Developing a medical picture book for reducing venipuncture distress in preschool-aged children

Source: International Journal of Nursing Practice

Ying Tsao, Hui-Chen Kuo, Hsui-Chuan Lee and Shuenn-Jiun Yiin
Version of Record online: 20 JUL 2017 | DOI: 10.1111/ijn.12569

Abstract

Aim

Distress associated with needle-related procedures is a major concern in preschool-aged children nursing. This study developed a medical picture book for supporting preschool-aged children facing a venipuncture and determined the effectiveness of such a book intervention in decreasing behavioural distress.

Methods

The picture book was designed in 3 stages: developing stories on medical situations, penning the text, and drafting the book. We conducted a quasiexperimental study to examine the effectiveness of the book. The behavioural distress of the control and picture book groups were assessed before, during, and after the intervention by using the Observational Scale of Behavioral Distress-Revised (OSBD-R).

Results

We created a 12-page picture book, Sick Rui-Rui Bear, in which cartoon characters were depicted undergoing venipunctures, as a guide for vein injection and for facilitating positive venipuncture outcomes in preschool-aged children. Over time, the OSBD-R scores of the picture book group were significantly lower than those of the control group (P < .001).

Conclusion

We recommend the picture book be routinely read and used during venipunctures to decrease procedural distress in preschool-aged children.

SUMMARY STATEMENT
What is already known about this topic?

  • Venipunctures may cause varying levels of distress in preschool-aged children. Pain is experienced during venipunctures, which often terrifies children and prolongs the intravenous procedures and the associated displeasure.
  • Although some picture books have been used to describe the medical procedures to children, to our knowledge, the process of venipunctures has not been explained for preschool-aged children.

What this paper adds: (research findings/key new information)

  • We created a picture book titled Sick Rui-Rui Bear, in which cartoon characters were depicted as receiving venipunctures. This 12-page book is a guide to vein injection and is aimed at facilitating excellent venipuncture outcomes for preschool-aged children.
  • We adopted analytical statistics to compare the behavioural distress scores of the control and venipuncture picture book groups. Results showed that the picture book group had significantly lower scores of OSBD-R over time than that of the control group.

The implications of this paper: (how findings influence or can be used to change policy/practice/research/education)

  • When administering a venipuncture, nurses should be concerned about the distress in preschool-aged children. Interaction among nurses, parents, and preschool-aged children can be stimulated by providing them with a venipuncture picture book, thereby enabling preschool-aged children to face such a medical treatment experience.
  • Nurses can use a venipuncture picture book to reduce distress in preschool-aged children during vein injection.

 

 

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