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Published on: January 27, 2010
Multimodal distraction reduces intravenous cannulation pain and anxiety in preschoolers: Controlled prospective study
Leana Phebe Wilson1, Zubair Khan2, Pushparaj Nilkanth Patil3
1Department of Pediatric Nursing, NAMO College of Nursing, Silvassa 396230, Dadra and Nagar Haveli and Daman and Diu, India.
Insights
A simple, low-cost distraction technique significantly reduced pain and anxiety in hospitalized preschoolers during intravenous (IV) therapy. This nurse-led intervention, using balloons, art, and kaleidoscopes, offers a scalable solution for pediatric care.
Area of Science:
- Pediatric Nursing
- Child Psychology
- Pain Management
Background:
- Hospitalization and intravenous (IV) procedures cause significant pain and anxiety in preschool children.
- Existing distraction techniques are often underutilized in resource-limited settings.
- Effective, low-cost interventions are needed to manage procedural pain and anxiety in young children.
Purpose of the Study:
- To evaluate the effectiveness of a nurse-led multimodal distraction intervention for reducing pain and anxiety in hospitalized preschoolers undergoing IV therapy.
- The intervention combined balloon blowing, art therapy, and kaleidoscope use.
- To assess the impact of this strategy in a resource-limited setting.
Main Methods:
- A posttest-only controlled observational study involving 600 preschoolers (aged 3-6 years) at Shri Vinoba Bhave Civil Hospital, India.
- Participants were randomly assigned to an experimental group (distraction intervention) or a control group (routine care).
- Pain and anxiety were measured using validated scales, with outcomes assessed on day 3.
Main Results:
- The experimental group showed significantly lower pain scores (3.07 ± 1.39) compared to the control group (8.80 ± 1.01) (P < 0.00001).
- Anxiety levels were also significantly reduced in the experimental group (5.85 ± 1.56 mm) versus the control group (9.39 ± 0.73 mm) (P < 0.00001).
- Moderate positive correlations between pain and anxiety were observed in both groups (r = 0.67; r = 0.66).
Conclusions:
- A simple, low-cost, nurse-led multimodal distraction strategy effectively reduces pain and anxiety in preschool children during IV therapy.
- The intervention's ease of use and scalability make it suitable for immediate integration into pediatric care.
- This approach is particularly valuable for low-resource healthcare settings.
Background:
Hospitalization and intravenous (IV) procedures are known to provoke significant pain and anxiety in preschool children, potentially leading to long-term psychological distress. Despite growing evidence supporting distraction techniques, practical, low-cost interventions suited for resource-limited settings remain underutilized.
Aim:
To determine the effectiveness of a nurse-led multimodal distraction intervention - comprising balloon blowing, art therapy, and kaleidoscope use - in reducing pain and anxiety during IV therapy among hospitalized preschool children.
Methods:
A posttest-only controlled observational study was conducted at Shri Vinoba Bhave Civil Hospital, India. A total of 600 hospitalized preschoolers (aged 3-6 years) were randomly allocated to either an experimental group (n = 300; distraction intervention) or control group (n = 300; routine care). Pain was measured using the Wong-Baker FACES Pain Rating Scale, and anxiety was assessed using the Visual Analogue Anxiety Scale. The distraction intervention included daily 5-minute sessions: (1) Pre-procedure familiarization (balloon/art); (2) Intra-procedure distraction (kaleidoscope and balloon blowing); and (3) Post-procedure relaxation. Outcomes were evaluated on day 3. Data were analyzed using independent t-tests and correlation analysis.
Results:
Children in the experimental group had significantly lower pain scores [mean ± SD (3.07 ± 1.39)] than the control group (8.80 ± 1.01) (t = 58.56, P < 0.00001). Anxiety levels were also reduced in the experimental group (5.85 ± 1.56 mm) compared to controls (9.39 ± 0.73 mm) (t = 35.55, P < 0.00001). A moderate positive correlation was found between pain and anxiety in both groups (experimental: r = 0.67; control: r = 0.66; P < 0.05). Significant associations were also found between pain levels and variables such as age, IV site, cannula size, and medication type (P < 0.05).
Conclusion:
This study demonstrates that a simple, low-cost, nurse-led multimodal distraction strategy can significantly reduce pain and anxiety in preschool children undergoing IV therapy. Its ease of use and scalability make it highly suitable for immediate integration into pediatric care, especially in low-resource healthcare settings.
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