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A kaleidoscope for reduced pain and anxiety in children undergoing catheter dressing changes?

In this randomized controlled trial in children undergoing central venous catheter dressing changes, playing with a kaleidoscope reduced pain and anxiety associated with this procedure.

Background

A central venous catheter (CVC) is a catheter that is placed in a large vein such as the jugular or femoral vein. Pediatric cancer patients frequently have CVCs for delivery of chemotherapy and other therapies. CVCs are usually covered with a dressing, both to secure them and to prevent infection, and this dressing needs to be regularly changed. However, children may find the dressing changes painful and scary. Playing with toys reduces children's pain and anxiety during other medical procedures; could playing with a kaleidoscope decrease children's pain and anxiety during CVC dressing changes?

The study

In this randomized controlled trial, 60 Turkish children (ages 6–12) with nonterminal cancer and CVCs were randomized to a kaleidoscope or a control group. Before, during, and immediately after a CVC dressing change, the researchers asked all participants to rate their pain and fear using face-based scales and also measured their heart rate and oxygen saturation (SpO2)

All participants rated their fear 3 minutes before the dressing change. The kaleidoscope group participants were then given the kaleidoscope and a researcher asked them questions about what they saw while they played with it during the dressing change. The control group received no intervention during the dressing change. Immediately after the dressing change, all participants rated their fear and pain during and after the procedure using the face-based scales.

The results

The children in the kaleidoscope group reported significantly less pain and fear than the children in the control group. Their average heart rate during and after the procedure was also significantly lower, and their SpO2 was significantly higher before and during the dressing change.

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