Determining the effect of atraumatic care package applied before, during and after the peripheral intravenous catheter intervention in preschool children on the child's pain level, emotional and physiological indicators

Çalı, Ö. (2020). Determining the effect of atraumatic care package applied before, during and after the peripheral intravenous catheter intervention in preschool children on the child's pain level, emotional and physiological indicators, Yeditepe University Institute of Health Sciences, Department of Nursing, The Master Thesis. Istanbul. Introduction: Peripheral intravenous catheter is a medical procedure that is frequently applied in the diagnosis and treatment procedures of children who apply to the hospital. Although it seems like a minor intervention, it causes extremely important pain and stress. Preschool children are more affected by invasive procedures than children of other ages. Peripheral intravenous catheter application causes a more complicated process in children and causes more pain and anxiety. It shows its effect on physiological and emotional findings, it has short or long term negative effects. Objective: In the application of peripheral intravenous catheter in preschool children (pre-processing, peri-processing, post-processing), the use of a therapeutic intervention in accordance with the philosophy of atraumatic care has been applied to determine the effect of the child on pain level, emotional and physiological indicators (pulse, oxygen saturation) and processing time. Materials and Methods: The sample of the study consisted of 60 people between the ages of 3-6 who applied to the clinic where the children were treated in a public hospital affiliated to the Provincial Health Directorate of the Istanbul Governorship at September and November 2019. In order to ensure randomization, the children who met the criteria were selected to the control group that came in the first week (group left to routine practice), and the children who came in the second week to the experimental group (group with atraumatic care package applied). This cycle continues until the end of the study. In the first stage of the atraumatic care package, the child in the experimental group was given a booklet titled "Kelebek" before the procedure, "Kıpırdak ve Şıpırdak" cartoon video was watched during the process in the second stage and the therapeutic game was played with the teddy bear after the procedure in the third stage. The control group is also left to routine practice. Before suppling the data, an introductory information form was given to the preschool children and their parents, who underwent perideric intravenous catheter. Wong-Baker Facial Expressions Scale and Emotional Indicators Scale in Children (CTSS) method was evaluated by the researcher at every stage of the process (pre-processing, peri-processing, post-processing). Data were evaluated with SPSS 21.0 program, descriptive statistical analysis (number, percentage, mean, standard deviation, minimum-maximum value), Independent Sample-t, Anova, Repeated Measures, Mann-Whitney U, Kruskal-Wallis H, Friedman test and Bonferroni correction and Pearson-χ2 test statistics. Results: As a result of the research, it was found that there was no statistically difference between the experimental group and the control group children in terms of sociodemographic characteristics and processing features (P> 0.05). In terms of pain and emotional indicators, it was found that the mean scores were lower and the difference between them was statistically significant at all stages (pre-processing, peri-processing, post-processing) of the experimental group (p<0.05). Although the pulse and respiratory rate values in the experimental group tended to show very low decreases until after the procedure, it was found that there was no difference between them and it reached a statistically significant lower value than all other measurements after the procedure (p<0,05). When SpO2 values are analyzed, it was found that the values are close to each other and there is no statistically significant difference between them (p>0.05). Conclusion and recommendation: In all stages of painful medical procedures, the use of a therapeutic intervention in accordance with the philosophy of atraumatic care has been shown to be effective in reducing pain and negative emotional indicators in children. It was found that pain, physiological and emotional indicators were not affected by sociodemographic and procedural features. At all stages of painful medical procedures, it is recommended to use atraumatic care method, to reduce pain and emotional indicators, to inform health professionals about the effectiveness and use of atraumatic care, to investigate the effectiveness of other painful procedures and chronic diseases in pain management. Keywords: Pain, atraumatic care, non-pharmacological methods, peripheral intravenous catheter, therapeutic play