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İyi Z, İşler A, Özer Z. Effectiveness of ShotBlocker application on reducing the pain of needle-related procedures in children: A systematic review and meta-analysis. J Pediatr Nurs 2024:S0882-5963(24)00306-3. [PMID: 39129083 DOI: 10.1016/j.pedn.2024.08.006] [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: 02/11/2024] [Revised: 07/22/2024] [Accepted: 08/04/2024] [Indexed: 08/13/2024]
Abstract
PROBLEM Needle-related procedures are quite common throughout life, especially during childhood. Pain caused by these procedures is the most common complication. ShotBlocker is an alternative non-pharmacological method to reduce pain during injection-related procedures. However, the effectiveness of the ShotBlocker application in children for reducing pain needle-related procedures remains unclear. This review aimed to evaluate the effectiveness of ShotBlocker application on pain during needle-related procedures in children from Randomized Controlled Trials. ELIGIBILITY CRITERIA Eight electronic databases were searched until November 2023 for articles published in English. The methodological quality and evidence strength were appraised using the Cochrane Risk of Bias 2 tool and the GRADE approach. A random-effects model was used to determine the effect of the ShotBlocker application on pain levels. The review included results involving assessments from the child, parents, and an observer in pain evaluation. SAMPLE A total of nine studies with 1205 children patients were included. RESULTS The evaluation data showed that ShotBlocker application significantly reduced the pain caused by needle-related procedures in children. The Cochrane GRADE approach showed moderate level evidence for the effect of ShotBlocker application on pain during needle procedures. CONCLUSIONS As a result of the studies included in this meta-analysis, it was determined that ShotBlocker application significantly reduced the pain caused by needle-related procedures in children. IMPLICATIONS ShotBlocker, a non-pharmacological method, can be used by pediatric nurses to reduce pain during needle-related procedures in children. Randomized controlled studies with well-designed methods are needed to create strong evidence in this field.
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Affiliation(s)
- Zahide İyi
- Department of Pediatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | - Ayşegül İşler
- Department of Pediatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
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Sönmez Düzkaya D, Karakul A, Akoy İ, Andi S. Effects of ShotBlocker® and the Helfer skin tap technique on pain and fear experienced during intramuscular injection among children aged 6-12 years in pediatric emergency units: A randomized controlled trial. Int Emerg Nurs 2024; 76:101502. [PMID: 39126884 DOI: 10.1016/j.ienj.2024.101502] [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: 03/11/2024] [Revised: 06/24/2024] [Accepted: 07/20/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND In pediatric emergency units, intramuscular injection is one of the most common procedures that cause pain and fear in children. Reducing pain and fear is important for patient comfort. OBJECTIVE This randomized controlled experimental study aimed to determine the effects of ShotBlocker® and the Helfer skin tap technique on the pain and fear experienced by children aged 6-12 years during intramuscular injection in pediatric emergency units. METHODS This study was conducted from April 2022 to October 2023 among 177 children aged 6-12 years. ShotBlocker and the Helfer skin tap technique were applied during intramuscular injection among children in the intervention groups (ShotBlocker group: n = 59, Helfer skin tap technique group: n = 59), while children in the control group received routine injections. (n = 59). The levels of pain and fear were measured. RESULTS In the analysis of the age distribution of the children, the average age of the Helfer skin tap technique group was found to be 8.54 ± 2.00 years; ShotBlocker group, 8.46 ± 1.99 years; and control group, 9.19 ± 2.01 years. There was a significant difference in the post-intervention Wong-Baker Pain Scale and Child Fear Scale scores based on the evaluation of the children, parents, and observer nurses between the groups (p < 0.05). The pain and fear scores of the ShotBlocker group were lower than those of the control group (p < 0.05). CONCLUSIONS ShotBlocker is more effective in reducing pain than the Helfer skin tap technique among children receiving intramuscular injection. These cheap and easy-to-use methods are recommended for use in emergency units.
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Affiliation(s)
- Duygu Sönmez Düzkaya
- Tarsus University, Faculty of Health Sciences, Nursing Department, Mersin, Turkey.
| | - Atiye Karakul
- Tarsus University, Faculty of Health Sciences, Nursing Department, Mersin, Turkey.
| | - İrem Akoy
- Tarsus State Hospital, Pediatric Emergency Unit, Mersin, Turkey.
| | - Senem Andi
- Hasan Kalyoncu University, Department of Nursing, Gaziantep, Turkey.
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Moura JWDS, Bitencourt ADS, Silva TL, do Carmo ACF, dos Santos LM, Rocha PK. Utilization of local pressure devices in pain management during injections: scoping review. Rev Bras Enferm 2024; 77:e20230399. [PMID: 39082544 PMCID: PMC11290735 DOI: 10.1590/0034-7167-2023-0399] [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: 10/18/2023] [Accepted: 03/13/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. METHODS scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. RESULTS a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. FINAL CONSIDERATIONS the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.
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Affiliation(s)
| | | | - Thiago Lopes Silva
- Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil
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Jin F, Wang X, Qi M, Zhang W, Zhang Y. Effectiveness and safety of Buzzy device in needle-related procedures for children under twelve years of age: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37522. [PMID: 38608108 PMCID: PMC11018245 DOI: 10.1097/md.0000000000037522] [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: 09/29/2023] [Accepted: 02/15/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Pain transcends simple physiology, encompassing biological, emotional, psychological, and social facets. Children show pronounced immediate and enduring responses to pain-related procedures. The aim of this meta-analysis is to investigate the efficacy and safety of the Buzzy device for needle-related procedures in children aged twelve years or younger. METHODS PubMed, Web of Science, and Embase were searched from inception to July 2023. Only randomized controlled trials utilizing the Buzzy device for needle-related procedures in children under twelve years old were included. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment. Random-effects models were utilized, and analyses were performed using mean differences or standardized mean differences as well as risk ratios. RESULTS A total of 19 studies were included, involving 2846 participants (Buzzy = 1095, Control = 1751). Compared to no intervention, the Buzzy device significantly reduced pain response [self-report SMD = -1.90 (-2.45, -1.36), parental SMD = -3.04 (-4.09, -1.99), observer SMD = -2.88 (-3.75, -2.02)] and anxiety scores [self-report SMD = -1.97 (-3.05, -0.88), parental SMD = -2.01 (-2.93, -1.08), observer SMD = -1.92 (-2.64, -1.19)]. Compared to virtual reality (VR), the Buzzy device reduced self-reported anxiety levels SMD = -0.47 (-0.77, -0.17), and compared to distraction cards, the Buzzy device reduced parental and observer-reported pain [parental SMD = -0.85 (-1.22, -0.48), observer SMD = -0.70 (-1.00, -0.40)] and anxiety [parental SMD = -0.96 (-1.46, -0.47), observer SMD = -0.91 (-1.40, -0.42)]. Subgroup analysis results showed that procedure type, patient age, measurement scales used, and distance of operation were not the reason of heterogeneity. The summarized first puncture attempt success rate did not differ from other interventions. There were no significant adverse events in the included studies. CONCLUSION The Buzzy device reduces pain and anxiety in children during needle procedures, ensuring success and safety. Additionally, the effectiveness of the Buzzy device in reducing pain during venipuncture is superior when compared to its effectiveness during intramuscular injections.
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Affiliation(s)
- Faguang Jin
- Clinical Medical College, Weifang Medical University, Weifang, China
| | - Xiaofang Wang
- Clinical Medical College, Weifang Medical University, Weifang, China
| | - Maomao Qi
- Department of Pediatrics, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Wenhua Zhang
- Department of Pediatrics, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Yongfeng Zhang
- Department of Pediatrics, Affiliated Hospital of Weifang Medical University, Weifang, China
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Girgin BA, Göl İ, Gözen D, Çarikçi F, Kirmizibekmez H. Effects of applications manual pressure and shotblocker to reduce needle-related pain and fear in children with type 1 diabetes mellitus. J Pediatr Nurs 2023; 73:84-90. [PMID: 37651942 DOI: 10.1016/j.pedn.2023.08.024] [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: 05/15/2023] [Revised: 08/05/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Pain and fear associated with insulin injections can cause children with type 1 diabetes mellitus to avoid insulin injections and skip doses. OBJECTIVE To evaluate and compare pain and fear levels in children aged 6-12 years receiving subcutaneous insulin injection using the manual pressure and ShotBlocker methods. METHODS A randomized controlled study was conducted with 90 children with type 1 diabetes who were allocated using block randomization to the manual pressure, ShotBlocker, and control groups (n = 30 in each group). Fear and pain levels were rated by the children, their parents, and a member of the study team immediately before and after insulin injection using the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale, respectively. RESULTS All groups had similar self-, parent-, and researcher-reported levels of preprocedural pain and fear (p > 0.05). However, pain and fear scores were lower in the manual pressure and ShotBlocker groups than in the control group after injection (p = 0.0001). There was no significant difference in pain and fear scores between the two intervention groups (p > 0.05). CONCLUSION Manual pressure and the ShotBlocker both reduced fear and pain associated with insulin injection in 6- to 12-year-old children with type 1 diabetes. IMPLICATIONS FOR PRACTICE Both the manual pressure and ShotBlocker methods can easily be applied in children receiving insulin injections. As manual pressure is completely cost- and equipment-free, it is a useful option to reduce pain and fear related to insulin injection. CLINICAL TRIAL REGISTRATION NUMBER National Institutes of Health (NIH), ClinicalTrials.gov, NCT05789810.
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Affiliation(s)
- Burcu Aykanat Girgin
- University of Health Sciences, Hamidiye Faculty of Nursing, Department of Pediatric Nursing, Tıbbiye Cad. No:38 Haydarpaşa, Üsküdar, Istanbul, Turkey.
| | - İlknur Göl
- Çankırı Karatekin University, Faculty of Health Sciences, Nursing Department of Public Health Nursing, Uluyazı, Çankırı, Turkey
| | - Duygu Gözen
- İstanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Pediatric Nursing Department, Turkey
| | - Fatma Çarikçi
- İstanbul Yeni Yüzyıl University, Vocational School of Health Sciences, İstanbul, Turkey
| | - Heves Kirmizibekmez
- İstanbul Ümraniye Research and Training Hospital, Pediatric Endocrinology Service, Ümraniye, Turkey
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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).
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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.
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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.
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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
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Yurdakul Z, Esenay FI. Effects of two different ball types on pain and anxiety during venous blood draw in children: A randomized controlled study. J Pediatr Nurs 2023; 72:e201-e209. [PMID: 37414624 DOI: 10.1016/j.pedn.2023.06.029] [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: 03/06/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Children presenting to hospitals for healthcare are often exposed to venous blood draw procedures which cause significant pain and stress for children. OBJECTIVES Tactile stimulation and active distraction methods can be used during procedural pain management in children. This study was conducted to determine and compare the effects of tactile stimulation and active distraction methods on levels of pain and anxiety during venous blood draw procedure in children. METHODS A randomized controlled study design was adopted with a parallel trial design to compare four different intervention groups with a control group. The children's anxiety levels were evaluated using the Children's Fear Scale, and their perceived pain levels were evaluated using the Wong Baker Pain Scale. RESULTS The results of the child and observer evaluations revealed the perceived level of pain during the procedure to be lower in the intervention groups than in the control group, and lower in the spiky ball groups than in the round ball groups. The level of anxiety during the procedure was found to be significantly lower than that recorded prior to the procedure, based on the self-evaluation of the child and the evaluation of the observer in the intervention groups. A positive correlation was found between pain and anxiety levels during the procedure. PRACTICE IMPLICATIONS The results of this study support the effectiveness of the spiky ball method to reduce perceived pain and anxiety in children during venous blood draw procedures in the pediatric blood draw units.
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Affiliation(s)
- Zeynep Yurdakul
- Ankara Etlik City Hospital, Education Unit, Ankara Etlik City Hospital, Halil Sezai Erkut Cd. No:5, Yenimahalle, Ankara, Turkey.
| | - Figen Işık Esenay
- Pediatric Nursing Department, Ankara University Faculty of Nursing, Plevne Cd. No:7, Altındağ, Ankara, Turkey
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Sivri BB, Balci S, Dolgun G. The Effect of 3 Methods (Buzzy, ShotBlocker, and DistrACTION Cards) Used While Taking Blood Samples From Children with Pain and Anxiety: A Randomized Controlled Trial. Pediatr Emerg Care 2023; 39:600-607. [PMID: 36730932 DOI: 10.1097/pec.0000000000002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim of this study was to compare the effectiveness of 3 methods (Buzzy, ShotBlocker, and DistrACTION Cards) in reducing pain and anxiety while taking venous blood samples in children. METHODS The study population consisted of children aged 9 to 12 years admitted to the Child Health and Diseases Department in a Faculty of Medicine in Turkey. The sample of the study consisted of 242 children (Buzzy = 60, ShotBlocker = 61, DistrACTION Cards = 60, control = 61) who met the patient selection criteria and agreed to participate in the study. The data were obtained using an Information Form, the State-Trait Anxiety Inventory for Children, visual analog scale, and the Faces Pain Scale-Revised. DESIGN This article is an experimental randomized controlled study. RESULTS During venous blood collection, the scores of visual analog scale were significantly lower in ShotBlocker, Buzzy, and DistrACTION Cards groups than the control group. It was also observed that the control group experienced more anxiety than the other groups. CONCLUSIONS Methods such as Buzzy, ShotBlocker, and DistrACTION Cards can be used to reduce the anxiety and pain of children during painful procedures such as blood collection and vascular access. Among these methods, "Buzzy" and "DistrACTION Cards" can be preferred as it is equally effective, and then ShotBlocker can be preferred.
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Affiliation(s)
- Birsen Bilgen Sivri
- From the Department of Nursing Sciences, Tübingen Eberhard-Karls-University Faculty of Medicine, Tübingen, Germany
| | - Serap Balci
- Department of Pediatric Nursing, Florence Nightingale Nursing Faculty
| | - Gülümser Dolgun
- Midwifery Department, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Yu J, Chen W, Liu Q, Mi J. Investigating 3D-printed disk compressing against skin for pain relief in intradermal infiltration anesthesia: a randomized controlled trial. BMC Anesthesiol 2023; 23:144. [PMID: 37118673 PMCID: PMC10148480 DOI: 10.1186/s12871-023-02088-y] [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: 11/10/2022] [Accepted: 04/10/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Pain intensity may be varied during the needle advancing through different skin layers, injection into the intradermal layer may exclude mixed pain from deeper planes. This study aimed to investigate whether compressing a three-dimensional (3D)-printed disk against the skin may relieve pain associated with intradermal injection of local anesthetic which mimics the skin test procedure. METHODS After institutional review board approval, 3D-printed disks with projections were designed for this study. Enrolled patients were randomized to receive either a disk compressing against the axillary skin during the intradermal injection of local anesthesia (compressing disk group) or an intradermal injection of local anesthesia without any compression (no compressing disk group). The primary outcomes were pain intensity (100-mm visual analog scale) and satisfaction (5-point Likert scale) as assessed by patients. RESULTS Ninety patients with American Society of Anesthesiologists I-II physical status receiving intradermal local anesthesia prior to an ultrasound-guided axillary approach were included. Eighty-seven patients completed the study, with 44 and 43 patients in disk and no disk groups, respectively. Pain scores were significantly different (P < 0.001) in compressing disk (median, 10; IQR, 5-20) and no compressing disk (median, 30; IQR, 20-40) groups. The median satisfaction score was 5 in both groups. No complications occurred during follow-up. CONCLUSION Compressing a 3D-printed disk against the skin may reduce intradermal needle pain and offers an effective alternative for nerve block induction.
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Affiliation(s)
- Jiong Yu
- Department of Sports Medicine, Wuxi 9Th People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, China.
| | - Wenxuan Chen
- Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Qianyuan Liu
- Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Jingyi Mi
- Department of Sports Medicine, Wuxi 9Th People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, China.
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Göthesson J, Håkansson L, Olinder AL, Hanberger L, Mörelius E, Nilsson S, Forsner M. Children's and adolescent's narratives about pain and negative experiences in diabetes treatment. J SPEC PEDIATR NURS 2023; 28:e12396. [PMID: 36316154 DOI: 10.1111/jspn.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 08/04/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022]
Abstract
UNLABELLED Pain and fear associated with needle procedures have been found to be more common among children and adolescents treated for type 1 diabetes (T1D) than among others in their age group. Furthermore, high glycated haemoglobin (HbA1c) values are associated with needle-related fear. AIM To describe negative experiences of needle procedures in childhood diabetes treatment from children's and adolescents' own perspectives. METHODS Short written narratives (n = 83) and drawings (n = 2) from children and adolescents treated for T1D, aged 7-18 years, were subjected to inductive qualitative content analysis. RESULTS Negative experiences with needle procedures had many facets, such as pain and fear, changing over time and affecting everyday life. All kinds of needle procedures caused difficulties, but venipunctures were described as the worst. CONCLUSION All needle procedures involved in diabetes treatment are potentially experienced as creating pain and fear, but the negative experiences are multifaceted and vary between individuals. These experiences create suffering for children and adolescents, and influence their daily lives. Besides finding techniques to decrease the number of needle procedures in the treatment, research should focus on implementing methods to decrease pain, fear, and other negative experiences as well as to promote self-coping. This is urgent, since needle-related fear has an impact on glycaemic control and therefore increases the risk of long-term complications. CLINICAL IMPLICATIONS When caring for children and adolescents with diabetes, their previous experiences with needle procedures need to be considered.
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Affiliation(s)
- Johanna Göthesson
- Department of Clinical Science and Education, Sachs' Children and Youths Hospital, Södersjukhuset, Stockholm, Sweden
| | - Linnéa Håkansson
- Department of Women's & Children's Health, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Lindholm Olinder
- Department of Clinical Science and Education, Sachs' Children and Youths Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Lena Hanberger
- Division of Nursing, Department of Health, Medicine and Care Sciences, Linköping University, Linköping, Sweden
| | - Evalotte Mörelius
- Department of Nursing and Midwifery, Edith Cowan University and Perth Children's Hospital, Perth, Western, Australia
| | - Stefan Nilsson
- Department of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Forsner
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Biosciences and Nutrition, Karolinska Instituten, Stockholm, Sweden
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Gürdap Z, Cengiz Z. Comparison of cold spray and shotblocker to reduce intramuscular injection pain: A randomized controlled trial. J Clin Pharm Ther 2022; 47:1249-1256. [PMID: 35385141 DOI: 10.1111/jcpt.13663] [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: 01/18/2022] [Revised: 03/17/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE It is important to identify effective, easy-to-use and cost-effective non-pharmacological methods in the management of pain caused by medical interventions. The purpose of this study is to compare the effects of cold spray and ShotBlocker on pain in adults in reducing pain caused by intramuscular injection in the adult emergency department. METHODS This is a randomized controlled trial with two experimental groups, two placebo groups and a control group. The study was conducted on 195 adults who received diclofenac sodium injections. In the study, the injection procedure was performed by following the same injection protocol in all five groups. In the injection process, cold spray or ShotBlocker was used in the intervention groups based on the group, and cold spray with distilled water or the smooth surface of the ShotBlocker was used in the placebo groups. Following the injection, the pain caused by the injection was evaluated using the Visual Analog Scale. RESULTS AND DISCUSSION The study was completed with the remaining 195 patients. In the study, the average pain scores due to injection of the individuals in the cold spray group were lower than those of the control group (p < 0.05). There was no statistically significant difference between the pain score averages due to injection of the individuals in the ShotBlocker group and cold spray, control, ShotBlocker placebo and cold spray placebo groups. WHAT IS NEW AND CONCLUSION The routine use of a fast-acting, cost-effective and easy-to-use method, cold spray, to reduce pain in the intramuscular injection will be beneficial in increasing patient satisfaction and quality of care.
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Affiliation(s)
- Züleyha Gürdap
- Department of Fundamentals of Nursing, Nursing Faculty, Inonu University, Malatya, Turkey
| | - Zeliha Cengiz
- Department of Fundamentals of Nursing, Nursing Faculty, Inonu University, Malatya, Turkey
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Zengin M, Yayan EH. A Comparison of Two Different Tactile Stimulus Methods on Reducing Pain of Children During Intramuscular Injection: A Randomized Controlled Study. J Emerg Nurs 2021; 48:167-180. [PMID: 34952709 DOI: 10.1016/j.jen.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/27/2021] [Accepted: 10/23/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Pediatric patients in the emergency department often require intramuscular injection procedures, which may lead to pain, fear, and anxiety. The purpose of this study was to test a novel nonpharmacological intervention to reduce needle-related pain in the pediatric emergency department. METHODS The study was conducted as a parallel-group, randomized controlled design. The study population consisted of 159 children aged 7 to 10 years cared for in the emergency department who received an intramuscular injection of ampicillin/sulbactam. The children were randomly assigned to Palm Stimulator, ShotBlocker, or control groups. The children's preprocedure fear levels were evaluated using the Children's Fear Scale, and their perceived pain levels during the procedure were evaluated using the Faces Pain Scale-Revised and Visual Analog Scale. Parents and observers also completed the pain level scores. RESULTS According to all raters (child, parent, and observer), the Palm Stimulator group had the lowest mean Faces Pain Scale-Revised score averages (P < .001). The Visual Analog Scale score averages of the children in the Palm Stimulator group (Visual Analog Scale: M = 27.94, standard deviation = 19.13) were statistically significantly lower than the ShotBlocker (Visual Analog Scale: M = 46.07, standard deviation = 24.96) and control group (Visual Analog Scale: M = 53.43, standard deviation = 29.01) score averages (F = 14.94, η2 = 0.16, P = .001). DISCUSSION The results of this study support the effectiveness of the Palm Stimulator to reduce perceived pain in children during intramuscular injection administration in the pediatric emergency department.
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Abstract
This study was conducted to evaluate the effect of ShotBlocker on the intramuscular injection pain and satisfaction in emergency adult patients. This research was designed as a randomized controlled, double-blind, experimental study. The study was conducted with 74 patients who applied to the adult emergency department. Patients were randomized to ShotBlocker and control groups. Patient Assessment Form, Visual Analog Scale, and Visual Analog Patient Satisfaction Scale were used. The mean scores of postinjection pain and satisfaction level were analyzed between the groups; it was determined that while postinjection pain mean score of the experimental group was statistically significantly lower than that of the control group (p = 0.0001), satisfaction scores were statistically significantly higher in the experimental group than in the control group (p = 0.004). When the correlation between the intragroup Pain Scores (VAS) and the Satisfaction Scores (VAS) of the groups after injection was examined, a statistically significant and inverse correlation was found (p < 0.05). It was determined that ShotBlocker was effective in reducing intramuscular injection pain and increasing satisfaction levels.
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Sato R, Fintan B. Fear, knowledge, and vaccination behaviors among women in Northern Nigeria. Hum Vaccin Immunother 2020; 16:2438-2448. [PMID: 32083514 DOI: 10.1080/21645515.2020.1723365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Although vaccine hesitancy is a global concern, the evaluation on how fear of vaccination affects vaccination-related knowledge, behaviors, and perceptions is extremely scarce in developing countries. This study contributes to the literature by filling the knowledge gap on the fear of vaccination by focusing on Nigerian caregivers. Methods: The study evaluates the correlation between fear of vaccination and knowledge, actual behaviors, and perception among caregivers in 11 settlements in the Jada local government area of Adamawa State, northeastern Nigeria. The data were collected in September 2019. We use logistic regression analysis to evaluate the correlation. Results and Discussions: About 15% of caregivers have some form of fear regarding vaccination. However, such fear is not correlated with most of the socio-demographic characteristics among caregivers. Fear is significantly correlated with the lack of accurate vaccination knowledge, with a lower likelihood of vaccination uptake for their children, and with the lack of perceptions of vaccination importance and intention to vaccinate their children. Results from our study are consistent with findings from existing studies conducted in developed countries.
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Affiliation(s)
- Ryoko Sato
- Global Health and Population, Harvard T.H Chan School of Public Health , Boston, MA, USA
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Erdoğan Ç, Turan T, Pınar B. The effect of maternal voice for procedural pain in paediatric intensive care unit: A randomised controlled trial. Intensive Crit Care Nurs 2020; 56:102767. [PMID: 31735564 DOI: 10.1016/j.iccn.2019.102767] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/24/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of the maternal voice in reducing pain during painful procedures in children between one and three years old receiving treatment in paediatric intensive care unit. DESIGN AND METHODS This research was designed as a randomised controlled experimental study. Sixty children were randomised into two groups, the maternal-voice group and the controls. The children in the maternal-voice group listened to the maternal voice during the procedure. Although questionnaire forms were used to determine the descriptive characteristics of infants, the Face, Legs, Activity, Cry, Consolability (FLACC) pain assessment scale was used to evaluate pain level. Heart rate and oxygen saturation were also measured. RESULTS There were significant differences in the pain, heart rate and oxygen saturation levels between the maternal-voice and control groups. Pain levels and heart rates of the children in the experimental group during and after the painful procedures were much lower, and their oxygen saturations were higher than those of the children in the control group. PRACTIC IMPLICATIONS Distraction methods, such as listening to the maternal voice, should be used as a nursing intervention to reduce pain and decrease heart rate and increaseoxygen saturation in children during painful procedures in the paediatric intensive care unit. The maternal voice is recommended as a helpful option in cases when a pain control method is required. Future research needs to explore different interventional practices.
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Affiliation(s)
- Çiğdem Erdoğan
- Faculty of Health Science, Pediatric Nursing Department, Pamukkale University, Denizli, Turkey.
| | - Türkan Turan
- Faculty of Health Science, Pediatric Nursing Department, Pamukkale University, Denizli, Turkey.
| | - Bakiye Pınar
- Pamukkale University Hospital, Pediatric Intensive Care Unit, Pamukkale University, Denizli, Turkey
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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
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Madrigal MA, López M, Sánchez A, Cao MJ, Castro MJ, Jiménez JM. Type 1 Diabetes Mellitus in Pediatric Patients and Its Impact on Relationships in the Family Environment. Diabetes Metab Syndr Obes 2020; 13:4973-4980. [PMID: 33364801 PMCID: PMC7751600 DOI: 10.2147/dmso.s281949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study is to assess the impact of type 1 diabetes mellitus on family environment relationships, as well as the management and approach to this disease. PATIENTS AND METHODS One hundred one children, 52.47% male and 47.52% female, with an average age of 8.55 ± 4.01 years, diagnosis of type 1 diabetes mellitus. Quantitative cross-sectional descriptive study was conducted using the validated questionnaires "Modified Diabetes Quality of Life" and "Questionnaire for the assessment of psychological impact in parents/guardians of diabetic children". RESULTS Most of the children (70.3% versus 29.7%) identified diabetes as unpleasant or not fun. The ≤5-year-olds expressed that they felt concerned about the consequences of being diabetic (8.1% by age group), as opposed to the 10-year-olds who did not feel concerned (85.1% by age group), P <0.001. The family environment was affected in 98.1% (n=99) of the cases. CONCLUSION Self-care of type 1 diabetes mellitus in pediatric patients is a complex process that impacts the family environment and their relationship with their peers, especially for children under the age of 5. Fear, concern and insecurity were prevalent feelings in children suffering type 1 diabetes mellitus.
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Affiliation(s)
- Miguel Angel Madrigal
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María López
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Correspondence: María LópezFaculty of Nursing, Universidad de Valladolid, Avda Ramón y Cajal, Nº 7, Valladolid, SpainTel +34 983184056 Email
| | - Alicia Sánchez
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María José Cao
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
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