title: Audiovisual distraction for pain relief in paediatric inpatients: A crossover study.
abstract: Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients.
  
  
  
  The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance.
  
  
  
  The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention.
  
  
  
  Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients.
  
  
  
  The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were detected in subsequent acute painful procedures.
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: N C A C
authors.initials: NC
authors.lastname: Oliveira
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: J L F
authors.initials: JL
authors.lastname: Santos
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: M B M
authors.initials: MB
authors.lastname: Linhares
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D001288:Attention; D058443:Catastrophization; D002648:Child; D018592:Cross-Over Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D000073818:Procedural Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D018962:Phlebotomy