Investigating the Effects of picture book on Reducing Distress Caused by Intravenous Catheterization among School-aged Children (randomized clinical trial)

Abstract Background: Hospitalized pediatric patients experience pain, fear, and distress during intravenous catheterization. This study investigates the effects of a picture book on reducing distress caused by intravenous (IV) catheterization among school-aged children.Methods: seventy four Pediatric emergency room patients age 6-12 years old requiring Iv Infusion were enrolled in this randomized clinical trial. The intervention, providing a description of the IV catheterization procedure using a picture book, was compared to the same description of the procedure without a picture book (standard of care). Subject distress was measured using the Observation Scale of Behavior Distress Revised (OSBD_R) which assigns a score to eight observable behaviors. Before, during, and after the procedure at 15-second intervals (measured using a timer), a trained observer assigned an OSBD_R score of distress. A total score of 22 is considered maximum distress. The primary endpoint for the study was OBSD_R score difference in Phase 3 (Performing catheterization procedure, attaching and infusion therapy). Chi-square, Mann-Whitney and Wilcoxon tests were used for data analysis. Results: The mean distress score in third phases for the intervention group (0.667 ± 0.610) was significantly less than that of the control group (3.218 ± 1.799). A significant difference in distress score was observed before and after the intervention (p< 0.001).Conclusions: Children’s distress due to IV catheterization can be reduced with a simple, nonpharmacological picture book intervention. The children’s orientation on the IV catheterization plays a significant role in controlling and reducing their distress during and after the intervention. We suggested using the picture book to reduce the children distress before Intravenous Catheterization.