Effectiveness of distraction-based interventions for relieving anxiety, fear, and pain in hospitalized children during venous blood sampling: a systematic review and meta-analysis
Saija Huhtala, Anna-Kaija Palomaa, Shingo Ueki, Anna-Maria Tuomikoski, Tarja PölkkiObjective:
This review evaluates the effectiveness of active distraction-based interventions, compared with passive distraction-based ones, for relieving anxiety, fear, and pain in hospitalized preschool and school-age children during venous blood sampling.
Introduction:
Venous blood sampling is a procedure that causes anxiety, fear, and pain in hospitalized children. It is essential that health care professionals relieve a child’s negative emotions and pain because untreated pain may have many long-term effects on children’s development. It is important to know which distraction-based interventions are effective for relieving these outcomes in children during blood sampling.
Eligibility criteria:
This review considered randomized controlled trials (RCTs) and quasi-experimental studies that included active and passive distraction-based interventions for relieving hospitalized preschool and school-age children’s anxiety, fear, and pain during venous blood sampling.
Methods:
CINAHL, PubMed, Scopus, and Cochrane Library databases were searched for published studies, and MedNar, Google Scholar, and PsycArticles were searched for in-progress and unpublished studies in English, Finnish, or Swedish. Two independent researchers performed critical appraisal and data extraction using the JBI methodology. The data were described in a statistical meta-analysis of RCTs. If statistical analysis was not possible, the findings were reported narratively using a Synthesis Without Meta-analysis (SWiM) approach. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess certainty in the quality of the evidence.
Results:
Eleven RCTs involving 1164 children were identified. Blinding of the participants, those delivering the treatment, and assessors was not achieved in all of the studies, thereby introducing a potential risk of bias. A passive distraction-based intervention was significantly effective in relieving the children’s fear during blood sampling according to observers (MD: 0.77, 95% CI: 0.16 to 1.38,
Conclusions:
Passive distraction-based interventions were more effective in relieving children’s fear during blood sampling according to the observers. There was no statistically significant difference between the groups in relieving children’s anxiety and pain during blood sampling. Blinding was not possible in most of the studies, the population`s age range was large, and analysis heterogeneity was high.
Review registration:
PROSPERO CRD42023455617
Supplemental digital content:
Japanese- https://links.lww.com/SRX/A200 and Finnish-language https://links.lww.com/SRX/A201 versions of this abstract are available.