated, and the level of perceived pain during the procedure was immediately evaluated after the intervention. Parents and nurses also rated the level of pain. Data were analyzed with non-parametric tests using SPSS version 26.0. RESULTS According to the evaluations made by children, mothers, and nurses, there was a significant difference between pain scores of children in the vibration and pressure intervention groups during the procedure and children in the control group (p < 0.000). There was a significant difference between anxiety and fear scores of children in the vibration and pressure groups and children in the control group before and after the intervention according to the evaluations of the children, mothers, and nurses (p < 0.000). CONCLUSION Vibration and pressure interventions used during intramuscular injections administered to children in the emergency department were found to reduce pain, anxiety, and fear based on the evaluations of children, mothers, and nurses. PRACTICE IMPLICATIONS Vibration and pressure are effective and useful in relieving pain associated with intramuscular injections in children aged between 5 and 10 years.
Collapse
Affiliation(s)
- Hatice Uzsen
- Nursing Department, Pediatric Nursing, Health Sciences Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Esra Tural Buyuk
- Nursing Department, Pediatric Nursing, Health Sciences Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Emel Odabasoglu
- Pediatric Nursing Department, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Merve Koyun
- Nursing Department, Pediatric Nursing, Health Sciences Faculty, Ondokuz Mayis University, Samsun, Turkey.
| |
Collapse
|
7
|
Utsumi S, Maiko S, Moriwaki T, Miyake H, Yuhei S, Kubota S, Uematsu S, Takehara K, Kubota M. Benefits to Clinicians of Nonpharmacological Distraction During Pediatric Medical Procedure. Hosp Pediatr 2024; 14:e123-e131. [PMID: 38273770 DOI: 10.1542/hpeds.2023-007322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
CONTEXT Nonpharmacologic distraction (NPD) during medical procedures in children is known to be beneficial to patients; however, no reviews have assessed their benefits to medical providers. OBJECTIVES We aimed to assess the benefits of NPD to medical providers. DATA SOURCES We searched 5 databases for relevant articles. STUDY SELECTION Peer-reviewed published randomized controlled trials comparing NPD with standard care that included children who had undergone medical procedures were included. DATA EXTRACTION Primary outcomes were procedure time, number of medical staff involved, and initial success rate of venipuncture. Two reviewers assessed the risk of bias by using the Cochrane Collaboration (Oxford, United Kingdom)'s Randomized Controlled Trials Risk of Bias Tool, and we performed a meta-analysis to assess efficacy. RESULTS We included 22 trials with 1968 participants. The main NPD was audiovisual distraction, such as tablets. No significant difference was found in venipuncture procedure time (mean difference: -9.79; 95% confidence interval: -22.38 to 2.81; low certainty). We found no studies on the number of medical staff. CONCLUSIONS Our review did not find any clear NPD-associated benefit for the medical provider. The review included a small amount of literature, analyzed a small number of cases, and had a low certainty of evidence regarding procedure duration; therefore, further studies are needed to conclude the benefits to clinicians of NPD.
Collapse
Affiliation(s)
- Shu Utsumi
- Division of Emergency and Transport Services
| | | | | | - Hiromu Miyake
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Shimada Yuhei
- School of Public Health, Department of Medicine, the University of Tokyo, Tokyo, Japan
| | - Shoko Kubota
- School of Public Health, Department of Medicine, the University of Tokyo, Tokyo, Japan
| | | | | | - Mitsuru Kubota
- General Medicine and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| |
Collapse
|
8
|
Kurt A, Dinç F, Akkoç B. Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study. Arch Pediatr 2024; 31:148-154. [PMID: 38262864 DOI: 10.1016/j.arcped.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain. AIM This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection. METHOD This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4-10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong-Baker FACES Pain Rating Scale, the Child Anxiety Scale-State, and the Child Fear Scale. RESULTS After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p<0.001 for all scores). CONCLUSION The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection.
Collapse
Affiliation(s)
- Aylin Kurt
- Bartın University, Faculty of Health Sciences, Department of Nursing, Bartın, Turkey.
| | - Fatma Dinç
- Bartın University, Faculty of Health Sciences, Department of Nursing, Bartın, Turkey.
| | - Betül Akkoç
- Bartın Maternity and Children's Hospital, Bartın, Turkey.
| |
Collapse
|
9
|
Yaz ŞB, Başdemir S, Geçtan E. The effect of vibrating cold application and puppet use on pain and fear during phlebotomy in children: A randomized controlled study. J Pediatr Nurs 2024; 74:77-84. [PMID: 38029689 DOI: 10.1016/j.pedn.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/11/2023] [Accepted: 11/12/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Non-pharmacological methods are often used as a creative strategy to reduce pain and fear in children during a painful procedure such as phlebotomy. OBJECTIVES This study was conducted to evaluate the effects of Bee Buzzy and puppet use on pain and fear during phlebotomy in children. METHODS This randomized controlled study was conducted in the pediatric phlebotomy unit of a university hospital. The CONSORT checklist was used in this study. The sample of 3-6 years children (n = 105) was divided into groups by block randomization. Children's pain and fear scores were evaluated with the Wong-Baker Faces Pain Rating Scale and Children's Fear Scale by the parents and the nurse who attempted phlebotomy during phlebotomy. RESULTS A statistically significant difference was found between the Bee Buzzy and puppet and Bee Buzzy and control groups in pain scores (p < .05). Pain scores were lower in the Bee Buzzy group than in the puppet and control groups. A statistical difference was found between Bee Buzzy and the control group or puppet and control group according to all fear scores (p < .05). Fear scores were lower in the Bee Buzzy and puppet group (p < .05). CONCLUSIONS The results show that the use of Bee Buzzy during phlebotomy has a pain-relieving effect, and the use of Bee Buzzy and puppet has an anti-fear effect in 3-6-year-old children. IMPLICATIONS FOR PRACTICES The use of Bee-Buzzy and puppets is effective in reducing pain and fear in children as they increase effective communication and distract attention. CLINICAL TRIAL REGISTRATION National Institutes of Health (NIH), ClinicalTrials.gov, NCT05827783.
Collapse
Affiliation(s)
- Şeyda Binay Yaz
- Izmir Bakırcay Unıversity, Faculty of Health Sciences, Pediatric Nursing Department, Izmir, Turkey.
| | - Sinem Başdemir
- Izmir Bakırcay Unıversity, Faculty of Health Sciences, Pediatric Nursing Department, Izmir, Turkey.
| | - Eliz Geçtan
- Izmir Provincial Health Directorate Bakırçay University Çiğli Regional Education Hospital, Izmir, Turkey.
| |
Collapse
|
10
|
Einarsdóttir Egeland S, Lie HC, Woldseth EM, Korsvold L, Ruud E, Larsen MH, Viktoria Mellblom A. Exploring reported distress before and pain during needle insertion into a venous access port in children with cancer. Scand J Caring Sci 2023; 37:927-937. [PMID: 35076943 DOI: 10.1111/scs.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Venous access port is commonly used during cancer treatment in children, yet little is known about how children experience such needle insertion procedures. AIM To study distress before and pain after venous access port needle insertion among children and adolescents with cancer. A second aim was to explore associations between their self-report of procedure-related distress and pain with proxy reports by parents and nurses. METHOD The sample included 43 children/adolescents, aged 1-16 years with cancer, treated at two Norwegian university hospitals. The patient, parent(s), and the nurse performing the procedure completed developmentally appropriate 11-point distress and pain scales before and immediately after the venous access port procedure. Data were analysed using descriptive statistics and non-parametric correlations. ETHICAL ISSUES The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Regional Committee for Medicine and Health Research and the data protector officer at the hospitals. RESULTS For the youngest children (1-5 years), the median distress proxy score was 8 (range 0-9) and pain proxy score 4 (range 0-10). Median distress and pain scores for children aged 6-12 years were 3 (range 0-9) and 1 (range 0-10), respectively, and for the adolescents (age 13-16) 0 (range 0-6) and 1 (range 0-5), respectively. Patients' self-reported distress and pain correlated highly with parents' (distress: rho = 0.83, p < 0.001, pain: rho = 0.92, p < 0.001) and with nurses' proxy ratings (distress: rho = 0.89, p < 0.001, pain: rho = 0.88, p < 0.001). CONCLUSION There were individual age differences in experienced distress/pain associated with venous access port needle insertion, with a trend for younger children to experience higher levels of distress/ pain than the older children. Children's self-report of distress/ pain concurred with both parental and nurse proxy reports.
Collapse
Affiliation(s)
- Steinunn Einarsdóttir Egeland
- Department of Paediatric Oncology and Haematology, Division for Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen Martha Woldseth
- Department of Pediatric Oncology Medicine and Haematology, Division for Pediatric and Adolescent Medicine, St.Olav's Hospital, University Hospital of Trondheim, Norway
| | | | - Ellen Ruud
- Department of Paediatric Oncology and Haematology, Division for Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Marie Hamilton Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Anneli Viktoria Mellblom
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP), Oslo, Norway
| |
Collapse
|
11
|
Turczynowicz A, Jakubów P, Niedźwiecka K, Kondracka J, Pużyńska W, Tałałaj M, Guszczyn T, Grabala P, Kowalczuk O, Kocańda S. Mu-Opioid Receptor 1 and C-Reactive Protein Single Nucleotide Polymorphisms as Biomarkers of Pain Intensity and Opioid Consumption. Brain Sci 2023; 13:1629. [PMID: 38137077 PMCID: PMC10741726 DOI: 10.3390/brainsci13121629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Children constitute a special group in pain therapy. Single nucleotide polymorphisms that are associated with differences in postoperative, inflammatory pain perception and opioid requirement are the A118G SNP in the mu-opioid receptor 1 (OPRM1) gene and the rs1205 CRP. This study aimed to determine connection between OPRM1 and rs1205 CRP SNPs in pediatric patients postoperatively and pain intensity, the opioid dose needed to control pain after scoliosis correction, and other clinical aspects. Genotypes of rs1205 CRP and OPRM1 polymorphisms in a sample of 31 patients were specified, and statistical analysis was performed in terms of age, genotype frequency, pain assessment, sufentanil flow, post-anesthesia care unit stay, and the use of coanalgesics. The frequency of A/A and A/G genotypes in the OPRM1 gene was in line with 1000Genomes data for the European population. Patients from the AG group of OPRM1 SNP more frequently required coanalgesics for adequate pain control; however, it was of weak statistical significance. Other parameters measured in the study were not statistically significant in relation to OPRM1 and CRP polymorphisms. The effect of SNPs on postoperative pain management and opioid therapy in children was not confirmed by this study. An expansion of the study sample and other opioid-related SNPs is required.
Collapse
Affiliation(s)
- Aleksander Turczynowicz
- Department of Anesthesiology and Intensive Care for Children and Adolescents with Postoperative and Pain Treatment Unit, Medical University of Bialystok, 15-274 Bialystok, Poland; (P.J.); (J.K.); (M.T.)
| | - Piotr Jakubów
- Department of Anesthesiology and Intensive Care for Children and Adolescents with Postoperative and Pain Treatment Unit, Medical University of Bialystok, 15-274 Bialystok, Poland; (P.J.); (J.K.); (M.T.)
| | - Karolina Niedźwiecka
- Department of Cardiosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland; (K.N.)
| | - Julia Kondracka
- Department of Anesthesiology and Intensive Care for Children and Adolescents with Postoperative and Pain Treatment Unit, Medical University of Bialystok, 15-274 Bialystok, Poland; (P.J.); (J.K.); (M.T.)
| | - Weronika Pużyńska
- Department of Palliative Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Mariola Tałałaj
- Department of Anesthesiology and Intensive Care for Children and Adolescents with Postoperative and Pain Treatment Unit, Medical University of Bialystok, 15-274 Bialystok, Poland; (P.J.); (J.K.); (M.T.)
| | - Tomasz Guszczyn
- Department of Pediatric Orthopedics and Traumatology, Medical University of Bialystok, 15-274 Bialystok, Poland; (T.G.); (P.G.)
| | - Paweł Grabala
- Department of Pediatric Orthopedics and Traumatology, Medical University of Bialystok, 15-274 Bialystok, Poland; (T.G.); (P.G.)
| | - Oksana Kowalczuk
- Department of Clinical Molecular Biology, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Szymon Kocańda
- Department of Cardiosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland; (K.N.)
| |
Collapse
|
12
|
Cil M, Fidanci BE. The effect of dry heat and dry cold application on pain, anxiety and fear levels before blood sample collection in school age children (7-12 years): A randomized controlled study. J Pediatr Nurs 2023; 73:e401-e408. [PMID: 37863785 DOI: 10.1016/j.pedn.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Blood sampling, which is frequently performed on children admitted to hospital, causes them pain, anxiety and fear. OBJECTIVES The study was carried out to determine the effects of dry heat and dry cold application before blood sampling on pain, anxiety and fear levels in school age children. METHODS The study was conducted between June and January 2021 with a parallel-group randomized controlled experimental design. It was carried out with 117 children who applied to the Pediatric Blood Collection Polyclinic of a training and research hospital. The children were assigned to dry heat application, dry cold application and control group by simple randomization. Data were collected using the Child-Family Introductory Information Form, Wong Baker Faces Pain Rating Scale (WBFPS), Child Fear Anxiety Scale (CFAS) and Medical Procedure Fear Scale (MPFS). In the data analysis, descriptive statistics, the Kruskal-Wallis H test, the Dunn test, Yates correction and the Pearson Chi-Square test were used. A level of p < 0.05 was considered statistically significant. RESULTS It was found that children who were treated with dry heat and dry cold before blood sampling experienced less pain. The anxiety of the children in the dry heat treatment group was lower than the control group. According to the children's MPFS Operational Fear sub-dimension median scores, procedural fear was found to be lower in the dry heat application group. PRACTICE IMPLICATIONS Pediatric nurses can safely use dry heat and dry cold application in the management of invasive procedure-related pain, and dry heat application in the management of anxiety. TRIAL REGISTRATION This trial is registered with the US National Institutes of Health (ClinicalTrials.gov) under the number NCT05974319.
Collapse
Affiliation(s)
- Merve Cil
- Department of Child Health and Disease Nursing, Faculty of Health Sciences, University of Lokman Hekim, Söğütözü, Ankara, Turkey.
| | - Berna Eren Fidanci
- Department of Child Health and Disease Nursing, Gulhane Faculty of Nursing, University of Health Sciences, Etlik, Ankara, Turkey.
| |
Collapse
|
13
|
Bilgen Sivri B, Feng YS, Michler C, Kuemmerle-Deschner J, Mahler C. The effect of buzzy®, DistrACTION® cards on reducing pediatric pain and fear during blood collection in the rheumatology polyclinic: A randomized controlled trial. J Pediatr Nurs 2023; 73:e446-e454. [PMID: 37919179 DOI: 10.1016/j.pedn.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/08/2023] [Accepted: 10/08/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE The aim of this study was to compare the effectiveness of Buzzy® and DistrACTION® Cards in reducing children's pain and fear while taking venous blood samples. METHODS This research was designed as a randomized controlled experimental study. The study population consisted of children aged 6-12 years admitted to the Pediatric Rheumatology Diseases Polyclinic in a Faculty of Medicine in Germany. The sample of the study consisted of 96 children (Buzzy® = 32, DistrACTION® Cards = 32, control = 32) who met the patient selection criteria and agreed to participate in the study. The data were obtained using a Child and Family Information Form, the Children Fear Scale (CFS), and the Faces Pain Scale-Revised (FPS-R). The data were evaluated using the Pearson chi-square test, Kruskal-Wallis test, One-way ANOVA test with Bonferroni correction, and Fisher-Freeman-Halton. FINDINGS In the study, the average age of the children was 9.21 ± 2.15 years. The Buzzy® group had the lowest pain and procedural fear scores (self-report = 0.88 ± 1.13, 0.31 ± 0.47; parent report = 0.75 ± 0.98, 0.34 ± 0.48, and researcher report = 0.81 ± 1.00, 0.31 ± 0.54, respectively) than the DC, and control groups. CONCLUSIONS The Buzzy® method was effective in reducing venipuncture pain and fear in children. PRACTICE IMPLICATIONS Nurses can use the Buzzy® methods to help reduce venipuncture pain and fear in children. The clinical trial registration number is NCT05560074. (https://clinicaltrials.gov/ct2/show/study/NCT05560074).
Collapse
Affiliation(s)
- B Bilgen Sivri
- University of Tuebingen, Department of Nursing Science, Hoppe-Seyler-Str. 9, 72076 Tübingen, Germany.
| | - Y S Feng
- University of Tuebingen, Institute for Clinical Epidemiology and Applied Biometry (IKEAB), Silcherstraße 5, 72076 Tübingen, Germany.
| | - C Michler
- University of Tuebingen, Department of Pediatric Rheumatology Clinic, Hoppe-Seyler-Str.1, 72076 Tübingen, Germany.
| | - J Kuemmerle-Deschner
- University of Tuebingen, Department of Pediatric Rheumatology Clinic, Hoppe-Seyler-Str.1, 72076 Tübingen, Germany.
| | - C Mahler
- University of Tuebingen, Department of Nursing Science, Hoppe-Seyler-Str. 9, 72076 Tübingen, Germany.
| |
Collapse
|
14
|
Merino-Lobato C, Rodríguez-Gallego I, Pabón-Carrasco M, Romero-Castillo R, Jiménez-Picón N. Virtual reality vs. buzzy®. efficacy in pain and anxiety management during pediatric venipuncture. Systematic review and meta-analysis. J Pediatr Nurs 2023; 73:22-33. [PMID: 37603924 DOI: 10.1016/j.pedn.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/13/2023] [Accepted: 08/13/2023] [Indexed: 08/23/2023]
Abstract
PROBLEM Non-pharmacological distraction methods are novel alternatives that can help to alleviate pain and anxiety generated by venipuncture in the pediatric population. The aim is to determine the effectiveness of virtual reality, compared to cold and vibration devices (Buzzy® device), as a distraction method used during venipuncture in the management of pain and anxiety in children. ELIGIBILITY CRITERIA Clinical trials, cohort and quasi-experimental studies, published between 2017 and 2022, in Spanish or English and pediatric age, found in Medline, the Cochrane Library, Scopus, Web Of Science, CINAHL and Embase databases. SAMPLE Twenty-one studies were included and ten met the criteria for meta-analysis. RESULTS Fifty-seven percent of the studies evaluate virtual reality, 33.3% the Buzzy® device and 9.5% both comparatively. The effectiveness of virtual reality in reducing pain (66.6%, n = 14) and anxiety (47.6%, n = 10) compared to standard care (control group), 95% CI = 1.53 [0.91-2.16], p < 0.001, I2 = 78% and 95% CI = 1.53 [1.16-1.90]), p < 0.001, I2 = 77% respectively is demonstrated. Similarly, the effectiveness of Buzzy® in reducing pain (42.9%, n = 9) and anxiety (23.8%, n = 5), 95% CI = 1.62 [0.90-2.34], p < 0.001, I2 = 94% and 95% CI = 1.40 [0.06-2.20, p < 0.001, I2 = 91% respectively is demonstrated. Comparatively, there is no significant difference between both methods 95% CI = 0.29 [-0.19-0.78], p = 0.24, I2 = 81%. CONCLUSIONS The methods studied are effective in relieving pain and anxiety during venipuncture. Further research is needed on the level of satisfaction, adverse effects and cost-benefit. IMPLICATIONS This study provides evidence of novel tools in daily practice to provide more humane, holistic and quality care.
Collapse
Affiliation(s)
| | - Isabel Rodríguez-Gallego
- Virgen del Rocio University Hospital, 41013, Seville, Spain; Centro Universitario de Enfermería Cruz Roja, adscrito a la Universidad de Sevilla, 41009 Seville, Spain.
| | | | - Rocío Romero-Castillo
- Departamento de Enfermería de la Universidad de Sevilla, Centro Universitario de Enfermería Cruz Roja, adscrito a la Universidad de Sevilla, 41009 Seville, Spain.
| | - Nerea Jiménez-Picón
- Centro Universitario de Enfermería Cruz Roja, adscrito a la Universidad de Sevilla, 41009 Seville, Spain.
| |
Collapse
|
15
|
Arıkan A, Esenay FI. The Effect of Distraction Methods During Venous Blood Sampling on Pain Levels in School-Age Children: A Systematic Review. Pain Manag Nurs 2023; 24:e109-e114. [PMID: 37479642 DOI: 10.1016/j.pmn.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 06/12/2023] [Accepted: 06/30/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVES This systematic review was conducted to examine the available evidence on the effects of distraction methods during venous blood sampling on pain levels in school-age children. DESIGN A systematic review. DATA SOURCES Pubmed, Web of Science, Scopus, Science Direct were searched using search terms. REVIEW/ANALYSIS METHODS A systematic review of all relevant articles published between June 2017 and June 2022, was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. RESULTS The applied search strategy identified 612 articles in four databases. A total of 2,032 school-age children in the 15 studies who met the study inclusion criteria were included in the review. Four studies used active distraction, eight studies used passive distraction, and three studies used both distraction methods. CONCLUSIONS Active and passive distractions are efficacious interventions during venous blood sampling in reducing pain in school-age children. However, more studies are needed to determine the superiority between these two methods.
Collapse
Affiliation(s)
- Aylin Arıkan
- From the Graduate Schools of Health Sciences at Ankara University, Ankara, Turkey.
| | - Figen Işık Esenay
- Assistant Professor, Department of Pediatric Nursing, Faculty of Nursing, Ankara University, Ankara, Turkey
| |
Collapse
|
16
|
Simoncini E, Stiaccini G, Morelli E, Trentini E, Peroni DG, Di Cicco M. The Effectiveness of the Buzzy Device in Reducing Pain in Children Undergoing Venipuncture: A Single-Center Experience. Pediatr Emerg Care 2023; 39:760-765. [PMID: 37478814 PMCID: PMC10547103 DOI: 10.1097/pec.0000000000003011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
OBJECTIVES Needle-related procedures are among the most important sources of pain in children in different health care settings. Our study was aimed to evaluate the effectiveness of Buzzy (MMJ Labs, Atlanta, Ga.), a palm-sized bee/ladybug-shaped device combining vibration and cold, as a nonpharmacological strategy to manage needle-related pain in children. METHODS In this single-center, randomized (1:1) controlled open-label study, we enrolled patients aged from 1 month to 18 years who had to undergo a planned outpatient blood sampling in Pisa University Hospital's Department of Pediatrics and randomly allocated them to either the BUZZY group (intervention group) or NO BUZZY group (control group). Pain was estimated using proper pain scales according to age. RESULTS Between May 2021 and January 2022, 234 children aged 8.8 ± 5.1 years (50.8% girls) were enrolled and 117 were treated with the Buzzy device. In the study population, pain inversely correlated with age (r = -0.52, P < 0.001); the intervention group showed significantly lower pain (2.5 ± 2.4 vs 4.7 ± 2.8, P < 0.001) and no difference was found between boys and girls. Significant reduction in pain scores was confirmed when stratifying children by age (29 days to <3 years, P = 0.002; ≥3 to ≤8 years, P < 0.001; >8 years, P < 0.001). CONCLUSIONS The Buzzy device effectively reduces pain caused by percutaneous antecubital venipuncture in children in different age groups and represents a cheap and easy-to-use strategy to manage routine needle-related procedures.
Collapse
Affiliation(s)
- Elisa Simoncini
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
| | - Giulia Stiaccini
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elena Morelli
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Trentini
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
| | - Diego G. Peroni
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Di Cicco
- From the Paediatrics Unit, Pisa University Hospital, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
17
|
Akarsu Ö, Semerci R, Kılınç D. The Effect of 2 Different Distraction Methods on Pain, Fear, and Anxiety Levels During Venous Blood Draw in Children in a Pediatric Emergency Unit: A Randomized Controlled Study. J Nurs Care Qual 2023; 38:E51-E58. [PMID: 36943230 DOI: 10.1097/ncq.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Blood draw procedures can cause pain, fear, and anxiety in the pediatric population. PURPOSE To compare the effects of watching cartoons either with virtual reality (VR) or via a tablet on pain, fear, and anxiety during venous blood draw procedures in children. METHODS A randomized controlled study was conducted with 159 children aged 5 to 12 years in the pediatric emergency unit. The 3 groups included cartoons with VR (n = 53) or a tablet (n = 53), and a control group (n = 53). RESULTS Children in the 2 intervention groups had lower perceptions of pain, fear, and anxiety, with those watching cartoons via VR having the lowest perceptions. CONCLUSIONS Findings from this study showed a reduction in the perception of pain, fear, and anxiety in children who watched cartoons with VR or tablets during blood draw procedures. Nurses should consider using these nonpharmacological methods to reduce pain, fear, and anxiety, among pediatric patients.
Collapse
Affiliation(s)
- Özlem Akarsu
- Department of Pediatric Nursing, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey (Dr Akarsu); Department of Pediatric Nursing, Faculty of Nursing, Koç University, İstanbul, Turkey (Dr Semerci); and Health Sciences University Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, İstanbul, Turkey (Dr Kilinç)
| | | | | |
Collapse
|
18
|
Calandrino A. End of Life in Pediatrics: The "Relief" of Poetry on Pain by Reaching Children's Spirituality. J Pain Symptom Manage 2023; 66:e443-e447. [PMID: 36332770 DOI: 10.1016/j.jpainsymman.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Andrea Calandrino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (A.C.), University of Genoa, 16132 Genoa, Liguria, Italy; IRCCS Istituto Giannina Gaslini (A.C.), 16147 Genoa, Liguria, Italy.
| |
Collapse
|
19
|
Maiandi S, Ghizzardi G, Edefonti V, Giacchero R, Lusignani M, Giannì ML. Is the equimolar mixture of oxygen and nitrous oxide (EMONO) associated with audiovisuals effective in reducing pain and side effects during peripheral venous access placement in children? Protocol for a single-centre randomised controlled trial from Italy. BMJ Open 2023; 13:e067912. [PMID: 37419632 PMCID: PMC10335544 DOI: 10.1136/bmjopen-2022-067912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/31/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Nurses frequently place a peripheral venous catheter during children's hospitalisation. Many studies suggest treatment of venipuncture-related pain. The administration of an equimolar mixture of oxygen and nitrous oxide (EMONO) is employed for pain control; however, no studies have analysed the association between EMONO and audiovisuals.The purpose of the study is to evaluate the effect of EMONO administration when combined with audiovisuals (EMONO+Audiovisual) versus EMONO alone on perceived pain, side effects and level of cooperation during peripheral venous access placement in children aged 2-5 years. METHODS AND ANALYSIS The first 120 eligible children admitted to the paediatric ward of the Lodi Hospital and presenting the indication for peripheral venous access will be enrolled. Sixty children will be randomly assigned to the experimental group (EMONO+Audiovisual) and 60 to the control group (EMONO alone).The Face, Legs, Activity, Cry, Consolability scale will be used to assess pain in the children aged 2-years old; pain in the children aged 3-5 years will be assessed using the Wong-Baker scale. The cooperation throughout the procedure will be measured using the Groningen Distress Rating Scale. ETHICS AND DISSEMINATION The Milan Area 1 Ethics Committee approved the study protocol (Experiment Registry No. 2020/ST/295). The trial results will be presented at conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05435118.
Collapse
Affiliation(s)
- Stefano Maiandi
- Healthcare Professions Directorate - ASST di Lodi, Lodi, Italy
| | - Greta Ghizzardi
- Healthcare Professions Directorate - ASST di Lodi, Lodi, Italy
| | - Valeria Edefonti
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology, "G.A. Maccacaro," University of Milan, Milano, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Maura Lusignani
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milano, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| |
Collapse
|
20
|
Shabani SM, Darabi F, Azimi A, Shabani M. Effectiveness of motion graphic-based narrative therapy with a cognitive-behavioral approach in reducing fluoride varnish therapy anxiety for six-year-old children. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:189. [PMID: 37545986 PMCID: PMC10402765 DOI: 10.4103/jehp.jehp_837_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND Fluoride varnish therapy (FVT) is a dental caries preventive service that its effectiveness has been well documented. A lot of children, especially the five-year-old and six-year-old ones, are suffering with anxiety during this service and do not readily allow it. The present study aimed to cast light on the effect of motion graphic-based narrative story with a cognitive-behavioral approach in reducing FVT anxiety among six-year-old children. MATERIALS AND METHODS This study was an intervention trial type that was conducted in Ardabil city and among school students. Five children suffering from FVT anxiety were randomly selected for the intervention. First, Venham and Gaulin-Kremer's anxiety scale was completed for them. The motion graphic-based narrative therapy was implemented for six weeks. Session 1 was assigned to filling the questionnaire and collecting data. The motion graphic-based narrative therapy started from the second session. The anxiety scale was filled for the children every ten days for a total of four times. The results were analyzed by Blanchard and Schwarz's progress formula and control charts. The intervention sessions included gathering information, watching motion graphics, relaxation skills, watching the process of performing fluoride varnish therapy, teaching the advantages of fluoride varnish therapy, and in the last session performing fluoride varnish therapy with the technique of attention diversion while watching motion graphics. RESULTS The motion graphic-based narrative therapy by the cognitive-behavioral approach proved effective in reducing anxiety. At the end of the intervention sessions, the level of anxiety decreased from 8 to 2.2 and the statistical control chart of the process shows that the intervention process is stable and the stability in order to reduce anxiety and the results are within the control limits. CONCLUSION The results show that motion graphic-based narrative therapy can be a psychotherapy method for reducing the symptoms of dental anxiety among children.
Collapse
Affiliation(s)
- Sevil Momeni Shabani
- Psychological Counseling and Leadership Group, Department of Educational Sciences, Faculty of Education, Istanbul Kültür University, Istanbul, Turkey
| | - Fatemeh Darabi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Ahad Azimi
- Mental Health Group, Deputy for Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Masoud Shabani
- Department of Community Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| |
Collapse
|
21
|
Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
Collapse
Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
| |
Collapse
|
22
|
Yılmaz D, Ayhan D, Yılmaz DU, Düzgün F. Effect of the coughing technique during subcutaneous heparin injection on pain severity and individual satisfaction. Rev Lat Am Enfermagem 2023; 31:e3923. [PMID: 37194813 PMCID: PMC10202412 DOI: 10.1590/1518-8345.6504.3923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/18/2023] [Indexed: 05/18/2023] Open
Abstract
to examine the effect of the medium intensity coughing technique during subcutaneous low molecular weight heparin injection on pain severity and individual satisfaction in general surgery patients. the prospective, quasi-experimental study included 100 patients who had been prescribed a subcutaneous low molecular weight heparin injection once in 24 hours. Each patient received two injections by the same researcher, one using the standard injection technique with medium intensity coughing technique and the other only the standard injection technique. there was a statistically significant difference between patients' mean scores on pain severity and satisfaction levels after injections administered by the two techniques (p= 0.000). Also, it was found that gender affected pain severity relating to the injection but did not affect the level of individual satisfaction. the medium intensity coughing technique was found to reduce pain severity and increase patient satisfaction in general surgery patients receiving subcutaneous low molecular weight heparin injections. Trial registration: NCT05681338.
Collapse
Affiliation(s)
- Dilek Yılmaz
- Bursa Uludağ University, Faculty of Health Sciences, Department of Nursing, Bursa, Turquía
| | - Dilan Ayhan
- Bursa Uludağ University, Health Application and Research Center, Bursa, Turquía
| | - Derya Uzelli Yılmaz
- Bursa Uludağ University, Health Application and Research Center, Bursa, Turquía
| | - Fatma Düzgün
- İzmir Katip Çelebi University, Faculty of Health Sciences, Department of Nursing, İzmir, Turquía
| |
Collapse
|
23
|
Turgut MA, Türkmen AS. The effect of lighted toy on reducing pain and fear during blood collection in children between 3 and 6 years: A randomized control trial. J Pediatr Nurs 2023; 70:111-116. [PMID: 36905910 DOI: 10.1016/j.pedn.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/05/2023] [Accepted: 02/21/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND This study was carried out as an experimental research to determine the effect of the light toy on reducing pain and fear during blood collection in children. METHODS The data were obtained 116 children. The "Interview and Observation Form Children's Fear Scale, Wong-Baker Faces, Luminous Toy and Stopwatch" was used for data collection. The data were evaluated using percentage, mean, standard deviation, chi-square, t-test, correlation analysis and Krusskal Wallis test in SPSS 21.0 package program. FINDINGS The fear score average of the children in the lighted toy group was 0.95 ± 0.80, while it was 3.00 ± 0.74 in the control group. The difference between the groups in terms of the fear score average of the children was found statistically significant (p < 0.05). When the difference between groups in terms of pain status of children is examined, the pain level of children in the lighted toy group (2.83 ± 2.82,) was found to be significantly lower than the pain level of the children in the control group (5.86 ± 2.72) (p < 0.05). DISCUSSION As a result of the study, it was found that the lighted toy given to the children during blood collection reduces their fear and pain levels. In the light of these findings, it is recommended to increase the use of lighted toys in blood collection. APPLICATION TO PRACTICE The use of lighted toys as a distraction method during blood collection in children is an effective, easy-to-access and low-cost method. This method demonstrates that there is no need for expensive methods of distraction.
Collapse
Affiliation(s)
| | - Ayşe Sonay Türkmen
- Karamanoglu Mehmetbey University Health Science Faculty, Pediatric Nursing Department, Karaman, Turkey
| |
Collapse
|
24
|
Semerci R, Akarsu Ö, Kılıç D. The effect of buzzy and cold spray on pain, anxiety, and fear of children during venipuncture in pediatric emergency department in Turkey; A randomized controlled study. J Pediatr Nurs 2023; 68:e1-e7. [PMID: 36089558 DOI: 10.1016/j.pedn.2022.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE It was aimed to evaluate the efficacy of Buzzy and cold spray in reducing pain, anxiety, and fear of children during venipuncture in the emergency department (ED). METHODS This study is an experimental, parallel-group (intervention-control), randomized controlled, single-blind design. The study was conducted with 161 children aged 5-12 years in pediatric ED. Data were collected by the 'Personal Information Form', 'Wong Baker-Facial Expression Rating Scale', 'Child Anxiety Statement Scale', and 'Child Fear Inventory'. Data were analyzed with descriptive statistics, Mann Whitney U test, Kruskal Wallis H test, and Intraclass Correlation. RESULTS Descriptive features of the children were homogeneous. 'Wong Baker-Facial Expression Rating Scale', 'Child Anxiety Statement Scale', and 'Child Fear Scale' score averages of the children in the control group were higher than the children in the Buzzy group and the cold spray group (p < 0.001). The pain scores of the Buzzy group were higher than those in the cold spray group (p < 0.001). The anxiety and fear mean scores of the children in the Buzzy and cold spray groups were similar (p > 0.05). CONCLUSION It was determined that Buzzy and cold spray were more effective than standard care in reducing the level of pain, anxiety, and fear in children ages 5-12 years during venipuncture in the pediatric emergency. The cold spray was more effective in reducing pain than Buzzy. PRACTICE IMPLICATIONS Nurses can use Buzzy and cold sprays to manage the fear, anxiety, and pain associated with venipuncture.
Collapse
Affiliation(s)
- Remziye Semerci
- Koç University, School of Nursing, Department of Child Health and Disease Nursing, İstanbul, Turkey.
| | - Özlem Akarsu
- Istanbul Medeniyet University, Faculty of Health Sciences, Department of Nursing, Department of Child Health and Diseases, Istanbul, Turkey
| | - Derya Kılıç
- Health Sciences University Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
25
|
Wu Y, Zhao Y, Wu L, Zhang P, Yu G. Non-Pharmacological Management for Vaccine-Related Pain in Children in the Healthcare Setting: A Scoping Review. J Pain Res 2022; 15:2773-2782. [PMID: 36106315 PMCID: PMC9467445 DOI: 10.2147/jpr.s371797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine how research was conducted on non-pharmacological management in children with vaccine-related pain in the healthcare setting, so as to provide reference for the relief of vaccine-related pain in children. Methods This study conducted a scoping review guided by the methodological framework of Arksey and O’Malley. MEDLINE, Cochrane Library, EMBASE, CINAHL, PubMed databases were searched in detail, and search strategy included the keyword “vaccine”, the keyword “pain”, and the keyword “children”. Two researchers conducted literature screening and data extraction independently, and any disagreements were resolved through team consultation. Results This study retrieved 1017 literatures, of which 22 were finally included, including 18 randomized controlled studies, 3 quasi-experimental studies and 1 cohort study. Non-pharmacological management measures were summarized in the study, mainly involving taste, tactile, olfactory, visual, exercise, and postural interventions and injection technique. All the above non-pharmacological management were effective in mitigating vaccine-related pain in children. The study population in the included literatures was mainly neonates and infants. Regarding the analgesic effects of taste intervention, breastfeeding was better than sweeteners, and sweeteners were better than sterile water or non-nutritive sucking. However, there was a lack of comparative studies on the analgesic effects of other non-pharmacological management. Conclusion There are many non-pharmacological management measures with varying analgesic effects. Diversified non-pharmacological management measures can provide more analgesic choices for children. For reducing vaccine-related pain in newborns and infants, breastfeeding is recommended first, then sweeteners, and then non-nutritious sucking. In addition to the taste intervention, the analgesic effects of other non-pharmacological management measures need further comparative studies. Moreover, medical staff can use a combination of non-pharmacological analgesic measures to maximize the analgesic effect, and medical staff should also fully consider the analgesia willingness of children and parents.
Collapse
Affiliation(s)
- Yujie Wu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Liping Wu
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Ping Zhang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Genzhen Yu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| |
Collapse
|
26
|
BÜLBÜL F, ÖZDEMİR S. The comparative effects of ball squeezing and cartoon watching in pain management in children during intramuscular injection: A randomized control trial. MEHMET AKIF ERSOY ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2022. [DOI: 10.24998/maeusabed.1123566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study was designed as a randomized controlled trial to investigate the comparative effect of ball squeezing and watching cartoons on pain management in children during intramuscular injection. The population of the study was comprised of 6-12 years old children who came to emergency for intramuscular injection. Power analysis was performed by G*Power program. Approximately 147 protocols completed with 6-12 years old children (each group 49 children). In the study, a questionnaire including child and socio-demographic characteristics their experiences of hospitalization data and Facial Pain Scale- Revised (FPS-R), Visual Analog Scale (VAS), and ball (for squeezing) were used. According to the results of the study, the FPS-R score during the procedure was the lowest in the stress ball group and was statistically significant (p˂0.05). The lowest VAS scores during the procedure the lowest score was in the stress ball group and the differences between the relevant groups were statistically significant (p˂0.05). It was determined that squeezing the ball and watching cartoons were effective in reducing pain during injection, however, the ball squeezing group had the lowest pain level. Among non-pharmacological methods, ball squeezing can be preferred as a practical and effective method, especially by pediatric nurses, in reducing pain during intramuscular injection in children.
Collapse
|
27
|
Virtual reality for pain and anxiety of pediatric oncology patients: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2022; 9:100152. [DOI: 10.1016/j.apjon.2022.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/17/2022] [Indexed: 11/23/2022] Open
|
28
|
Saiu S, Grosso E. Controlled audio-visual stimulation for anxiety reduction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 223:106898. [PMID: 35780520 DOI: 10.1016/j.cmpb.2022.106898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 03/09/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Recent clinical data suggest that 75% of patients undergoing surgery are anxious, despite pharmacological measures to relieve anxiety. As an alternative to the administration of drugs, the scientific literature reports the relevant psychophysiological effects of auditory and visual stimulation in reducing preoperative anxiety. The main objective of this study is the development of a portable computer-controlled device for the simultaneous combined administration of audio-visual stimuli and the evaluation of this device through the collection and the statistical analysis of psychophysiological parameters strictly related to the state of anxiety. METHODS A new algorithmic approach for the real-time association of sounds and colours is proposed and implemented in a low-cost architectural platform. The combined administration of auditory and visual stimuli is tested on 220 subjects undergoing dental surgery; in particular, psychophysiological parameters are collected and evaluated in four experimental conditions, in order to demonstrate the efficacy of cross-modal stimulation (auditory and visual) compared to non-pharmacological treatments based on monomodal stimuli (auditory or visual). RESULTS Non-parametric statistical techniques applied to the recorded experimental data show that the experimental conditions considered significantly differ. Pairwise comparisons between experimental groups show that the combined administration of sounds and colors significantly reduces the level of anxiety, systolic blood pressure and heart rate to a greater extent than monomodal stimulation. CONCLUSION The study demonstrates the potential benefits of a device for the combined administration of auditory and visual stimuli. The developed device has proven effective in reducing preoperative anxiety levels, becoming a serious candidate for non-pharmacological therapies. The study also encourages a deeper investigation of models capable of better capturing the potential of cross-modal stimulation, maximizing the desired effects (relaxation, arousal) on patients awaiting specific medical treatments.
Collapse
Affiliation(s)
- Salvatore Saiu
- Research Fellow in Computer Science, University of Sassari Computer Vision Laboratory, Sassari, Italy.
| | - Enrico Grosso
- Full Professor in Computer Science, Computer Vision Laboratory, University of Sassari, Sassari, Italy
| |
Collapse
|
29
|
Ugucu G, Akdeniz Uysal D, Guzel Polat O, Artuvan Z, Polat Kulcu D, Aksu D, Gulgun Altintas M, Cetin H, Orekici Temel G. Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6-8 years: A randomized experimental study. J Pediatr Nurs 2022; 65:e107-e114. [PMID: 35410736 DOI: 10.1016/j.pedn.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6-8 years. DESIGN AND METHODS This experimental study randomly assigned 56 children aged 6-8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests. RESULTS The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008). CONCLUSION This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6-8 years compared to bubble-blowing as an active distraction method. PRACTICE IMPLICATIONS The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6-8 years.
Collapse
Affiliation(s)
- Guzide Ugucu
- Department of Pediatric Nursing, Faculty of Nursing, Mersin University, 33343 Mersin, Turkey.
| | | | | | | | - Didem Polat Kulcu
- Department of Nursing, Faculty of Health Sciences, Toros University, 33140 Mersin, Turkey.
| | - Done Aksu
- Mersin University Hospital, 33343 Mersin, Turkey
| | | | - Hacer Cetin
- Department of Pediatric Nursing, Faculty of Nursing, Mersin University, 33343 Mersin, Turkey.
| | - Gulhan Orekici Temel
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, 33343 Mersin, Turkey
| |
Collapse
|
30
|
The effect of virtual reality glasses against the fear of circumcision: A randomized controlled trial. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.993190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background/Aim: Circumcision is an invasive operation that male children undergo in our country and some others. During this process, the child can experience fear, anxiety, and pain simultaneously. As a randomized controlled VR study, this research was conducted to determine the effect of virtual reality (VR) glasses on reducing fear/anxiety and pain during circumcision in children.
Methods: The study was conducted on 125 children (6-11 years old). The same healthcare team performed the circumcision of the children in both groups. The children were randomly split into VR and control groups. The children in the VR group, just before the circumcision, watched their preferred cartoon film via VR glasses. No additional procedure was applied to the children in the control group except for ordinary procedures in the hospital. The fear and pain status measured by Wong-Baker Faces Pain Rating Scale and Children Fair Scale of all the children were evaluated before and after the operation by the child, parents, and the observer. Descriptive statistics, chi-square, and t-tests analyzed the data.
Results: There was no significant difference between the groups regarding demographic characteristics such as age, BMI, previous hospitalization, and anesthetic drug used before the procedure of the children included in the study. Preoperative (VR = 1.03 (0.18), control = 1.05 (0.22)) and pre-procedural (VR = 2.61 (1.02), control = 2.33 (1.22)) fear levels were also similar (P > 0.05). After the procedure, it was determined that the mean duration of the procedure (365.36 (64.73) sec), crying time (21.31 (41.74) sec), and fear scores (0.36 (0.68)) of the children in the VR group were lower (P < 0.001). However, pain mean scores were similar (P > 0.05).
Conclusion: It is thought that watching a cartoon with VR glasses during the circumcision operation may be effective in reducing the child's fear level, crying, and operation time.
Collapse
|
31
|
Suleman SK, Atrushi A, Enskär K. Effectiveness of art-based distraction in reducing pain and anxiety of hospitalized children during cannulation procedure: A randomized controlled trial. BELITUNG NURSING JOURNAL 2022; 8:213-221. [PMID: 37547118 PMCID: PMC10401380 DOI: 10.33546/bnj.2054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/18/2022] [Accepted: 04/26/2022] [Indexed: 08/08/2023] Open
Abstract
Background Peripheral venous cannulation (PIVC) is one of the most common needle procedures associated with the therapies of pediatric patients, which causes pain and anxiety in children. Trace Image and Coloring for Kids-Book (TICK-B) is one of the arts-based interventions to relieve pain and anxiety, but none of the existing studies use the TICK-B to decrease children's pain intensity and anxiety levels during PICV. Objective This study aimed to investigate the effectiveness of the Trace Image and Coloring for Kids-Book (TICK-B) in decreasing children's pain and anxiety during PIVC. Methods A parallel, randomized, double-blind controlled trial was used in this study. Children aged 6-12 years were randomly allocated to one of two groups: intervention or control. The intervention group (n = 48) received the TICK-B during the PIVC, compared to no intervention in the control group (n = 52). The children, their parents, and an observer nurse rated outcomes 1-2 min after completion of the procedure. The patients in both groups were similar in age, gender, duration of hospitalization, injections, mother's age, and education. Faces Pain Scale-Revised (FPS-R), Children's Fear Scale (CFS), and Visual Analog Scale (VAS) were used to measure pain and anxiety. Paired and independent t-tests were used for data analysis. Results Patients in the intervention group reported significantly reduced pain levels than those in the control group (p <0.001), as reported by children (3.08 vs. 7.06), parents (3.08 vs. 7.13), and the observer nurse (3.06 vs. 7.13), respectively. Anxiety levels were also significantly lower among patients in the intervention group than in the control group (p <0.001), as reported by children (0.88 vs. 3.17), parents (0.94 vs. 3.19), and the observer nurse (0.85 vs. 2.94), respectively. Conclusions TICK-B is an effective technique for reducing children's pain and anxiety during PIVC. TICK-B is a simple, inexpensive, and effective technique that nurses can use to decrease the levels of pain and anxiety of pediatric patients during intravenous cannulation.
Collapse
Affiliation(s)
- Sherzad Khudeida Suleman
- Nursing Department, Faculty of Health Sciences, Witten/Herdecke University, Germany
- Nursing College, Duhok University, Kurdistan Region, Iraq
| | - Akram Atrushi
- Pediatric Unit, College of Medicine, Duhok University, Kurdistan Region, Iraq
| | - Karin Enskär
- Department of Women’s and Children’s Health, Uppsala University, Sweden
| |
Collapse
|
32
|
Getchell, K, McCowan, K, Whooley, E, Dumais, C, Rosenstock, A, Cole A, DeGrazia M. Child Life Specialists Decrease Procedure Time, Improve Experience, and Reduce Fear in an Outpatient Blood Drawing Lab (CLS Decrease Procedure Time). J Patient Exp 2022; 9:23743735221105679. [PMID: 35694015 PMCID: PMC9174556 DOI: 10.1177/23743735221105679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Children can experience extreme fear when undergoing medical procedures,
including blood draws. A growing body of evidence points to the benefits of
Child Life Specialists supporting children throughout medical procedures in
various medical settings. This prospective cohort study aimed to describe the
impact of Child Life Specialist facilitated play on children's fear and
caregiver satisfaction in an outpatient blood drawing lab. A nonrandomized
convenience sample of 150 children and their caregivers were enrolled.
Seventy-five patients received the Child Life Specialist intervention during
their blood draw, while the remaining 75 patients were enrolled as controls.
Children and caregivers in the intervention group spent less time in the
procedure room, with a median time of 3 min (interquartile range: 2-5) as
compared to 5 min (interquartile range: 5-6; P < .001) for
the control group. Caregivers in the intervention group reported the atmosphere
(P = .032) and experience (P < .001)
more positively, and children reported lower fear scores
(P = .007) as compared to the control group. The findings of
this study suggest that Child Life Specialist interventions in pediatric
outpatient blood drawing labs improve satisfaction and reduce fear.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Michele DeGrazia
- Neonatal Intensive Care Unit, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
33
|
Domingo-Lopez DA, Lattanzi G, H. J. Schreiber L, Wallace EJ, Wylie R, O'Sullivan J, Dolan EB, Duffy GP. Medical devices, smart drug delivery, wearables and technology for the treatment of Diabetes Mellitus. Adv Drug Deliv Rev 2022; 185:114280. [PMID: 35405298 DOI: 10.1016/j.addr.2022.114280] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/21/2022] [Accepted: 04/05/2022] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus refers to a group of metabolic disorders which affect how the body uses glucose impacting approximately 9% of the population worldwide. This review covers the most recent technological advances envisioned to control and/or reverse Type 1 diabetes mellitus (T1DM), many of which will also prove effective in treating the other forms of diabetes mellitus. Current standard therapy for T1DM involves multiple daily glucose measurements and insulin injections. Advances in glucose monitors, hormone delivery systems, and control algorithms generate more autonomous and personalised treatments through hybrid and fully automated closed-loop systems, which significantly reduce hypo- and hyperglycaemic episodes and their subsequent complications. Bi-hormonal systems that co-deliver glucagon or amylin with insulin aim to reduce hypoglycaemic events or increase time spent in target glycaemic range, respectively. Stimuli responsive materials for the controlled delivery of insulin or glucagon are a promising alternative to glucose monitors and insulin pumps. By their self-regulated mechanism, these "smart" drugs modulate their potency, pharmacokinetics and dosing depending on patients' glucose levels. Islet transplantation is a potential cure for T1DM as it restores endogenous insulin and glucagon production, but its use is not yet widespread due to limited islet sources and risks of chronic immunosuppression. New encapsulation strategies that promote angiogenesis and oxygen delivery while protecting islets from recipients' immune response may overcome current limiting factors.
Collapse
|
34
|
Mao Y, Huang X, Yang H, Zhou S, Yuan A, Lin G, Geng G. The Effect of a New Ligation and Venipuncture Method on Vena Basilica Vessel. Appl Bionics Biomech 2022; 2022:9384983. [PMID: 35607428 PMCID: PMC9124119 DOI: 10.1155/2022/9384983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study evaluated the impact of a novel venipuncture method on vascular parameters of vena basilica to provide a new technical option for the clinical management of difficult venipuncture. Methods 32 volunteers examined by ultrasound at the Medical Imaging Center of The First People's Hospital of Nantong, Jiangsu province, from February 2020 to April 2020 were randomly selected. One hand of each patient was ligated with the traditional single tourniquet and the new ligation method for 20 seconds. Then, the distance between the left or right vena basilica and the skin and the diameter of blood vessels were measured by ultrasound. 98 patients with peripheral venipuncture difficulty who were examined by ultrasound of a third-grade hospital from April 2019 to March 2020 were selected and randomly divided into control group (n = 49) and experimental group (n = 49). The traditional method was used in the control group, and the new peripheral venipuncture was used in the experimental group. The success rate of single puncture, preparation time before puncture, time required for puncture operation, pain reaction during puncture, intravascular congestion after puncture, subcutaneous tissue injury, and vascular reuse rate after puncture were compared between the two methods. Results The new ligation and puncture method increased the diameter of peripheral superficial vein vessels by 0.51 ± 0.04 mm, and the change of vena basilica diameter was not significantly associated with gender and age of patient. The success rate of single puncture and the vascular reuse rate were significantly higher in the experimental group than in the control group, while the preparation time and venipuncture time, as well as the patient's pain response, were significantly lower in the experimental group compared to the control group, and the intravascular congestion and subcutaneous tissue injury were lower. In addition, the mean satisfaction score of patients in the experimental group was higher than that of the control group. Conclusion The new ligation and puncture method was an effective vena basilica dilation technique for filling the peripheral superficial veins, improving puncture success rate of peripheral difficult vein, and reducing patient pain, which was worth popularizing and applying in clinic.
Collapse
Affiliation(s)
- Yuanhong Mao
- Medical Imaging Department, Nantong First People's Hospital, Jiangsu, China
| | - Xiaomei Huang
- Radiotherapy Department, Nantong First People's Hospital, Jiangsu, China
| | - Hong Yang
- Medical Imaging Department, Nantong First People's Hospital, Jiangsu, China
| | - Shu Zhou
- Medical Imaging Department, Nantong First People's Hospital, Jiangsu, China
| | - Aihong Yuan
- Medical Imaging Department, Nantong First People's Hospital, Jiangsu, China
| | - Gang Lin
- Internal Medicine-Cardiovascular Department, Nantong First People's Hospital, Jiangsu, China
| | - Guiling Geng
- School of Nursing, Nantong University Medical School, Jiangsu, China
| |
Collapse
|
35
|
Rantala A, Vuorinen A, Koivisto J, Similä H, Helve O, Lahdenne P, Pikkarainen M, Haljas K, Pölkki T. A gamified mobile health intervention for children in day surgery care: Protocol for a randomized controlled trial. Nurs Open 2022; 9:1465-1476. [PMID: 34859602 PMCID: PMC8859057 DOI: 10.1002/nop2.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/11/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
AIMS To describe a study protocol for a randomized controlled trial which will evaluate the effectiveness of a gamified mobile health intervention for children in whole day surgery care. DESIGN A study protocol for a two-arm randomized controlled trial. METHODS Participants will be randomly assigned to the intervention group (N = 62), in which patients receive routine care and play a mobile game designed for children or the control group (N = 62), in which patients receive routine care, including a mobile phone application that supports parents during the care path. The primary outcome is children's pre-operative anxiety, while the secondary outcome measures included fear and postoperative pain, along with parental satisfaction and anxiety. Data collection started in August 2020. RESULTS The results of the ongoing randomized controlled trial will determine whether the developed gamified mobile health intervention can be recommended for hospital use, and whether it could be used to educate children about their surgical treatment to decrease anxiety.
Collapse
Affiliation(s)
- Arja Rantala
- Research Unit of Nursing Science and Health ManagementFaculty of MedicineUniversity of OuluOuluFinland
| | | | - Jonna Koivisto
- Faculty of Information Technology and Communication SciencesTampere UniversityTampereFinland
| | - Heidi Similä
- VTT Technical Research Centre of FinlandOuluFinland
| | - Otto Helve
- ClinicumUniversity of HelsinkiHelsinkiFinland
- Pediatric Research CenterDepartment of PediatricsHelsinki University HospitalHelsinkiFinland
| | - Pekka Lahdenne
- Department of PediatricsHelsinki University HospitalHelsinkiFinland
| | - Minna Pikkarainen
- VTT Technical Research Centre of FinlandOuluFinland
- Research Group of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
- Martti Ahtisaari InstituteOulu Business SchoolOulu UniversityOuluFinland
| | | | - Tarja Pölkki
- Research Unit of Nursing Science and Health ManagementFaculty of MedicineUniversity of OuluOuluFinland
| |
Collapse
|
36
|
Binay Yaz Ş, Bal Yilmaz H. The Effects of Designing an Educational Animation Movie in Virtual Reality on Preoperative Fear and Postoperative Pain in Pediatric Patients: A Randomized Controlled Trial. J Perianesth Nurs 2022; 37:357-364. [PMID: 35177320 DOI: 10.1016/j.jopan.2021.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of the study was to investigate the effects of watching an educational animated movie on fear and pain in children aged 6 to 12 years old. DESIGN A randomized controlled trial. METHODS In this study, the CONSORT checklist was used as a guide. The sample of participants (n = 132) was allocated to the Educational Animation Group (n = 44), Documentary Group (n = 44), and Control Group (n = 44) using block randomization. During the data collection, an information form, the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale were used. FINDINGS Preoperative fear and postoperative pain scores were significantly lower in the Educational Animation group than in the other groups. CONCLUSIONS The educational animated movie was found to be an effective method in reducing preoperative fear and postoperative pain. Educational animated movies, which were effective in reducing the fear and pain of the child in the preparatory operations, increased the educational effectiveness and cooperation of the child.
Collapse
Affiliation(s)
- Şeyda Binay Yaz
- Faculty of Health Sciences, Nursing Department/Pediatric Nursing, Izmir Bakırçay University, Izmir, Turkey.
| | - Hatice Bal Yilmaz
- Faculty of Nursing, Pediatric Nursing Department, Ege University, Izmir, Turkey
| |
Collapse
|
37
|
Lee HN, Hwang S, Jung JY, Park JW, Kim DK, Kwak YH. Tablet personal computer distraction during intravenous placement for young children in the pediatric emergency department: A pilot study. Pediatr Int 2022; 64:e15150. [PMID: 35510723 DOI: 10.1111/ped.15150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intravenous (IV) placement is a common procedure experienced by children visiting the pediatric emergency department (PED). However, uncontrolled anxiety and pain cause children to interfere with the procedure. In this pilot study, we sought to evaluate the effectiveness of tablet personal computers as a distraction method during IV placement. METHODS This is a single-center pilot study conducted at a tertiary teaching hospital. Children visiting the PED were eligible if they were aged 3-5 years and required IV placement during the PED visit. After written consent was obtained from the guardian, the child was randomly assigned to a control group or an intervention group. For the intervention group, an animated video was played via tablet PC during IV placement. For both groups, children's anxiety, heart rate, and pain scale scores (the Face, Legs, Activity, Cry, Consolability and Evaluation Enfant Douleur) and guardian satisfaction were recorded. RESULTS 22 children were eligible for the final analysis. There was no significant difference in the pain scale scores between the two groups, with the exception of the degree of pain relief after the procedure measured using Evaluation Enfant Douleur (intervention group: 6.0, interquartile range (IQR): 4.2-6.8, and control group; 3.0, IQR: 2.0-3.8, P = 0.011) and Face, Legs, Activity, Cry, Consolability (intervention group: 4.0, IQR: 4.0-4.2 and control group; 3.0, IQR: 1.5-3.5, P = 0.043). CONCLUSION In this pilot study, distraction using tablet personal computers may have reduced children's distress during the recovery phase after venipuncture. Further study with a larger sample size and different methods of distraction is essential.
Collapse
Affiliation(s)
- Ha Ni Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Soyun Hwang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Jae Yun Jung
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Joong Wan Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Do Kyun Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Young Ho Kwak
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| |
Collapse
|
38
|
Abstract
ABSTRACT I.V. catheter placement is one of the most common causes of procedural pain in children. Interventions to address this pain are readily available but inconsistently used in practice. The focus of this article is to identify and encourage best practice for pain mitigation in peripheral I.V. catheter placement in children.
Collapse
Affiliation(s)
- Christina Schott
- In Washington, D.C., Christina Schott is a clinical research assistant at Children's National Medical Center; Victoria Brown is an RN I at Children's National Medical Center; and Sarah Vittone is an assistant professor at the School of Nursing & Health Studies and a clinical bioethicist at the Pellegrino Center for Clinical Bioethics at Georgetown University
| | | | | |
Collapse
|
39
|
Su HC, Hsieh CW, Lai NM, Chou PY, Lin PH, Chen KH. Using Vibrating and Cold Device for Pain Relieves in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Pediatr Nurs 2021; 61:23-33. [PMID: 33735633 DOI: 10.1016/j.pedn.2021.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/28/2021] [Accepted: 02/28/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Needle procedures are the most common source of pain, anxiety, and fear among children. A combination of a cooling ice-pack and/or a vibrating motor for pain management in children has been evaluated in trials, but their overall effects await a synthesis of the available evidence. METHOD Comprehensive search was conducted using Cochrane, PubMed, EMBASE, PsycINFO, CINAHL and Airiti. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3. A meta-regression was conducted to investigate the effects of mean age on MD of pain. RESULTS A total of 1479 children from 16 publications were included. Compared with the control group, using cold-vibrating device significantly decreased pain level above the age of 2 (MD -3.03, 95% CI: -3.38, -2.68), as well as lower anxiety level among parents (MD -1.3, 95% CI: -1.9, -0.7). Meta-regression demonstrated a significant negative correlation of pain score with age. For children at 8.5 years, cold-vibration reduced the pain score by 0.13 averagely for every increment in year compared with controls (MD -0.13; 95% CI: -0.25, -0.01). No adverse events were reported in included studies. DISCUSSION The cold-vibrating device reduced pain levels significantly among children without adverse effects. Variation of factors might contribute to the heterogeneity of our study, such as age, different needle procedures, psychological strategies…etc. CONCLUSIONS Cool-vibration treatment reduced pain levels in children who underwent needle procedures and the treatment appears more effective in older children. The device is promising in clinical setting due to its non-invasiveness and ease of usage.
Collapse
Affiliation(s)
- Hui-Chuan Su
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Chia-Wen Hsieh
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Malaysia; School of Pharmacy, Monash University, Malaysia
| | - Pao-Yu Chou
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Pu-Hung Lin
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Kee-Hsin Chen
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan; Cochrane Taiwan, Taipei Medical University, Taiwan; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taiwan; Evidence-Based Knowledge Translation Center, Wan Fang Hospital, Taipei Medical University, Taiwan.
| |
Collapse
|
40
|
Cozzi G, Crevatin F, Dri V, Bertossa G, Rizzitelli P, Matassi D, Minute M, Ronfani L, Barbi E. Distraction Using Buzzy or Handheld Computers During Venipuncture. Pediatr Emerg Care 2021; 37:e512-e516. [PMID: 30601349 DOI: 10.1097/pec.0000000000001689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Venipuncture is one of the most frequently performed painful procedures in children. The aim of this study was to investigate the effectiveness of 2 analgesic strategies for venipuncture in children in a specific setting like a blood-drawing center. METHODS This was a prospective randomized controlled trial. It was conducted in the blood-drawing center of a tertiary level children's hospital in Italy, between November 2014 and February 2015. Eligible patients were children aged from 4 to 12 years referred to the blood-drawing center for venipuncture. Enrolled children were randomized to be distracted by Buzzy device or by playing with a handheld computer. The procedural pain was measured with the faces pain scale-revised by children aged from 4 to 7 years and with a numerical rating scale by children aged from 8 to 12 years. RESULTS Two hundred children with a median age of 8 years were enrolled in the study. The self-reported procedural pain was not statistically different between the Buzzy group and the handheld computer group: median (interquartile range) = 3.0 (1.0-4.8) and 2.0 (1.0-4.8), respectively (P = 0.72). Children reported significant pain in 25% of cases with both distraction strategies. The procedural success rate at the first attempt was not significantly different in the 2 groups. CONCLUSIONS Analgesia provided by Buzzy or by a handheld computer was not significantly different in children undergoing venipuncture in a blood-drawing center, with the great proportion of them reporting no or mild pain during procedure.
Collapse
Affiliation(s)
- Giorgio Cozzi
- From the Institute for Maternal and Child Health IRCCS Burlo Garofolo
| | - Franca Crevatin
- From the Institute for Maternal and Child Health IRCCS Burlo Garofolo
| | | | | | | | - Daniela Matassi
- From the Institute for Maternal and Child Health IRCCS Burlo Garofolo
| | - Marta Minute
- From the Institute for Maternal and Child Health IRCCS Burlo Garofolo
| | - Luca Ronfani
- From the Institute for Maternal and Child Health IRCCS Burlo Garofolo
| | | |
Collapse
|
41
|
Erdogan B, Aytekin Ozdemir A. The Effect of Three Different Methods on Venipuncture Pain and Anxiety in Children: Distraction Cards, Virtual Reality, and Buzzy® (Randomized Controlled Trial). J Pediatr Nurs 2021; 58:e54-e62. [PMID: 33485746 DOI: 10.1016/j.pedn.2021.01.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to determine the effect of the distraction cards, virtual reality and Buzzy® methods on venipuncture pain and anxiety in children aged 7-12 years. DESIGN AND METHODS This was a randomized controlled trial with parallel groups conducted between November 16, 2017 and August 14, 2018 at the pediatric venipuncture unit of a university hospital in Western Turkey. The sample consisted of 142 children who met the inclusion criteria. The experimental group consisted of 108 children divided into three groups: Distraction Cards (DC; n = 35), Virtual Reality (VR; n = 37), and Buzzy® (n = 36). The control group (n = 34) received no intervention during venipuncture. Data were collected using a descriptive characteristics form, and the Visual Analog Scale (VAS), Wong-Baker FACES, and Children's Fear Scale (CFS). The participants themselves and their parents and the researcher scored venipuncture pain and anxiety levels. The study was approved by the Ethics Committee. Permission was obtained from related institutions. Informed consent was obtained from parents. Verbal consent was obtained from children prior to participation. RESULTS Buzzy® group had the lowest mean VAS score (2.2 ± 2.0), followed by the VR (2.7 ± 2.8), DC (3.4 ± 2.4), and control (5.2 ± 2.8) groups (p < 0.05). According to all raters (child, parent, and researcher), the Buzzy® group had the lowest mean Wong Baker FACES score, followed by the VR, DC, and control groups (p < 0.05). According to all raters, the Buzzy® group had the lowest mean CFS score, followed by the VR, DC, and control groups (p < 0.05). CONCLUSIONS The DC, VR, and Buzzy® methods were effective in reducing venipuncture pain and anxiety in children. PRACTICE IMPLICATIONS Nurses can use the DC, VR, and Buzzy® methods to help reduce venipuncture pain and anxiety in children. The clinical trial registration number is NCT04421430. (https://clinicaltrials.gov/ct2/show/study/NCT04421430).
Collapse
Affiliation(s)
- Birgül Erdogan
- Gazi University, Department of Nursing, Faculty of Health Sciences, Turkey.
| | | |
Collapse
|
42
|
Jang E, Zhimanov E, Parsh B. Minimizing immunization injection pain in children. Nursing 2021; 51:13-14. [PMID: 33674527 DOI: 10.1097/01.nurse.0000734008.07791.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Emily Jang
- At Sacramento State School of Nursing in Sacramento, Calif., Emily Jang and Ekaterina Zhimanov are nursing students and Bridget Parsh is a professor of nursing. Dr. Parsh is also a member of the Nursing2021 editorial board
| | | | | |
Collapse
|
43
|
Cozzi G, Valerio P, Kennedy R. A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation. Acta Paediatr 2021; 110:423-432. [PMID: 32772423 DOI: 10.1111/apa.15526] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023]
Abstract
Venepuncture and peripheral intravenous cannulation are two of the most commonly paediatric performed medical procedures in many healthcare settings. These procedures can cause significant pain and distress at any age, during childhood, so appropriate management is strongly recommended. This review examines the evidence related to pain and distress management during venepuncture and peripheral intravenous cannulation, including preparing the environment, assessing and preparing patients, parental involvement and psychological and pharmacological interventions. It specifically refers to neonates, children with cognitive impairment and children with difficult intravenous access. We provide a brief management strategy, with easily implemented techniques to improve daily practice.
Collapse
Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy
| | - Paolo Valerio
- Department of Pediatrics OLVG Hospital Amsterdam The Netherlands
| | - Robert Kennedy
- Washington University School of Medicine St Louis MO USA
| |
Collapse
|
44
|
The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial. J Emerg Nurs 2020; 47:76-87. [PMID: 32690314 DOI: 10.1016/j.jen.2020.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Intravenous insertion is the most common invasive procedure made for administering intravascular fluid and medicine. Peripheral venous catheterization may cause pain, fear, and stress in children. This study aimed to compare the effects of watching a cartoon and an information video about intravenous insertion on the pain and fear levels of children aged 6-12 years. METHODS The study was an experimental, randomized controlled clinical trial. It was conducted with 477 children aged 6-12 years randomized into 3 groups: the informative animated video group, the cartoon group, and the control group. Fear and pain perception were evaluated on the basis of the feedback from the child, observer nurse, and parents. The Children's Fear Scale was used to evaluate the fear level and the Wong-Baker FACES Scale was used to assess pain levels. Data were analyzed using one-way analysis of variance, the chi-square test, and the intraclass correlation coefficient test. RESULTS The children who watched the information video before the intravenous insertion procedure and those who watched a cartoon during the procedure had lower mean pain and fear scores as evaluated by the child (pain: F = 278.67, P = 0.001; fear: F = 294.88, P = 0.001), parent (pain: F = 279.53, P = 0.001; fear: F = 294.47, P = 0.001), and nurse (pain: F = 286.88, P = 0.001; fear: F = 300.81, P = 0.001) than children in the control group. DISCUSSION This study showed that watching an animation video or a cartoon was effective in lowering children's perceived level of pain and fear during an intravenous insertion intervention.
Collapse
|
45
|
Köse S, Arıkan D. The Effects of Cartoon Assisted Endoscopy Preparation Package on Children's Fear and Anxiety Levels and Parental Satisfaction in Turkey. J Pediatr Nurs 2020; 53:e72-e79. [PMID: 32173165 DOI: 10.1016/j.pedn.2020.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The study was conducted to determine the effect of the cartoon-assisted preparation package, developed for children undergoing an endoscopy procedure, on children's fear and anxiety levels and parental satisfaction. DESIGN AND METHODS The study was conducted in a randomized controlled experimental design between April 2018-July 2019. The study sample consisted of a total of 65 children and their parents (33 in the intervention group and 32 in the control group) who met the research inclusion criteria in this study population. The intervention group was prepared for an endoscopy procedure with the cartoon-assisted preparation package for endoscopy. RESULTS The mean fear scores of the children in the intervention group were 3.39 ± 0.56 before endoscopy, 1.67 ± 0.54 during endoscopy, and 0.52 ± 0.67 after endoscopy, with statistically significant difference between the mean fear scores. The mean fear scores in the control group were 3.00 ± 0.80 before endoscopy, 3.13 ± 0.79 during endoscopy, and 2.25 ± 1.16 after endoscopy, with statistically significant difference between the mean fear scores. The anxiety scores of the children were 33.79 ± 4.00 in the intervention group and 36.56 ± 3.52 in the control group before endoscopy, and the difference between anxiety scores was statistically significant (p < 0.05). The mean satisfaction scores of the parents in the experimental group after endoscopy (78.44 ± 10.01) was higher than that of the control group (73.52 ± 12.92), but the difference between the groups was not statistically significant (p > 0.05). CONCLUSION The cartoon-assisted preparation package for endoscopy was found to be effective in reducing fear and anxiety that may occur in children undergoing endoscopy, in the 7-12 age group.
Collapse
Affiliation(s)
- Semra Köse
- Department of Child Health and Diseases Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey.
| | - Duygu Arıkan
- Department of Child Health and Diseases Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| |
Collapse
|
46
|
Yildizeli Topcu S, Akgun Kostak M, Semerci R, Guray O. Effect of Gum Chewing on Pain and Anxiety in Turkish Children During Intravenous Cannulation: A Randomized Controlled Study. J Pediatr Nurs 2020; 52:e26-e32. [PMID: 31889572 DOI: 10.1016/j.pedn.2019.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE Although gum chewing is a simple intervention that can be used for the management of pain and anxiety in the nursing care of children, few studies have assessed this intervention. This study aimed to investigate the effect of gum chewing on pain and anxiety during intravenous (IV) cannulation in children. DESIGN AND METHODS This randomized controlled study assessed 73 children aged 6 to 12 years in the general paediatric unit in a university hospital in the Trachy Region, Turkey from April to September 2017. In the experimental group, children chewed gum during the procedure. The standard care was applied to the control group. Data were collected via the Children's Anxiety Pain Scale and the Data Collection Form. RESULTS According to the children's self-report and the nurse's report, the pain level of the experimental group was significantly lower than the control group. Although no significant difference was noted between experimental and control groups' anxiety levels, nurses stated higher anxiety levels than children. CONCLUSIONS The IV cannulation procedure causes pain and anxiety in children. Nurses reported the perception of a higher level of anxiety during the procedure than the children actually experienced. Gum chewing might reduce pain during IV cannulation. Nurses should consider using gum chewing as a simple nursing implementation to increase the effects of other pharmacological and non-pharmacological techniques for management of children's procedural pain. PRACTICE IMPLICATIONS Nurses who work with the children could use gum chewing as a simple, inexpensive, and pleasurable intervention for the management of pain.
Collapse
Affiliation(s)
- Sacide Yildizeli Topcu
- Trakya University, Faculty of Health Sciences, Department of Surgical Nursing, Edirne, Turkey.
| | - Melahat Akgun Kostak
- Trakya University, Faculty of Health Sciences, Department of Child Health and Disease Nursing, Edirne, Turkey
| | - Remziye Semerci
- Trakya University, Faculty of Health Sciences, Department of Child Health and Disease Nursing, Edirne, Turkey
| | - Ozlem Guray
- Trakya University, Health Practice and Research Center, Pediatric Surgery Service, Edirne, Turkey
| |
Collapse
|
47
|
Gates M, Hartling L, Shulhan-Kilroy J, MacGregor T, Guitard S, Wingert A, Featherstone R, Vandermeer B, Poonai N, Kircher J, Perry S, Graham TAD, Scott SD, Ali S. Digital Technology Distraction for Acute Pain in Children: A Meta-analysis. Pediatrics 2020; 145:peds.2019-1139. [PMID: 31969473 DOI: 10.1542/peds.2019-1139] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Digital distraction is being integrated into pediatric pain care, but its efficacy is currently unknown. OBJECTIVE To determine the effect of digital technology distraction on pain and distress in children experiencing acutely painful conditions or procedures. DATA SOURCES Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Institute of Electrical and Electronics Engineers Xplore, Ei Compendex, Web of Science, and gray literature sources. STUDY SELECTION Quantitative studies of digital technology distraction for acutely painful conditions or procedures in children. DATA EXTRACTION Performed by 1 reviewer with verification. Outcomes were child pain and distress. RESULTS There were 106 studies (n = 7820) that reported on digital technology distractors (eg, virtual reality and video games) used during common procedures (eg, venipuncture, dental, and burn treatments). No studies reported on painful conditions. For painful procedures, digital distraction resulted in a modest but clinically important reduction in self-reported pain (standardized mean difference [SMD] -0.48; 95% confidence interval [CI] -0.66 to -0.29; 46 randomized controlled trials [RCTs]; n = 3200), observer-reported pain (SMD -0.68; 95% CI -0.91 to -0.45; 17 RCTs; n = 1199), behavioral pain (SMD -0.57; 95% CI -0.94 to -0.19; 19 RCTs; n = 1173), self-reported distress (SMD -0.49; 95% CI -0.70 to -0.27; 19 RCTs; n = 1818), observer-reported distress (SMD -0.47; 95% CI -0.77 to -0.17; 10 RCTs; n = 826), and behavioral distress (SMD -0.35; 95% CI -0.59 to -0.12; 17 RCTs; n = 1264) compared with usual care. LIMITATIONS Few studies directly compared different distractors or provided subgroup data to inform applicability. CONCLUSIONS Digital distraction provides modest pain and distress reduction for children undergoing painful procedures; its superiority over nondigital distractors is not established. Context, preferences, and availability should inform the choice of distractor.
Collapse
Affiliation(s)
- Michelle Gates
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Lisa Hartling
- Department of Pediatrics and .,Alberta Research Centre for Health Evidence, and
| | | | - Tara MacGregor
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Samantha Guitard
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Aireen Wingert
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Robin Featherstone
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Ben Vandermeer
- Department of Pediatrics and.,Alberta Research Centre for Health Evidence, and
| | - Naveen Poonai
- Department of Pediatrics and Internal Medicine, Schulieh School of Medicine and Dentistry, Western University, London, Canada
| | - Janeva Kircher
- Department of Pediatrics and.,Emergency Medicine, Faculty of Medicine and Dentistry
| | - Shirley Perry
- Women and Children's Health Research Institute, University of Albert, Edmonton, Canada
| | - Timothy A D Graham
- Emergency Medicine, Faculty of Medicine and Dentistry.,Alberta Health Services Edmonton Zone, Edmonton, Canada; and
| | | | - Samina Ali
- Department of Pediatrics and.,Emergency Medicine, Faculty of Medicine and Dentistry.,Women and Children's Health Research Institute, University of Albert, Edmonton, Canada
| |
Collapse
|
48
|
Waite M, Iness EJ. Nociceptor-stimulating devices can help reduce pain, anxiety and fear in children requiring regular injections. Evid Based Nurs 2020; 23:21. [PMID: 31164397 DOI: 10.1136/ebnurs-2018-103033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Affiliation(s)
| | - Emma Jane Iness
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| |
Collapse
|
49
|
van der Heijden MJE, Mevius H, van der Heijde N, van Rosmalen J, van As S, van Dijk M. Children Listening to Music or Watching Cartoons During ER Procedures: A RCT. J Pediatr Psychol 2019; 44:1151-1162. [PMID: 31621845 DOI: 10.1093/jpepsy/jsz066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study aims to determine if listening to music and watching cartoons are effective to distract children from pain and distress during procedures in the emergency room (ER). METHODS This study is a single-center, 3-armed, superiority randomized controlled trial comparing listening to music, watching cartoons, and standard care during ER procedures in children aged 3-13 years. The primary outcome was pain measured from video footage with the Alder Hey Triage Pain Score (AHTPS). Children older than 4 years self-reported pain with the Faces Pain Scale-Revised (FPS-R). The secondary outcome was distress measured with the Observational Scale of Behavioral Distress-revised (OSBD-r). Another indicator of distress was heart rate. RESULTS Data of 191 participants were analyzed for the 3 groups: music (n = 75), cartoon (n = 62), and control (n = 54). The median age was 7.3 years (4.9-9.7). In multivariable analysis, pain assessed with the AHTPS was significantly lower (B = -1.173, 95% confidence interval -1.953, -0.394, p = .003) in the music group than in the control groups. Across the 3 groups, 108 children self-reported pain with the FPS-R after the procedure. The scores were lowest in the music group, but the differences between groups were not significant (p = .077). OSBD-r distress scores assigned during the procedures were not significantly different between the 3 groups (p = .55). Heart rate directly after the procedure was not statistically significantly different between the 3 groups (p = .83). CONCLUSIONS Listening to recorded music is a beneficial distraction for children experiencing pain during ER procedures, whereas watching cartoons did not seem to reduce pain or distress.
Collapse
Affiliation(s)
- Marianne J E van der Heijden
- Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital.,Department of Internal Medicine, Erasmus MC, Sophia Children's Hospital
| | - Hiske Mevius
- Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital
| | | | | | | | - Monique van Dijk
- Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital.,Department of Pediatric Surgery, Red Cross Children's Hospital
| |
Collapse
|
50
|
Najafi SS, Nazaribin S, Momennasab M, Kordi Yoosefinejad A. The Effect of Manual Acupressure (Point BL32) on Pain Associated with Intramuscular Injections of Magnesium Sulfate. J Acupunct Meridian Stud 2019; 12:67-72. [DOI: 10.1016/j.jams.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/06/2018] [Accepted: 07/17/2018] [Indexed: 12/26/2022] Open
|