Razi Journal of Medical Sciences

fa بررسی تاثیر پخش کارتون در کاهش درد در هنگام انجام بخیه کودکان 3 تا 6 سال: یک مطالعه کارآزمایی بالینی The Efficacy of Cartoon Playing in Pediatric Suturing Pain Relief among Children of 3 to 6 Years Old: A Randomized Clinical Trial بیماری‌های اطفال Pediatric Disease پژوهشي Research <div style="text-align: justify;">زمینه و هدف: درد یک احساس شخصی و یک تجربه انسانی است که به شکل یک احساس نامطلوب مرتبط با آسیب بافتی تعریف می‌شود و فرآیند درک درد توسط مغز صورت می‌گیرد. درد و ترس در ارائه خدمات سلامت در کودکان در اکثر موارد دیده می‌شود. روش کار: مطالعه حاضر یک مطالعه کارآزمایی بالینی تصادفی می‌باشد که بر روی 218 کودک ۳ تا ۶ سال مراجعه کننده به اورژانس‌های بیمارستان‌های مورد مطالعه که نیاز به انجام بخیه داشتند، انجام شد. یافته‌ها: در این مطالعه میانه درد بعد از پروسیجر در شرکت‌کنندگان مطالعه به صورت کلی ۳ (5-1IQR=) بوده است که این مقدار در گروه کنترل میانه ۳ (5-2IQR=) و در گروه مورد میانه برابر 2 (4-1IQR=) می‌باشد. در بررسی وجود تفاوت معنی‌دار بین دو گروه اختلاف معنی دار دیده شد (011/0Pvalue=). نتیجه‌گیری: مطالعه حاضر با هدف بررسی تاثیر پخش کارتون در کاهش درد در هنگام انجام بخیه  انجام شد که نتایج حاکی از وجود تفاوت معنی‌دار در درد بعد از پروسیجر در گروه مورد بود؛ بنابراین می‌توان از این تکنیک در اورژانس استفاده کرد.</div> <div style="text-align: justify;">Background & Aims: Pain is a personal and subjective feeling and a human experience, which is defined as an unpleasant feeling related to tissue damage, and the process of understanding pain is done by the brain. Providing medical services in children has always been associated with difficulties due to the difficulty in communicating and the ineffectiveness of reassuring methods in children as in adults. Pain and fear are seen in most cases in the provision of health services in children. Surveys show that 87% of children experience pain and stress associated with receiving medical services, which in most cases is the fear of needles and needle-related processes, which is the cause of aggravating anxiety, stress and psychological discomfort in children. It can manifest as crying, screaming, body twisting or muscle tightening. The child's conscious focus on pain causes the perception and feeling of pain to intensify, which in turn causes a decrease in the child's cooperation in the treatment, as well as an increase in the required time and effort required to perform the treatment correctly. There are treatment processes that waste the time and energy of the treatment staff. There are always painful processes in providing medical services to children, which include vaccinations, injections, repairing lacerations, changing burn dressings. Pain, in turn, causes a decrease in the child's participation in medical services and an increase in the required time and efforts required to perform the treatment procedures correctly. To deal with stress and then the pain caused by the procedures, various techniques are used, which are generally divided into two categories, pharmaceutical and non-pharmacological, according to the psychological importance of pain in treatment processes and psychological effects and feedback. Dealing with it correctly In this study, we examined the effect of cartoons on reducing pain during stitches in children aged 6 to 3 years who referred to the emergency room of Ali Asghar, Haft Tir and Firozabadi hospitals. Methods: The current study is a randomized clinical trial that was conducted on 218 children aged 3 to 6 years who referred to the emergency rooms of the studied hospitals who needed stitches. Children were randomly placed in two groups, case and control. For randomization, to conduct this study, simple randomization technique was used with the help of coin toss software to assign each patient to the case and control groups. Entry criteria included: child Between the ages of 3 and 6, he was referred to the emergency room of Ali Asghar, Haft Tir and Firozabadi medical centers with a complaint of stabbing injury. Exclusion criteria include: the child's lack of consent, the parents' lack of consent; multiple trauma cases were considered in the case group (case) in addition to the standard treatment i.e. local anesthesia, cartoons were also played for them and the control group only with the help of local anesthesia were treated and cartoons were not played for them. The child's pain level was asked based on the 10-point FLACC questionnaire in both groups. Quantitative descriptive statistics were expressed in the form of mean ± standard deviation and qualitative descriptive statistics were expressed as percentages. Statistical analysis was performed using Statistical Package for the social sciences (SPSS) v.26 software (IBM, New York, United States). Quantitative descriptive statistics were expressed as mean ± standard deviation and qualitative descriptive statistics were expressed as percentages. Due to the sample size, normal distribution was checked with the help of Kolmogorov-Smirnov test with a significance level of less than 0.001. The comparison between quantitative variables is done by the Independent Sample T-test, and in case of non-normal distribution, using the Mann-Whitney test. To examine quantitative variables with more than 2 categories, One-Way ANOVA test was used for variables with normal distribution and Kruskal-Wallis H test was used to examine variables with non-normal distribution. The comparison between the qualitative variables was also done using the Chi-square test, or if there were less than 5 samples in each subgroup, using the Exact Fisher test. A significance level of less than 0.05 and a standard deviation of 95% was considered. Results: This study consisted of 218 children who were examined in two control groups (without playing cartoons) and case group (group with playing cartoons). The average age of the children in this study was 4.52 years with a standard deviation of 1.29. In this study, the average age of the control group is 4.31 years with a standard deviation of 1.10, and the average age of the case group is 4.73 with a standard deviation of 1.12 years, and the control group consists of 62 girls (56.9%) and 47 boys (43.1%), and the case group includes 47 girls. (43.1%) and 62 boys (56.9%). In this study, in the review, the previous history of this amount in the control group was 82 cases with a history against 27 cases without a history and in the case group 84 cases with a history against 25 cases without a history. Similarly, in the control group, 53 cases were performed without versus 56 cases with presence, and in the case group, 42 cases without presence versus 67 cases with the presence of parents. The average pre-procedure pain in the study participants was 7.10 points with a standard deviation of 1.97, which in the control group was 7.17 with a standard deviation of 1.77 and in the case group with an average of 7.03 and a standard deviation of 2.05. There was no significant difference between the two groups (P-value=0.564). For post-procedure pain in the study participants, the overall score was 3.06 with a standard deviation of 2.13, which in the control group was 3.42 with a standard deviation of 2.06 and in the case group with an average of 2.71 and a standard deviation of 2.16. In examining the presence of a significant difference between the two groups, a significant difference was seen (P-value=0.011). Conclusion: The present study was conducted with the aim of investigating the effect of playing cartoons in reducing pain during sutures, and the results indicated that there was a significant difference in post-procedure pain in the case group, so this technique can be used in the emergency room.</div> درد, کودک, کارتون, بخیه Pain, Child, Cartoons, Suture 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7346-1&slc_lang=fa&sid=1 Hamidreza Khoshnezhad Ebrahimi حمیدرضا خوش نژاد ابراهیمی 3900319475328460089594 3900319475328460089594 No Associate Professor of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Health Management, Hazrat-e Ali Asghar Children's Hospital Iran University of Medical Sciences, Tehran, Iran دانشیار طب اورژانس، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، تهران، ایران Sanaz Yazdani ساناز یزدانی dr.yazdanisa@gmail.com 3900319475328460089595 3900319475328460089595 Yes MD, Emergency Medicine Resident, Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran دانشجوی تخصص طب اورژانس، گروه طب اورژانس، دانشکده پزشکی دانشگاه علوم پزشکی ایران، تهران، ایران Peyman Hafezi Moghadam پیمان حافظی مقدم 3900319475328460089596 3900319475328460089596 No Associate Professor of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Health Management, Hazrat-e Ali Asghar Children's Hospital Iran University of Medical Sciences, Tehran, Iran دانشیار طب اورژانس، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، تهران، ایران Mahya Naderkhani مهیا نادر خانی 3900319475328460089597 3900319475328460089597 No Assistant Professor of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Health Management, Hazrat-e Ali Asghar Children's Hospital Iran University of Medical Sciences, Tehran, Iran استادیار طب اورژانس، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، تهران، ایران Somayeh Esmaeilian سمیه اسمعیلیان 3900319475328460089598 3900319475328460089598 No Master of Pediatric Nursing, Department of Emergency Medicine, Faculty of Medicine, Iran University of Medical Sciences, Ali Asghar Children's Hospital, Tehran, Iran ارشدپرستاری کودکان، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، تهران، ایران Mahdi Rezai مهدی رضایی 3900319475328460089599 3900319475328460089599 No Assistant Professor of Emergency Medicine, Department of Emergency Medicine, School of Medicine, Health Management, Hazrat-e Ali Asghar Children's Hospital Iran University of Medical Sciences, Tehran, Iran استادیار طب اورژانس، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، تهران، ایران