[Reducing fear in preschool children receiving intravenous injections].
OBJECTIVE
Our pediatric medical ward administers an average of 80 intravenous injections to preschool children. We found that 91.1% exhibit behavior indicative of fear and anxiety. Over three-quarters (77.8%) of this number suffer severe fear and actively resist receiving injections. Such behavior places a greater than normal burden on human and material resources and often gives family members negative impressions that lower their trust in the healthcare service while raising nurse-patient tensions. Using observation and interviews, we found primary factors in injection fear to be: Past negative experiences, lack of adequate prior communication, measures taken to preemptively control child resistance, and default cognitive behavioral strategies from nursing staff.


OBJECTIVE
This project worked to develop a strategy to reduce cases of severe injection fear in preschool children from 77.8% to 38.9% and achieve a capacity improvement target for members of 50%.


METHODS
Our team identified several potential strategy solutions from research papers and books between August 1st, 2009 and April 30th, 2010. Our proposed method included therapeutic games, self-selection of injection position, and cognitive behavioral strategies to divert attention. Other measures were also specified as standard operating procedures for administering pediatric intravenous injections.


RESULTS
We applied the strategy on 45 preschool children and identified a post-injection "severe fear" level of 37.8%.


CONCLUSIONS
This project was designed to reduce fear in children to make them more accepting of vaccinations and to enhance children's positive treatment experience in order to raise nursing care quality.
Department of Nursing, Chang Gung Memorial Hospital, Linkou Branch, Republic of China. jane855455@yahoo.com.tw
Yi-Chuan
YC
Hsieh
Hui-Tzu
HT
Liu
Yen-Hua
YH
Cho
D002675:Child, Preschool; D005239:Fear; D006801:Humans; D007275:Injections, Intravenous / Q000523:psychology*