Nonpharmacological Methods for Children in Procedural Pain
Condition: Procedural Pain; Procedural Anxiety
MeSH terms: Pain, Procedural; Anxiety Disorders
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      The International Guide to Pediatric Anesthesia (Good Practice in Postoperative and
      Procedural Pain) recommends pharmacological and nonpharmacological methods to effectively
      manage and prevent acute procedural pain in children. Nonpharmacological methods alone or in
      combination with pharmacological methods help reduce pain, and therefore, have become popular
      especially in recent years. For pain management, nonpharmacological methods are easy to use,
      and cost- and time-effective methods with no side effects. Studies have evaluated a large
      number of pharmacological and nonpharmacological interventions for procedural pain management
      in children. However, most of those interventions are not used by healthcare professionals
      because they are expensive, time-consuming or hard to use. Therefore, easy-to-use, practical,
      non-invasive, cost-effective, and reusable nonpharmacological methods, such as distraction
      cards, virtual reality and Buzzy®, can be used especially in acute settings.
    

Intervention name(s): Distraction cards; Virtual reality; Buzzy
Intervention type(s): Other; Other; Other
Intervention description(s): The distraction cards contain various hidden pictures and patterns which are visible only when looked at carefully. During a procedure, the child is expected to focus on the cards and answer the questions asked about what they see in them. Just before the venipuncture, the researcher showed the distraction cards participants the distraction cards and asked them to check them and then asked them questions about what they saw on the cards and kept asking questions until the end of the venipuncture. The distraction cards intervention and venipuncture were terminated at the same time.; The virtual reality participants put on the virtual reality glasses and headsets about two minutes before the venipuncture and watched the 3D Dinosaur Animation movie throughout the procedure. The virtual reality intervention and venipuncture were terminated at the same time.; Buzzy® applies high frequency vibration and concentrated cold at injection site for procedural pain management and distraction before the shot in children and adults. Buzzy® was placed on the injection site (antecubital fossa) of the Buzzy® participants, and cold application and vibration was turned on 60 seconds before the procedure. After the 60 seconds, the nurse moved Buzzy® about 3 cm above the injection site and applied a tourniquet and performed the procedure. Buzzy® was on throughout the procedure. The Buzzy® intervention and venipuncture were terminated at the same time.
Other intervention name(s): Flippits1, MMJ Labs, Atlanta, Georgia, ABD
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants were randomized into the experimental and control groups using a block randomization method. Literature shows that age, gender, and fear are three factors affecting procedural pain and anxiety in children (Ball, Bindler, & Cowen, 2010; Twycross, 2009). Therefore, the variables of age (7-9 and 10-12 years), gender (girls and boys), and fear of procedure (yes and no) were used for block randomization. The blocks were repeated five times in each group (2X2X2X5), and 40 participants were assigned to each. The sealed envelope method was used to randomly assign participants to the groups.
Masking: Single (Investigator)
Primary purpose: Supportive Care
Keywords: Anxiety; Children; Nursing; Acute pain management