22 June 2012

Distract anxious kids during medical procedures

According to a new study, preschoolers were less anxious about having their warts removed if they watched their favourite TV show.


According to a new study, preschoolers were less anxious about having their warts removed if they watched their favourite TV show or movie right before the procedure.

Cryotherapy can be an uncomfortable and sometimes painful procedure, causing a lot of distress in young children – who often have to be coaxed or restrained during wart removal, researchers said.

"In the clinics, children crying and screaming is not an uncommon scene and this affects everyone in the clinic," Dr Hong Liang Tey, who led the study at Singapore's National Skin Centre, said.

Studies have suggested distracting anxious kids with toys, books and handheld video games can help them get through medical procedures. Dr Tey's team wanted to see if a TV show or movie could be a useful alternative.

Warts removed while watching videos

With handheld devices like iPads and tablets so widely available, this is something parents can now do themselves, Dr Tey said.

For the new study, the researchers measured anxiety levels in 35 kids, age two to six, as they went through the wart removal procedure with or without the help of a video.

In the video group, two- to four-year-olds watched Barney and five- and six-year-olds watched the movie Kung Fu Panda.

Thirteen youngsters had wart removal done while the videos played and 15 went through the procedure without TV or movies. Another seven kids experienced the treatment both with and without videos.

According to the findings, published in the Archives of Dermatology  all 15 children without video access were described as highly anxious before their treatment, based on their scores on the Yale Preoperative Anxiety Scale. In comparison, five out of the 13 kids who watched videos were described as highly anxious.

Children hospitals have video games

The researchers also found it took slightly less time to complete the wart-removal treatment when kids were distracted by the video: about 12 minutes, compared to 15 minutes in kids without a video. But that difference was not statistically significant.

Anxiety scores were also lower after video-watching in the seven kids who had procedures with and without the help of Barney and Kung Fu Panda.

Using videos to lower anxiety is a good idea, but the findings are not really new or surprising, according to Dr Anuradha Patel, a paediatric anaesthesiologist at New Jersey Medical School in Newark, who studies preoperative anxiety in kids and was not involved in the study.

A lot of children's hospitals have videos and video games, she said. Video players like those used in the study typically cost about R1, 600.

Consider the needs of a child

The study is limited by its small size, Dr Patel said. And it's hard to say whether the results were affected by some kids coping better with the procedure after they had gone through a number of treatments.

Dr Patel also said using the anxiety scale when kids are already distracted could lead to inaccurate results.

But finding a way to ease anxiety in children without using medication is important, she added – and holding kids down and letting them scream is not good for their psychological well-being.

"We chose cryotherapy for viral warts to study as this is a very commonly-performed procedure. The results can be extrapolated to various medical procedures in children, dermatological and non-dermatological," said Dr Tey.

"It does show that doctors, even in a busy outpatient office, should still consider the needs of the child," Dr Patel said. "It's very simple, now there are all these smartphones, and there are apps, like Angry Birds, that you can use to distract children."

(Natasja Sheriff, Reuters Health, June 2012) 

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