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Noise Reduction to Reduce Patient Anxiety During Cast Removal: Can We Decrease Patient Anxiety With Cast Removal by
Susan T Mahan1, Marie S Harris, Anneliese M Lierhaus
1Susan T. Mahan, MD, MPH, Department of Orthopaedics, Boston Children's Hospital, and Assistant Professor in Orthopaedic Surgery, Department of Orthopaedics, Harvard Medical School, Boston, MA. Marie S. Harris, MPH, Department of Orthopaedics, Boston Children's Hospital, Boston, MA. Anneliese M. Lierhaus, BA, Department of Orthopaedics, Boston Children's Hospital, Boston, MA. Patricia E. Miller, MS, Biostatistician, Department of Orthopedics, Boston Children's Hospital, Boston, MA. Rachel L. DiFazio, PhD, RN, PPCNP-BC, FAAN, Department of Orthopedics, Boston Children's Hospital, and Instructor in Orthopaedic Surgery, Harvard Medical School, Boston, MA.
Background:
Noise reduction headphones decrease the sound during cast removal. Their effectiveness in decreasing anxiety has not been studied.
Purpose:
Compare pediatric patients' anxiety levels during cast removal with and without utilization of noise reduction headphones combined with use of a personal electronic device.
Methods:
Quality improvement project. Patients randomly assigned to noise reduction headphone group or standard care group during cast removal. Faces, Legs, Activity, Cry, and Consolability Scale and heart rate were evaluated prior to, during, and after cast removal. Data were compared across groups.
Results:
Fifty patients were included; 25 per group. No difference detected between the 2 groups in Faces, Legs, Activity, Cry, and Consolability Scale score prior to (p = .05) or after cast removal (p = .30). During cast removal, the headphone group had lower FLACC Scale scores (p = .03). Baseline heart rate was lower in the headphone group prior to (p = .02) and after (p = .005) cast removal with no difference during cast removal (p = .24).
Conclusion:
Utilizing noise reduction headphones and a personal electronic device during the cast removal process decreases patient anxiety.
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