Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Çocuklarda İntramusküler Enjeksiyon Uygulamasında Dikkat Dağıtıcı Kartların ve Stres Topunun Ağrı ve Anksiyete Üzerine Etkisi: Randomize Kontrollü Bir Çalışma
Effect of Distraction Cards and Stress Ball on the Pain and Anxiety, in the Implementation of Intramuscular Injection on Children: A Randomized Controlled Study
Merve EROĞLUa , Türkan KADİROĞLUa
aAtatürk Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Bölümü, Çocuk Sağlığı ve Hastalıkları Hemşireliği ABD, Erzurum, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(4):961-70
doi: 10.5336/nurses.2023-96872
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, çocuklarda intramusküler (IM) enjeksiyon uygulamasında dikkat dağıtıcı kartların (DDK) ve stres topunun (ST) ağrı ve anksiyete üzerine etkisini incelemektir. Gereç ve Yöntemler: Bu çalışmada, paralel randomize kontrollü tasarım kullanıldı. Mayıs-Eylül 2022 tarihleri arasında yürütülen bu araştırma, bir devlet hastanesinin acil ünitesinde yapıldı. Araştırma, IM enjeksiyon uygulanan, 3-6 yaş grubu 93 çocuk ile yürütüldü. Çocuklar, DDK, ST ve kontrol grubu olmak üzere toplamda 3 gruba basit rastgele randomize olarak atandı. Randomizasyon yöntemi, birebir anlık randomizasyon şeklinde opak kapalı zarf yöntemi ile yapıldı. Veriler, tanıtıcı bilgi formu, Wong-Baker Yüzler Ağrı Derecelendirme Ölçeği (W-BYADÖ) ve Venham Anksiyete Değerlendirme Resim Ölçeği (VADRÖ) ile toplandı. Çalışma, Helsinki Deklarasyonu prensiplerine uygun olarak yapıldı. Çalışmanın Clinical Trial kayıt numarası NCT05444634'tür. Bulgular: Çocukların işlem öncesine göre işlem sonrası ortalama WBYADÖ ve VADRÖ düzeyleri kontrol grubunda arttı, DDK ve ST gruplarında azaldı. İşlem sonrası W-BYADÖ ve VADRÖ puan ortalamalarında gruplar arasında anlamlı farklılık bulundu (p<0,001). Bu anlamlı farklılığın kontrol grubundan kaynaklandığı saptandı. İşlem sonrası en düşük ortalama W-BYADÖ ve VADRÖ puanları sırasıyla DDK, ST ve kontrol gruplarında olduğu ve grupların etki büyüklüğünün büyük olduğu belirlendi. Sonuç: Çocuklarda IM enjeksiyon işleminde DDK ve ST uygulamaları, ağrı ve anksiyete düzeylerini azaltmıştır. Çocuklarda IM enjeksiyon uygulamasında hemşirelerin maliyeti düşük, kolay ve güvenli olan bu yöntemleri kullanması önerilmektedir.

Anahtar Kelimeler: Çocuk; enjeksiyon; hemşire; ağrı; anksiyete
ABSTRACT
 Objective: To examine the effect of distractor cards and stress ball on the pain and anxiety in intramuscular (IM) injection on children. Material and Methods: A parallel randomized controlled design was used in this study. The study was carried out in a state hospital emergency unit, between May-September 2022. The study was conducted with 93 children aged 3-6 years who received IM injections. Children were randomly assigned to three groups. Randomization method was carried out in the form of one-to-one instant randomization using the opaque closed envelope method. Information form, WongBaker Pain Faces Scale (W-BFS) and Venham Anxiety Evaluation Picture Scale (VAEPS) were used to collect the data. The research was conducted in accordance with the principles of the Declaration of Helsinki. The research's Clinical Trial registration number is NCT05444634. Results: The levels of W-BFS and VAEPS of children were increased in the after-procedure compared to the before-process in the control group, and were decreased others groups. There was a significant difference between the groups in the mean scores of W-BFS and VAEPS after-procedure (p<0.001). This significant difference was due to the control group. The lowest mean W-BFS and VAEPS scores after-procedure were; distraction card, stress ball and control groups and the effect size of the groups was found to be large. Conclusion: In the implementation of IM injection in children, distractor cards and stress ball decreased the pain and anxiety levels. It would be advisable for the nurses to use these low-cost, easy and safe methods in the application of IM injection to the children.

Keywords: Child; injection; nurse; pain; anxiety
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