Volume 5, Issue 1 (Winter 2019)                   JCCNC 2019, 5(1): 25-32 | Back to browse issues page

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Moosavi A, Shoghi M, Haghani H, Borimnejad L. The Effect of Medical-Directed Play on the Severity of Pediatric Pain During Burn Dressing Change in Children: A Clinical Randomized Trial. JCCNC 2019; 5 (1) :25-32
URL: http://jccnc.iums.ac.ir/article-1-194-en.html
1- Department of Pediatric Nursing, School of Nursing and Midwhfery, Iran Universtiy of Medical Sciences, Tehran, Iran.
2- Department of Pediatric Nursing, School of Nursing and Midwhfery, Iran Universtiy of Medical Sciences, Tehran, Iran.; Nursing Care Research Center, Iran Universtiy of Medical Sciences, Tehran, Iran.
3- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
4- Nursing Care Research Center, School of Nursing & Midwifery, Iran Unversity of Medical Sciences, Tehran, Iran. , Borimnejad.l@iums.ac.ir
Abstract:   (3465 Views)
Background: Pain management of children with a burn is one of the most important issues in pediatrics medicine. Non-pharmacological methods of pain control can play an important role in suitable some patients. This study was aimed conducted with the aim ofto investigating investigate the effect of Medical-directed play on the severity of pediatric pain during burn dressing change in children.
Methods: A randomized controlled trial was conducted on 82, 3- to 6- year-old children referring to a burn center in Tehran, Iran, for their first burn dressing change. The children were assigned into control (n=41) and intervention (n=41) groups by random allocation method. The Face, Legs, Activity, Cry, Consolability (FLACC) scale was used to measure the severity of pain before and during the dressings. The arterial blood oxygen level and pulse rate were also measured by a pulse oximeter. In the intervention group, the children were taught about the dressing steps 15 minutes before starting the procedure using a doll. The control group received routine care. The pain intensity, pulse rate, and arterial blood oxygen were compared between the groups by the Independent t-test, Paired t-test, Chi-square, and Fisher’s exact exact-test using in SPSS V. 20. 
Results: There was a significant difference between the groups between regarding the mean score of pain intensity during dressing between the groups (P=0.041). A significant difference was also found in the mean heart rate of the groups during dressing (P<0.001). No significant difference was seen in the arterial blood oxygen saturation between the groups.
Conclusion: Medical-directed play effectively reduces pediatric procedural pain through children’s cooperation during dressing changes. This cost-effective, non-invasive technique can be widely used for pain management in children with a burn.
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● Guided games before dressing change could reduce procedural pain in 3-6 years old children.
● Pain management in preschool children needs more attention.
● Pediatric nurses can use games with available devices and without any specialized training for children.
Plain Language Summary 
We studied the effect of the game on the severity of pain in children's burning dressing change. The results showed that performing the game before changing the dressing and explaining the procedure to children could reduce the amount of pain caused by the dressing change. Given the importance of reducing pain in burned patients, relaxation, and pain relief can result in a better outcome. Replacing the game with a guided game method can be useful and better than drug interventions to reduce the pain associated with burns.

Type of Study: Research | Subject: General
Received: 2018/09/2 | Accepted: 2018/12/28 | Published: 2019/02/1

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