Instructional Video did not reduce anxiety during pediatric cast removal: a prospective cohort study

Area of Science:

• Pediatric Orthopedics
• Child Psychology
• Medical Education

Background:

• Cast removal can induce anxiety in children.
• Distraction techniques are often used to manage procedural anxiety.
• The effectiveness of different video interventions for anxiety during cast removal requires further investigation.

Purpose of the Study:

• To evaluate the impact of an instructional video versus a general children's video on anxiety during cast removal in pediatric patients.
• To compare the anxiety levels of children receiving no video intervention, an instructional video, or a children's video during cast removal.

Main Methods:

• Sixty healthy children undergoing their first cast removal were divided into three groups: No Video, Instructional Video, and Children's Video.
• Anxiety was assessed by measuring heart rate in the waiting room, during the procedure, and post-procedure.
• Statistical analysis included a linear mixed-effect model, with age as a covariate.

Main Results:

• No statistically significant differences in heart rate were found between the groups for the overall model.
• The Children's Video group showed the smallest increase in heart rate during cast removal (17.7 beats/min), with a trend towards significance (P=0.12).
• A moderate effect size (η2P=0.0592) indicated that certain age groups may benefit from the Children's Video intervention when controlling for age.

Conclusions:

• A general children's video may serve as an effective distraction to reduce anxiety during cast removal.
• An instructional video demonstrating cast removal did not reduce anxiety as hypothesized.
• Age-specific benefits of distraction via children's videos warrant further exploration in pediatric procedural care.