Distraction-Based Interventions for Children Undergoing Venipuncture Procedures: A Randomized Controlled Study

Abstract

Little is known about the effects of distraction techniques when undertaking medical procedures with hospitalized pediatric patients in Asian countries. This study examined the effects of distraction interventions on behavioral distress related to venipuncture procedures in Taiwanese children aged 3 to 7 years. Using concealed randomization, eligible children were allocated to receive a picture book ( n = 92), or animated cartoon ( n = 92) compared with routine oral instructions ( n = 92), when being injected with an intravenous cannula. Two trained observers independently scored the responses of each child using the Observational Scale of Behavioral Distress-Revised before, during, and after the procedure. All children experienced distress during needle insertion, but distress was less in the distraction-based intervention groups. Moreover, distraction interventions were more effective for children aged 4 to 5 years. Our culturally tailored intervention engaged child participants, was age-appropriate, and could be adapted for use in other Chinese cultures.

Effects of immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a study protocol for a randomized controlled trial

“…With regard to the IVR modules, pilot work conducted by our research team found that cartoon animation was preferred by young patients, whereas the interactive game was preferred by adolescents; these results concurred with a previous study [24]. An IVR module that presents procedural information through a customized and child-friendly design more effectively mitigates pain and distress than that with off-the-shelf content [17, 29, 33]. However, these freely downloaded IVR modules that were developed in Western countries with English as the medium may not be completely appropriate for pediatric patients in Hong Kong.…”

“…The review suggested that distractions without adult involvement (supportive role articulated for the adult within the intervention) and child choice effectively reduce the intensity of self-reported distress [14]. Two recent studies further confirmed that distraction intervention integrated with procedural information produces significant outcomes [17, 18]. However, simultaneously providing age-appropriate distraction and procedural information may be difficult and may likely increase the workload of hospital staff.…”

“…Lazarus and Folkman’s theory [26] states that an individual’s evaluations of anxiety and stress-provoking experiences are influenced by their perceptions of control over a potential threat. Providing information may help improve pediatric patients’ sense of control over a procedure [17, 18, 27].…”

Tinjauan Literatur: MANFAAT STORYTELLING BAGI ANAK: REVIEW ARTIKEL

“…14 Penelitian yang dilakukan terhadap 276 anak usia 3-7 tahun menunjukkan bahwa distraksi menggunakan storytelling mampu menurjunkan distress pada anak. 15 Pada tahapan usia berikutnya yaitu saat anak mulai lebih banyak bersosialisasi di usia sekolah, storytelling mempunyai pengaruh positif terhadap penurunan kecemasan dan gangguan perilaku anak usia sekolah yang akan dilakukan pembedahan dan mengalami hospitalisasi. 9,16 Berdasarkan penelitian yang dilakukan terhadap 40 anak usia 6-12 tahun di Thailand, bimbingan imajinasi yang digabungkan dengan drawing storytelling dengan menggunakan komputer dikatakan mampu meningkatkan efek kebahagiaan dan relaksasi secara signifikan.…”

Vascular access in children

“…Smartphones have shown to be useful distraction gadgets in 3–7 years age group. [4] Similarly, non-nutritive sucking, swaddling, and rocking have been found useful in neonates and infants. [5] Local anaesthesia creams containing a mixture of lignocaine with prilocaine or tetracaine - like Prilox ® (Neon Laboratories Ltd. Mumbai, India) and Tetralid ® (Ajanta Pharma Ltd. Mumbai, India) applied in occlusive dressings an hour prior can help reduce the pain of vascular access.…”