title: Efficacy of a cartoon and photograph montage storybook in preparing children for voiding cystourethrogram.
abstract: BACKGROUND
  Undergoing voiding cystourethrogram (VCUG) can be distressing for children.
  
  
  OBJECTIVE
  To assess the efficacy of a cartoon and photograph montage storybook in preparing children for VCUG.
  
  
  METHODS
  Outpatient children (ages 2-14 years) who had VCUGs between December 2011 and June 2012 were randomly assigned to two groups; one group received the storybook a week before the procedure. Parents and guardians were asked to complete an anonymous survey rating their child's tolerance of the exam from 1 to 5, worst to best, immediately after VCUG. The VCUG technologist also rated the child's tolerance.
  
  
  RESULTS
  Children prepared for VCUG with the storybook had less distress than those without. Results were analyzed by Cochran-Mantel-Haenszel and Cochran-Armitage Trend exact tests, a P value of both tests of 0.0092 indicating a statistically significant difference between the tolerance scores of children prepared with the storybook and those without. Effects of gender and history of VCUG were not statistically significant. Two-thirds of all children had no other source of information.
  
  
  CONCLUSIONS
  The cartoon and photograph montage storybook format of preparing children for VCUG was effective in increasing their tolerance for the procedure. The storybook should be mailed out in advance because the majority of families did not pursue information on preparing their children for VCUG.
authors.affiliation: Department of Radiology, Section of Pediatric Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4252, USA, kgebarsk@umich.edu.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Gebarski
authors.forename: Jamie
authors.initials: J
authors.lastname: Daley
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gebarski
authors.forename: Nahid
authors.initials: N
authors.lastname: Keshavarzi
authors.forename: Ramiro J
authors.initials: RJ
authors.lastname: Hernandez
authors.forename: Vesna
authors.initials: V
authors.lastname: Ivanzic
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Gebarski
mesh_terms: D000293:Adolescent; D001878:Books, Illustrated; D002359:Cartoons as Topic / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D033262:Narration; D010353:Patient Education as Topic / Q000379:methods*; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D016896:Treatment Outcome; D014554:Urination; D014567:Urography / Q000009:adverse effects / Q000523:psychology