Research Article
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The Impact of Kaleidoscope and Distraction Cards on Pain Level During Blood Drawing in Children

Year 2024, Volume: 7 Issue: 3, 120 - 132, 31.10.2024
https://doi.org/10.55517/mrr.1408159

Abstract

Aim: This study is designed as a randomized controlled experimental study to investigate the impact of kaleidoscope and distraction cards on the pain level of child patients during blood drawing procedure.
Method: The population of the study was composed of children between the ages of 7-12 years who came to the pediatric blood drawing department of Alanya Training and Research Hospital between August 01, 2022 and November 15, 2022. The study sample included a total of ‘57’ children who met the criteria of the study, who came to the pediatric blood drawing department, who volunteered to take part in the study, and who were randomly selected from among the children between the ages of 7 and 12 years old with the consent of their parents as 28 study (separate kaleidoscope group and attention diversion cards were administered) and 19 control (no kaleidoscope or attention diversion card was administered) groups. The data were obtained by using the “Descriptive Information Form”, “Visual Equivalence Scale (VAS)”, and “Wong Baker Rating Scale for Facial Expressions”.
During blood drawing from the children in the study group, kaleidoscope and distraction cards were used. In the control group, standard blood drawing procedure was used without any intervention. Moreover, mean, percentage, chi-square, t-test, t-test in dependent and independent groups were used to analyze the data.
Results: It was found that the use of distraction cards and kaleidoscope significantly reduced the level of pain (p<0.05), and the pain levels of the individuals in the groups in which kaleidoscope and/or distraction cards were used were lower than the control group in reducing the pain that occurred during venous blood sampling in pediatric patients aged 7-12 years. It was determined that the highest decrease in pain score was realized in the kaleidoscope, distraction cards and control groups, respectively.
Conclusion: It was found that the use of kaleidoscope and distraction cards were efficient in pain management in blood drawing attempts in children. It was also found that pain scores decreased as the age of the children increased.

References

  • Mutlu B. Çocuklarda venöz kan örneği alırken oluşan ağrıyı azaltmada balon şişirme ve öksürme yöntemlerinin etkisi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü; 2012.
  • Svendsen EJ, Bjørk IT. Experienced nurses' use of non-pharmacological approaches comprise more than relief from pain. Journal of Pediatric Nursing. 2014;29(4):e19-e28.
  • Oakes LL. Infant and Child Pain Management. New York: Springer Publishing Company; 2011.
  • Yamamoto-Hanada K, Futamura M, Kitazawa H, Ohya Y, Kobayashi F, Kusuda T, et al. Relieving pain and distress during venipuncture: Pilot study of the Japan Environment and Children's Study (JECS). Pediatrics International. 2015;57(5):1044-7.
  • Özveren H. Ağrı kontrolünde farmakolojik olmayan yöntemler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2011;18(1):83-92.
  • Agosto C, Farina MI, Catalano I, Coccato F, Lazzarin P, Benini F. Procedural pain in Children: education and management. The approach of an Italian pediatric pain center. European Journal of Pediatrics. 2012;171(8):1175-83.
  • Cassidy KL, Reid GJ, McGrath PJ, Finley GA, Smith DJ, Morley C, et al. Watch needle, watch TV: audovisual distraction in preschool immunization. Pain Mad., 2002;3:108-118.
  • Cohen LL, Blount RL, Panopoulos G. Nurse coaching and cartoon distraction: an effective and practical intervention to reduce child, parent, and nurse distress. HSP. 2015;2(3):372-378
  • Aydin D, Şahiner NC, Çiftçi EK. Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: Ball squeezing, balloon inflating and distraction cards. Journal of Clinical Nursing. 2016;25:2328-35.
  • Chen YJ, Cheng SF, Lee PC, Lai CH, Hou IC, Chen CW. Distraction using virtual reality for children during intravenous injections in an emergency department: A randomized trial. J Clin Nurs. 2019;00:1-8.
  • Güdücü TF, Çelebioğlu A, Küçükoğlu S. Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture. Journal of Clinical Nursing, 2009; (18); 2180-2186.
  • İnal S, Kelleci M. Distracting children during blood draw: Looking through distraction cards is effective in pain relief of children during blood draw. International Journal of Nursing Practice. 2012;18(2):210-219.
  • Koller D, Goldman RD. Distraction techniques for children undergoing procedures: A critical review of pediatric research. Journal of Pediatric Nursing. 2012;27(6):652-81.
  • Canbulat N, Inal S, Sönmezer H. Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian Nursing Research. 2014;8(1):23-8.
  • İnal S, Canbulat N. Çocuklarda Prosedürel Ağrı Yönetiminde Dikkati Başka Yöne Çekme Yöntemlerinin Kullanımı. Sağlık Bilimleri ve Meslekleri Dergisi. 2015;2(3):372-8.
  • Carlson KL, Broome M & Vessey JA. Using distraction to reduce reported pain, fear and behavioral distress in children and adolescents: a multisite study. Journal of the Society of Pediatric Nurses, 2000;5: 75-85.
  • Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. The effects of two nonpharmacologic pain management methods for intramuscular injection pain in children. Acute Pain, 2006;8: 7-12.
  • Tulunay, M., Tulunay, FC. (2000). Ağrı değerlerlendirilmesi ve ağrı ölçümleri, Serap Erdine (Ed), Ağrı, 1. Baskı, Alemdar Ofset, İstanbul, s. 91-107.
  • Akbay A. Vizuel analog skala (VAS). http://www.spinetr.com/uploads/files/skor/vizuelanalogskala.pdf. (Erişim Tarihi:25 Ocak 2017).
  • Scott J, Huskisson EC. Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases. 1979; (38): (63-66).
  • Huguet A, Stinson JN, McGrath PJ. Measurement of self-reported pain intensity in children and adolescents. Journal of Psychosomatic Research. 2010;68(4):329-36.
  • Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404.
  • Greco CD, Bedre CB. Pain management in children. In: Behrman RE, Kliegman RM, Jenson HB (eds.) Nelson Textbook of pediatrics. Philadelphia: WB. Saunders Company. 2000: (74):306-12.
  • Stinson J. Pain assessment (In) Twycross A, Dowden S, Bruce E (eds.) Managing pain in children a clinical guide. USA. 2009: 86-108.
  • Talu GK. Çocukluk çağında ağrı. Devecioğlu Ö, Çıtak A. (Edt). Pediatride Rutinler‟de. istanbul, İstanbul Tıp Kitabevi; 2014:883-893.
  • Lundeberg S, Lebel AA. Acute pain. In: Sejersen T, Wong CH. (eds.) Acute Pediatric Neurology. London. 2014; 365-387.
  • Hodgins MJ, Lander J. Children's coping with venipuncture. J Pain Symptom Manage. 1997; 13(5):274-285387.
  • Mahoney L, Ayers S, Seddon P. The association between parent’s and healthcare professional’s behavior and children’s coping and distress during venepuncture. J Pediatr Psychol. 2010; 35(9);985-995
  • Bellieni, C.V. Cordelli, D.M, Raffaelli, M., Ricci, B., Morgese, G., Buonocore, G. (2006). Analgesic effect of watching TV during venipuncture. Arch Dis Child, 91, 1015–1017.
  • Caprilli S, Anastasi F, Grotto RP, Scollo Abeti M, Messeri A. Interactive music as a treatment for pain and stress in children during venipuncture: a randomized prospective study. J Dev Behav Pediatr. 2007; 28(5):399-403.
  • Caprilli S, Vagnoli L, Bastiani C, Messeri A. Pain and distress in children undergoing blood sampling: effectiveness of distractionwith soap bubbles. A randomized controlled study. Giornale Italiano di Scienze Infermieristiche Pediatriche. 2012; 4 (1):15-18.
  • Tunç Tuna P. Çocuklarda periferal kanül uygulaması öncesi işleme hazırlamaya yönelik yapılan uygulamaların ağrı ve anksiyete üzerine etkisi. Eskişehir: Eskişehir Osmangazi Üniversitesi Sağlık Bilimleri Enstitüsü; 2014.
  • Felluga M, Rabach I, Minute M, Montico M, Giorgi R, Lonciari I, et al. A quasi randomizedcontrolled trial to evaluate the effectiveness of clowntherapy on children’s anxiety and pain levels in emergency department. Eur J Pediatr. 2016;175(5):645-50.
  • Aydin D, Şahiner NC, Çiftçi EK. Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: Ball squeezing, balloon inflating and distraction cards. Journal of Clinical Nursing. 2016;25(15-16):2328-35.
  • Burns-Nader S, Joe L, Pinion K. Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial. Burns. 2017;1-9
  • Güdücü Tüfekci F, Çelebioğlu A, Küçükoğlu S. Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture J Clin Nurs. 2009;18 (15): 2180-2186

Çocuklarda Kan Alma Girişimi Esnasında Kaleidoskop ve Dikkati Başka Yöne Çekme Kartlarının Ağrı Şiddetine Etkisi

Year 2024, Volume: 7 Issue: 3, 120 - 132, 31.10.2024
https://doi.org/10.55517/mrr.1408159

Abstract

Amaç: Bu araştırma, kaleidoskop ve dikkati başka yöne çekme kartlarının, kan alma işlemi uygulanırken çocuk hastaların yaşadığı ağrı şiddetinin etkisini incelemek için randomize kontrollü deneysel türde planlanmıştır. Yöntem: Araştırma evrenini, 01 Ağustos 2022 – 15 Kasım 2022 tarihleri arasında Alanya Eğitim ve Araştırma Hastanesinin çocuk kan alma bölümüne gelen 7-12 yaş arası çocuklar oluşturmuştur. Araştırmanın örneklemi, araştırma kriterlerine uyan, çocuk kan alma bölümüne gelen, araştırmaya katılmaya gönüllü olan çocuklar ve anne-babalarının izin verdiği 7-12 yaşlardaki çocuklar arasından randomizasyonla belirlenen 28 çalışma (ayrı ayrı kaleidoskop grubu ve dikkati başka yöne çekme kartlarının uygulandığı) ve 19 kontrol (kaleidoskop ya da dikkati başka yöne çekme kartı uygulanmadığı) grubu olarak toplam ‘57’ çocuktan oluşmaktadır. Veriler, “Tanıtıcı Bilgi Formu”, “Görsel Eşdeğerlik Skalası (VAS)”, “Wong Baker Yüz İfadelerini Derecelendirme Ölçeği” kullanılarak toplanmıştır. Çalışma grubundaki çocuklardan kan alırken, kaleidoskop ve dikkati başka yöne çekme kartları kullanılmıştır. Kontrol grubu çocuklara herhangi bir uygulama yapılmaksızın standart kan alma girişimi uygulanmıştır. Ayrıca, araştırma verileri değerlendirilirken, ortalama, yüzdelik, ki kare, t testi, bağımlı ve bağımsız gruplarda t testi kullanılmıştır. Bulgular: 7-12 yaş çocuk hastalarda venöz kan alma girişimi esnasında meydana gelen ağrıyı azaltmada dikkati başka yöne çekme kartlarının ve kaleidoskop uygulamasının ağrı şiddetini anlamlı düzeyde azalttığı (p<0,05), kaleidoskop ve/ veya dikkati başka yöne çekme kartları kullanılan gruplardaki bireylerin ağrı düzeylerinin, kontrol grubundan düşük olduğu belirlendi. Ağrı puanında en çok düşüşün sırasıyla kaleidoskop, dikkati başka yöne çekme kartları ve kontrol gruplarında gerçekleştiği belirlendi. Sonuç: Kaleidoskop ve dikkati başka yöne çekme kartlarının kullanımının çocuklarda kan alma girişiminde ağrı yönetiminde etkili olduğu saptanmıştır. Çocukların yaşları arttıkça ağrı puanlarının azaldığı belirlenmiştir.

References

  • Mutlu B. Çocuklarda venöz kan örneği alırken oluşan ağrıyı azaltmada balon şişirme ve öksürme yöntemlerinin etkisi. İstanbul: İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü; 2012.
  • Svendsen EJ, Bjørk IT. Experienced nurses' use of non-pharmacological approaches comprise more than relief from pain. Journal of Pediatric Nursing. 2014;29(4):e19-e28.
  • Oakes LL. Infant and Child Pain Management. New York: Springer Publishing Company; 2011.
  • Yamamoto-Hanada K, Futamura M, Kitazawa H, Ohya Y, Kobayashi F, Kusuda T, et al. Relieving pain and distress during venipuncture: Pilot study of the Japan Environment and Children's Study (JECS). Pediatrics International. 2015;57(5):1044-7.
  • Özveren H. Ağrı kontrolünde farmakolojik olmayan yöntemler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2011;18(1):83-92.
  • Agosto C, Farina MI, Catalano I, Coccato F, Lazzarin P, Benini F. Procedural pain in Children: education and management. The approach of an Italian pediatric pain center. European Journal of Pediatrics. 2012;171(8):1175-83.
  • Cassidy KL, Reid GJ, McGrath PJ, Finley GA, Smith DJ, Morley C, et al. Watch needle, watch TV: audovisual distraction in preschool immunization. Pain Mad., 2002;3:108-118.
  • Cohen LL, Blount RL, Panopoulos G. Nurse coaching and cartoon distraction: an effective and practical intervention to reduce child, parent, and nurse distress. HSP. 2015;2(3):372-378
  • Aydin D, Şahiner NC, Çiftçi EK. Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: Ball squeezing, balloon inflating and distraction cards. Journal of Clinical Nursing. 2016;25:2328-35.
  • Chen YJ, Cheng SF, Lee PC, Lai CH, Hou IC, Chen CW. Distraction using virtual reality for children during intravenous injections in an emergency department: A randomized trial. J Clin Nurs. 2019;00:1-8.
  • Güdücü TF, Çelebioğlu A, Küçükoğlu S. Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture. Journal of Clinical Nursing, 2009; (18); 2180-2186.
  • İnal S, Kelleci M. Distracting children during blood draw: Looking through distraction cards is effective in pain relief of children during blood draw. International Journal of Nursing Practice. 2012;18(2):210-219.
  • Koller D, Goldman RD. Distraction techniques for children undergoing procedures: A critical review of pediatric research. Journal of Pediatric Nursing. 2012;27(6):652-81.
  • Canbulat N, Inal S, Sönmezer H. Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian Nursing Research. 2014;8(1):23-8.
  • İnal S, Canbulat N. Çocuklarda Prosedürel Ağrı Yönetiminde Dikkati Başka Yöne Çekme Yöntemlerinin Kullanımı. Sağlık Bilimleri ve Meslekleri Dergisi. 2015;2(3):372-8.
  • Carlson KL, Broome M & Vessey JA. Using distraction to reduce reported pain, fear and behavioral distress in children and adolescents: a multisite study. Journal of the Society of Pediatric Nurses, 2000;5: 75-85.
  • Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. The effects of two nonpharmacologic pain management methods for intramuscular injection pain in children. Acute Pain, 2006;8: 7-12.
  • Tulunay, M., Tulunay, FC. (2000). Ağrı değerlerlendirilmesi ve ağrı ölçümleri, Serap Erdine (Ed), Ağrı, 1. Baskı, Alemdar Ofset, İstanbul, s. 91-107.
  • Akbay A. Vizuel analog skala (VAS). http://www.spinetr.com/uploads/files/skor/vizuelanalogskala.pdf. (Erişim Tarihi:25 Ocak 2017).
  • Scott J, Huskisson EC. Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases. 1979; (38): (63-66).
  • Huguet A, Stinson JN, McGrath PJ. Measurement of self-reported pain intensity in children and adolescents. Journal of Psychosomatic Research. 2010;68(4):329-36.
  • Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404.
  • Greco CD, Bedre CB. Pain management in children. In: Behrman RE, Kliegman RM, Jenson HB (eds.) Nelson Textbook of pediatrics. Philadelphia: WB. Saunders Company. 2000: (74):306-12.
  • Stinson J. Pain assessment (In) Twycross A, Dowden S, Bruce E (eds.) Managing pain in children a clinical guide. USA. 2009: 86-108.
  • Talu GK. Çocukluk çağında ağrı. Devecioğlu Ö, Çıtak A. (Edt). Pediatride Rutinler‟de. istanbul, İstanbul Tıp Kitabevi; 2014:883-893.
  • Lundeberg S, Lebel AA. Acute pain. In: Sejersen T, Wong CH. (eds.) Acute Pediatric Neurology. London. 2014; 365-387.
  • Hodgins MJ, Lander J. Children's coping with venipuncture. J Pain Symptom Manage. 1997; 13(5):274-285387.
  • Mahoney L, Ayers S, Seddon P. The association between parent’s and healthcare professional’s behavior and children’s coping and distress during venepuncture. J Pediatr Psychol. 2010; 35(9);985-995
  • Bellieni, C.V. Cordelli, D.M, Raffaelli, M., Ricci, B., Morgese, G., Buonocore, G. (2006). Analgesic effect of watching TV during venipuncture. Arch Dis Child, 91, 1015–1017.
  • Caprilli S, Anastasi F, Grotto RP, Scollo Abeti M, Messeri A. Interactive music as a treatment for pain and stress in children during venipuncture: a randomized prospective study. J Dev Behav Pediatr. 2007; 28(5):399-403.
  • Caprilli S, Vagnoli L, Bastiani C, Messeri A. Pain and distress in children undergoing blood sampling: effectiveness of distractionwith soap bubbles. A randomized controlled study. Giornale Italiano di Scienze Infermieristiche Pediatriche. 2012; 4 (1):15-18.
  • Tunç Tuna P. Çocuklarda periferal kanül uygulaması öncesi işleme hazırlamaya yönelik yapılan uygulamaların ağrı ve anksiyete üzerine etkisi. Eskişehir: Eskişehir Osmangazi Üniversitesi Sağlık Bilimleri Enstitüsü; 2014.
  • Felluga M, Rabach I, Minute M, Montico M, Giorgi R, Lonciari I, et al. A quasi randomizedcontrolled trial to evaluate the effectiveness of clowntherapy on children’s anxiety and pain levels in emergency department. Eur J Pediatr. 2016;175(5):645-50.
  • Aydin D, Şahiner NC, Çiftçi EK. Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: Ball squeezing, balloon inflating and distraction cards. Journal of Clinical Nursing. 2016;25(15-16):2328-35.
  • Burns-Nader S, Joe L, Pinion K. Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial. Burns. 2017;1-9
  • Güdücü Tüfekci F, Çelebioğlu A, Küçükoğlu S. Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture J Clin Nurs. 2009;18 (15): 2180-2186
There are 36 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing
Journal Section Research Article
Authors

Hatice Gülsoy 0000-0001-5468-4047

Fadime Toru 0000-0002-0410-8209

Hatice Öntürk Akyüz 0000-0002-6206-2616

Fatma Özlem Üner 0000-0003-0185-7746

Early Pub Date October 30, 2024
Publication Date October 31, 2024
Submission Date December 21, 2023
Acceptance Date August 8, 2024
Published in Issue Year 2024 Volume: 7 Issue: 3

Cite

Vancouver Gülsoy H, Toru F, Öntürk Akyüz H, Üner FÖ. The Impact of Kaleidoscope and Distraction Cards on Pain Level During Blood Drawing in Children. MRR. 2024;7(3):120-32.