The effect of finger puppet activity applied to children during high-flow nasal cannula oxygen therapy on anxiety and effect on phsysiological parameters. randomized controlled study

This randomized controlled experimental study was conducted to determine the effects of a finger puppet intervention on anxiety levels and physiological parameters in children undergoing High-Flow Nasal Cannula (HFNC) oxygen therapy. The research took place between September 2023 and June 2024 in the pediatric clinics of Düzce University Health Practice and Research Center and Sakarya Training and Research Hospital. The study sample consisted of 70 children (intervention group = 35, control group = 35) who met the inclusion criteria and agreed to participate, as determined by a power analysis. Participants were randomly assigned to either the intervention or control group. During the procedure, children in the intervention group received a finger puppet activity, while those in the control group received only standard HFNC treatment. Physiological parameters (body temperature, heart rate, and oxygen saturation [SpO₂]) were measured before, during, and after the intervention in both groups. Additionally, the "Children's Emotional Manifestation Scale" (CEMS) was administered to assess anxiety levels. Data collection tools included a "Personal Information Form" to gather sociodemographic characteristics of the children and parents, the CEMS to evaluate anxiety during the procedure, and a "Physiological Parameters Recording Form" to document clinical data. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) for Windows version 22.0. The findings revealed a statistically significant difference in CEMS scores between the groups (p < 0.05), indicating that children in the control group experienced higher anxiety levels compared to those in the intervention group. While no statistically significant differences were found in body temperature and oxygen saturation (p>0.05), a significant difference was detected in heart rate values between the groups (p<0.05). In conclusion, the finger puppet activity applied during HFNC therapy was found to reduce anxiety in children and to have a positive impact on physiological parameters. Based on these findings, the use of finger puppets as a non-pharmacological intervention is recommended for children receiving HFNC therapy in pediatric emergency departments, pediatric wards, and pediatric intensive care units.