The Effect Of Use Of Raınstick And Kaleydoscope On Paın Anxıety Durıng Blood Draw
Condition: Pain; Child, Only; Anxiety; Pain, Procedural
MeSH terms: Pain, Procedural; Anxiety Disorders
Study type: Interventional

Summary: 
      Medical procedures are negative experiences that cause pain, distress, and anxiety and are
      not only uncomfortable during medical procedures, especially in children; negative
      consequences such as poor recovery, sleep disturbances, and post-traumatic stress symptoms.
      There are many different approaches, including pharmacological and non-pharmacological
      methods, for the treatment of pain and anxiety in children during medical procedures.
      Non-pharmacological methods vary depending on the child's age, level of development and the
      type of procedure, and non-pharmacological methods generally used in children fall into three
      groups: supportive, physical and cognitive or behavioral methods. Supportive methods are
      practices that include psychosocial care of the child, such as reading a book or playing
      games. Physical methods include techniques such as cold application, massage, and
      transcutaneous electrical nerve stimulation. Cognitive or behavioral methods include
      practices such as listening to music, daydreaming, relaxation, and various methods of
      distraction. Cognitive and behavioral approaches typically use the activating or relaxing
      effects of music for arousal or calming and to enhance the learning of certain skills and
      behaviors. Music therapy practice reduces pain and anxiety levels by stimulating the
      pituitary gland.

      Another method used is the use of kaleidoscope. In the literature, they reported that the use
      of kaleidoscope is effective in reducing the pain that may occur during blood collection in
      studies conducted with preschool and school children, children and adolescents, and
      school-age children. The results show that the kaleidoscope can be used effectively to
      distract children from the painful procedure and reduce the perception of pain.
    

Detailed description: 
      Data Collection After obtaining the necessary institutional permissions, parents and children
      will be informed about the research through the "Informed Voluntary Consent Form" in the
      interview room 15 minutes before the blood draw. Research data will be collected by the
      researcher by face-to-face interview technique. A questionnaire including questions such as
      the age of the child, the time of the last blood draw, the parent's presence with the child
      will be applied to the parents. To ensure randomisation, children will be asked to choose one
      of the sealed envelopes. Then, the blood collection room will be passed to perform the
      procedure.

      When the child to be taken to Experimental Group 1 sits in the patient's chair, the sound of
      the rain stick will be played 1 minute before the blood draw. The nurse will then begin to
      prepare the child for the blood draw. The tourniquet insertion procedure and the
      determination of the vein from which blood will be drawn from the antecubital region will be
      performed by the nurse. Blood collection will be taken from the antecubital region at once by
      the same nurse through the vacuum blood collection tube, and blood flow to the vacuum within
      5 seconds will show that the procedure is successful. In the meantime, a pulse oximeter will
      be attached to the index finger of the hand on the other arm, where blood is not drawn, and
      the heart rate will be evaluated before the procedure and after the procedure. This process
      will take about 2-3 minutes and the children will listen to the sound of the rain stick
      throughout the process. After the procedure is over, the children will be taken out of the
      blood collection room and taken to the waiting area, and they will be asked to determine the
      severity of pain they feel during the procedure. WBFPS will be used to find out how much pain
      the child has during the blood draw, and ÇAS-D will be used to determine the anxiety state.
      Pain and anxiety level will be evaluated by the child, nurse, parent and researcher.

      The Kaleidoscope will start to be watched 1 minute before the blood draw process, as the
      child, who will be taken into Experimental Group 2, sits in the patient's chair. The nurse
      will then begin to prepare the child for the blood draw. The tourniquet insertion procedure
      and the determination of the vein from which blood will be drawn from the antecubital region
      will be performed by the nurse. Blood collection will be taken from the antecubital region at
      once by the same nurse through the vacuum blood collection tube, and blood flow to the vacuum
      within 5 seconds will show that the procedure is successful. In the meantime, a pulse
      oximeter will be attached to the index finger of the hand on the other arm, where blood is
      not drawn, and the heart rate will be evaluated before the procedure and after the procedure.
      This process will take about 2-3 minutes, and children will be shown a kaleidoscope image
      throughout the process. After the procedure is over, the children will be taken out of the
      blood collection room and taken to the waiting area, and they will be asked to determine the
      severity of pain they feel during the procedure. WBFPS will be used to find out how much pain
      the child has during the blood draw, and ÇAS-D will be used to determine the anxiety state.
      Pain and anxiety level will be evaluated by the child, nurse, parent and researcher.

      No interventional procedure will be applied to the children in the control group. The blood
      collection will be arranged in such a way that it is taken from the antecubital region in one
      go by the same nurse by means of a vacutainer. In the meantime, a pulse oximeter will be
      attached to the index finger of the hand on the other arm, where blood is not drawn, and the
      heart rate will be evaluated before the procedure and after the procedure. After the
      procedure is over, the children will be taken out of the blood collection room and taken to
      the waiting area. WBFPS will be used to find out how much pain the child has during the blood
      draw, and ÇAS-D will be used to determine the anxiety state. Pain and anxiety level will be
      evaluated by the child, nurse, parent and researcher. In both groups, parents will be
      provided with their children in the blood collection room during the procedure.
    

Intervention name(s): RAINSTİCK; KALEİDOSCOPE
Intervention type(s): Other; Other
Intervention description(s): When the child, who was taken to Experimental Group 1, sat on the patient's chair, the sound of the rain stick was started to be played 1 minute before the blood draw. At that time, the nurse began to prepare the child for the blood draw. The tourniquet insertion procedure and the determination of the vein from which blood will be drawn from the antecubital region were performed by the nurse. Blood collection was taken from the antecubital region in one go by the same nurse by means of a vacuum blood collection tube, and blood flowed to the vacuum within 5 seconds, showing that the procedure was successful. This process took about 2-3 minutes and the children listened to the sound of rain sticks throughout the process.; The child, who was taken into Experimental Group 2, was started to watch the kaleidoscope 1 minute before the blood draw, as he sat on the patient's chair. At that time, the nurse began to prepare the child for the blood draw. The tourniquet insertion procedure and the determination of the vein from which blood will be drawn from the antecubital region were performed by the nurse. Blood collection was taken from the antecubital region in one go by the same nurse by means of a vacuum blood collection tube, and blood flow to the vacuum within 5 seconds showed that the procedure was successful. This process took about 2-3 minutes and children were watched with kaleidoscope throughout the process.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Anxiety; Blood draw; children; Nursing; Pain; Rainstick; Kaleidoscope