The Effect of Therapeutic Play During Peripheral Intravenous Catheterisation

Study Overview
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Brief Summary
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Therapeutic play (TP) is a non-pharmacological method used in the pain management in children. This study was conducted to determine the effect of therapeutic play on children's pain, anxiety, and mothers' anxiety during peripheral intravenous catheterisation (PIVC).

Detailed Description
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The hospitalisation of children due to an acute or chronic illness interrupts play, disrupts their daily routines, places them in an unfamiliar environment, forces them to encounter with unfamiliar people, exposes them to invasive procedures, and makes them suffer from pain and anxiety. Peripheral intravenous catheterisation (PIVC) is probably the most common procedure performed in paediatric clinics. It has been estimated that 80% of hospitalised children have a peripheral intravenous catheter in place. PIVC is a painful and traumatic experience that children usually go through for the first time and frequently during the hospitalisation. This experience of children impairs effective communication between them and healthcare professionals and also causes problems in adaptation to the care and treatment process in the hospital setting. As one of the non-pharmacological pain relief methods, therapeutic play (TP) is a distraction that is defined as the directed use of toys and materials, which can facilitate children to gain knowledge about the environment and the world they live in, to improve their perceptions thereof and to gain control, for a specific purpose. In order to call play with a child who is hospitalised as therapeutic, the play should encourage children to express their feelings and thoughts during the hospitalisation, assume an educational role in their positive or negative hospital experiences, and bring psychosocial and physical benefits. Children could be told facts such as the hospitalisation, the procedures to be followed and the time when this procedure would end through therapeutic play

Official Title
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The Effect of Therapeutic Play on Children's Pain, Anxiety, and Mothers' Anxiety During Peripheral Intravenous Catheterisation

Conditions
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Pain, Anxiety

Intervention / Treatment
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* Behavioral: Therapeutic play group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 3-6 year-old children, had no mental disability, were able to communicate, and had mothers volunteered to participate Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Therapeutic play<br>The therapeutic play method with the teddy bear during PIVC was applied in this group | Behavioral: Therapeutic play group<br>* The dramatization method with teddy bear, one of the TP methods, was applied during the PIVC intervention<br>|
| No Intervention: Control<br>The standard procedure of the clinic was applied in the control group. The routine invasive procedure of the clinic, the mothers accompany their children and are involved in the procedure | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from before in pain on the FLACC Scale at during peripheral intravenous catheterisation | The FLACC Scale was used to assess the pain scores of children. The scale is scored between 0 and 10 points indicating 0: the child is relaxed and calm, 1-3: the child is mildly uncomfortable, 4-6: the child has moderate pain and 7-10: the child has severe pain. | data collected just before and within 5 min after peripheral intravenous catheterization procedure | 
| Change from before in anxiety on the CEMS Scale at during peripheral intravenous catheterization | The CEMS scale was used to evaluate the anxiety scores of children.This scale, which consists of 5 different categories and 25 items, was used to evaluate the anxiety of children before and during medical procedures. Total score ranges between 5 and 25 points | data collected just before and within 5 min after peripheral intravenous catheterization procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from before in mothers' anxiety on STAI scale at during peripheral intravenous catheterization | The STAI scale was used to assess the anxiety mean scores of the mothers.This self-assessment scale with brief statements comprises a total of 40 items, including 20 items in each of two sections, the state anxiety inventory and the trait anxiety inventory. The 'State Anxiety Inventory' was designed to determine what was felt at that moment and the 'Trait Anxiety Scale' was designed to determine what was felt in the last week. | data collected just before and within 5 min after peripheral intravenous catheterization procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain, anxiety, Peripheral intravenous catheterisation, therapeutic play