Pediatrik Onkoloji Hastalarında Santral Venöz Kateter Pansuman Değişikliği Sırasında Çizgi Film İzlemenin Ağrı ve Kaygı Üzerine Etkisi: Randomize Kontrollü Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı pediatrik onkoloji hastalarında santral venöz kateter (SVK) pansuman değişiklikleri sırasında çizgi film izlemenin ağrı ve kaygıyı gidermeye etkisini incelemektir. Veri Kaynakları: Yaşları 5 ile 12 arasında değişen 80 pediatrik onkoloji hastasıyla paralel, randomize kontrollü bir çalışma yürütüldü. Çocuklar rastgele iki gruba ayrıldı: çizgi film (n = 40) ve kontrol (n = 40). Çocuklar, Wong-Baker FACES Ağrı Derecelendirme Ölçeği'ni kullanarak ağrılarını ve Çocuk Korku Ölçeği'ni kullanarak kaygılarını kendileri bildirdiler. Çocukların oksijen saturasyonu ve kalp atım hızı nabız oksimetresi cihazı kullanılarak değerlendirildi. Araştırmanın klinik araştırma kayıt numarası NCT05301374'tür. Sonuç: İşlem sırasında ve sonrasında çizgi film grubunda çocukların ağrı, anksiyete puanları ve kalp atım hızları kontrol grubuna göre anlamlı derecede düşüktü. Ancak iki grup arasında oksijen satürasyonu değerlerinde anlamlı bir fark görülmedi. Hemşirelik Uygulamalarına Yönelik Öneriler: Bu çalışma, pediatrik onkoloji hastalarında SVK pansuman değişimi sırasında çizgi film izlemenin ağrı ve anksiyeteyi gidermede etkili olduğunu göstermiştir. Hemşireler, CVC pansuman değişiklikleri sırasında çocuklarda işleme bağlı ağrı ve kaygıyı hafifletmeye yardımcı olmak için çizgi film dikkat dağıtma yöntemini kullanabilir.

Keywords

• anksiyete
• santral venöz kateter
• onkoloji
• ağrı
• pediatri

The Effect of Watching Cartoons on Pain and Anxiety During Central Venous Catheter Dressing Changes in Pediatric Oncology Patients: A Randomized Controlled Trial

Abstract

Objectives: The purpose of this study was to examine the effect of watching cartoons on relieving pain and anxiety during central venous catheter (CVC) dressing changes in pediatric oncology patients. Data Sources: A parallel randomized controlled trial was conducted with 80 pediatric oncology patients between 5 and 12 years old. Children were randomly allocated to two groups: cartoon (n = 40) and control (n = 40). Children self-reported their pain using the Wong-Baker FACES Pain Rating Scale and their anxiety using the Children’s Fear Scale. Children’s oxygen saturation and heart rate were evaluated using a pulse oximeter device. The clinical trial registration number of the study is NCT05301374. Conclusion: Children’s pain and anxiety scores, and heart rates were significantly lower in the cartoon group compared to the control group during and after the procedure. However, no significant difference was seen in oxygen saturation values between the two groups. Implications for Nursing Practice: This study demonstrated that watching cartoons during CVC dressing changes in pediatric oncology patients is effective on relieving pain and anxiety. Nurses can use the cartoon distraction method to help relieve procedure-related pain an anxiety in children during CVC dressing changes.

Keywords

• anxiety
• central venous catheter
• oncology
• pain
• pediatric

Supporting Institution

None

Ethical Statement

Ethics committee approval was obtained from the Akdeniz university clinical research ethics committee (Date: 18.08.2021, Decision No: KAEK-610), before commencing the study. Written permission was obtained from the hospital where the study was performed. The children and their parent were informed about the study. Children and their parent were also informed that they could withdraw from the study at any time without explanation and their verbal and written consents were obtained. This study was registered in the Clinical Trial Registry (NCT05301374). All procedures performed in studies involving human participants were in accordance with the ethical standards and with the Helsinki Declaration

References

1. Akgül, E. A., Karahan, Y., Başoğlu, F., Oğul, A., Öztornaci, B. Ö., Yetim, P., & Sari, H. Y. (2024). Effects of watching cartoons on pain scores in children undergoing venepuncture. Nursing children and young people, 36(6). https://doi.org/10.7748/ncyp.2018.e913
2. Baker, W. (2016). Wong-Baker FACES® Pain Rating Scale.
3. Bekar, P., Erkul, M., & Efe, E. (2022). The effect of using a kaleidoscope during central venous catheter dressing changes on pain and anxiety in children with cancer: A randomised controlled trial. European Journal of Oncology Nursing, 57, 102114. https://doi.org/10.1016/j.ejon.2022.102114
4. Canbulat, N., Inal, S., & Sönmezer, H. (2014). Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian nursing research, 8(1), 23-28. https://doi.org/10.1016/j.anr.2013.12.001
5. Cheraghi, F., Kalili, A., Soltanian, A., Eskandarlou, M., & Sharifian, P. (2021). A Comparison of the effect of visual and auditory distractions on physiological indicators and pain of burn dressing change among 6–12-year-oldchildren: a clinical trial study. Journal of Pediatric Nursing, 58, e81-e86. https://doi.org/10.1016/j.pedn.2021.01.011
6. Düzkaya, D. S., Bozkurt, G., Ulupınar, S., Uysal, G., Uçar, S., & Uysalol, M. (2021). The effect of a cartoon and an information video about intravenous insertion on pain and fear in children aged 6 to 12 years in the pediatric emergency unit: a randomized controlled trial. Journal of Emergency Nursing, 47(1), 76-87. https://doi.org/10.1016/j.jen.2020.04.011
7. Gavin, N. C., Webster, J., Chan, R. J., & Rickard, C. M. (2016). Frequency of dressing changes for central venous access devices on catheter‐related infections. Cochrane Database of Systematic Reviews, (2). https://doi.org/10.1002/14651858.CD009213.pub2
8. Gerçeker, G. Ö., Ayar, D., Özdemir, E. Z., & Bektaş, M. (2020). Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5–12 years old: A randomised controlled study. Journal of clinical nursing, 29(7-8), 1151-1161.https://doi.org/10.1111/jocn.15173

9. Gerçeker, G. Ö., Ayar, D., Özdemir, Z., & Bektaş, M. (2018). Gaining of children’s state anxiety and children’s fear scale to Turkish language. E-Journal of Dokuz Eylul University Nursing Faculty, 11(1), 9-13.
10. Gerçeker, G. Ö., Bektaş, M., Aydınok, Y., Ören, H., Ellidokuz, H., & Olgun, N. (2021). The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: Randomized controlled trial. European Journal of Oncology Nursing, 50, 101886. https://doi.org/10.1016/j.ejon.2020.101886
11. Howie, C., Crooks, B., Moorehead, P. (2020). Pediatric CNS tumor patients have significantly lower requirement of tissue plasminogen activator for episodes of central venous catheter dysfunction compared with other pediatric oncology patients: Results of a population-based cohort study. Journal of Pediatric Hematology/Oncology, 42(7), e623–e626. https://doi.org/10.1097/MPH.0000000000001670
12. Hundert, A. S., Birnie, K. A., Abla, O., Positano, K., Cassiani, C., Lloyd, S., Tiessen, P. H., Lalloo, C., Jibb, L. A., & Stinson, J. (2022). A Pilot Randomized Controlled Trial of Virtual Reality Distraction to Reduce Procedural Pain During Subcutaneous Port Access in Children and Adolescents With Cancer. The Clinical Journal of Pain, 38(3), 189–196. https://doi.org/10.1097/AJP.0000000000001017
13. Inan, G., & Inal, S. (2019). The impact of 3 different distraction techniques on the pain and anxiety levels of children during venipuncture: a clinical trial. The Clinical journal of pain, 35(2), 140-147. https://doi.org/10.1097/AJP.0000000000000666
14. Karakul, A., Akgül, E. A., Yalınız, R., & Meşe, T. (2022). Effectiveness of music during cardiac catheterization on children's pain, fear, anxiety and vital signs: A randomized, blind controlled trial. Journal of pediatric nursing, 65, e56–e62. https://doi.org/10.1016/j.pedn.2022.02.009
15. Kramer, C., Doellman, D., Blaser, C., Rosenberg, R. H., & Bernatchez, S. F. (2019). CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs. Journal of the Association for Vascular Access, 24(2), 11-19.
16. McMurtry, C. M., Noel, M., Chambers, C. T., & McGrath, P. J. (2011). Children's fear during procedural pain: preliminary investigation of the Children's Fear Scale. Health psychology, 30(6), 780. https://doi.org/10.1037/a0024817
17. Nguyen, T. N., Nilsson, S., Hellström, A. L., & Bengtson, A. (2010). Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. Journal of Pediatric Oncology Nursing, 27(3), 146-155. https://doi.org/10.1177/1043454209355983
18. Ozkan, T. K., Aslan, S., & Inci, R. (2021). Effect of watching cartoon during IV treatment on anxiety and fear levels in children: Randomized controlled trial. Clinical and Experimental Health Sciences, 11, 466-71.
19. Koç Özkan, T. (2020). Effects of distraction methods on pain perception and anxiety levels in children during blood collection. Archives of health science and research (Online), 7(3), 244-249. https://doi.org/10.5152/ArcHealthSciRes.2020.19042
20. Özkan, T. K., & Polat, F. (2020). The effect of virtual reality and kaleidoscope on pain and anxiety levels during venipuncture in children. Journal of PeriAnesthesia Nursing, 35(2), 206-211. https://doi.org/10.1016/j.jopan.2019.08.010
21. Sahiner, N. C., & Bal, M. D. (2016). The effects of three different distraction methods on pain and anxiety in children. Journal of Child Health Care, 20(3), 277-285. https://doi.org/10.1177/1367493515587062
22. Sajeev, M. F., Kelada, L., Wakefield, C. E., Wewege, M. A., Karpelowsky, J., Akimana, B., ... & Signorelli, C. (2021). Interactive video games to reduce paediatric procedural pain and anxiety: a systematic review and meta-analysis. British Journal of Anaesthesia, 127(4), 608-619. https://doi.org/10.1016/j.bja.2021.06.039
23. Wong, C. L., Li, C. K., Chan, C. W., Choi, K. C., Chen, J., Yeung, M. T., & Chan, O. N. (2021). Virtual reality intervention targeting pain and anxiety among pediatric cancer patients undergoing peripheral intravenous cannulation: a randomized controlled trial. Cancer Nursing, 44(6), 435-442. https://doi.org/10.1097/NCC.0000000000000844
24. Wong, D. L. B. C. (1988). Pain in children: comparison of assessment scales. Pediatr Nurs, 14(1), 9-17.
25. Yap, K. Y. L., Koh, D. W. H., Lee, V. S. J., & Wong, L. L. (2020). Use of virtual reality in the supportive care management of paediatric patients with cancer. The Lancet Child & Adolescent Health, 4(12), 899-908. https://doi.org/10.1016/S2352-4642(20)30240-6
26. Yildirim, M., Koroglu, E., Yucel, C., Kirlak, S., & Sen, S. (2019). The effect of hospital clown nurse on children’s compliance to burn dressing change. Burns, 45(1), 190-198. https://doi.org/10.1016/j.burns.2018.08.033