Comparison of the Effect of Two Methods of Distraction and Acupressure on Pain and Anxiety of Peripheral Intravenous Cannulation in Pediatric Cancer Patients: A Randomized Controlled Clinical Trial

Abstract

Abstract Introduction: The pain related to invasive procedures such as venipuncture, causes physical and psychological stress in children and therefore should be given relief. Methods that reduce the pain related to invasive procedures in children are among the major priorities in nursing profession. The aim of this study is to comparison of the effect of two methods of distraction and acupressure on pain and anxiety of peripheral intravenous cannulation in pediatric cancer patients. Materials and Methods: This was a cross-sectional clinical trial study and the target population included children aged 6 to 12 years with cancer hospitalized in the oncology department of the Tabriz and Urmia Children's Educational and Medical Center in 2018-19. After obtaining informed consent from the child and their parents and the approval of the Ethics Committee of Tabriz University of Medical Sciences, 30 children who were divided into three groups of 10 people entered the study. The samples were randomly assigned to peripheral intravenous cannulation three times under three methods: routine, distraction and acupressure. Among these three methods, the wash out period was considered to be 24 to 72 hours. Allocation of groups was done randomly which was asked from child to choose one of the matte envelopes to hide the allocation (allocation concealment). Each envelope contained a triple block (watching cartoon = A and Hugo’s point massage = B) and control (C), which showed the order of intervention on the child. In all three methods, the child's pain score (using the VAS scale) and anxiety (using the FAS scale) were determined and recorded by the researcher. The data were analyzed by the test of the mixed model with restricted likelihood estimation method and the unstructured covariance matrix using SPSS-PC (v. 26). Results: In this study, the mean age (standard deviation) of the subjects was (9.10 ±1.82) Years. The mean (SD) of hospitalization and chemotherapy shifts in the subjects of this study was (2.90 ±1.06) and (3.23 ±1.14), respectively. Not everyone in the study had any surgery or painkillers. In this study, the variables of pain and anxiety due to peripheral intravenous cannulation in pediatric cancer patients, in the group of acupressure and distraction, there was a significant decrease after the intervention compared to before the intervention (P> 0.001); While the variables of pain and anxiety due to peripheral intravenous cannulation in the studied children, in the routine group, there was no statistically significant difference between before and after the intervention (P >0.05). Also in this study, in addition to a significant reduction in the amount of pain and anxiety of peripheral intravenous cannulation in the studied pediatric in two methods of distraction and acupressure compared to the routine method (P> 0.001), the method of distraction was also significantly reduced compared to the method of acupressure in the amount of pain and anxiety (P> 0.001). Conclusion: According to the results of the present study, distraction and acupressure can both be used to reduce pain and anxiety due to venous line implantation in school-age children with cancer. Therefore, it is suggested that this issue be presented in the form of training workshops for nurses working in pediatric wards and provide the necessary facilities in the wards.