The effects of sound-and-light toy as a distraction method on pain and physiological parameters in infants regarding circumcision procedure: The effect of a distraction method in circumcision procedure

Ayşe Şener Taplak; Yağmur Sezer Efe; Levent  Ceyhan

doi:10.28982/josam.7497

Authors

Ayşe Şener Taplak Department of Child Health and Disease Nursing, Faculty of Health Science, Yozgat Bozok University, Yozgat, Turkey https://orcid.org/0000-0002-4229-038X
Yağmur Sezer Efe Department of Child Health and Disease Nursing, Faculty of Health Science, Erciyes University, Kayseri, Turkey https://orcid.org/0000-0003-0980-8439
Levent Ceyhan Department of Pediatric Surgery, Private Clinic, Kayseri, Turkey https://orcid.org/0000-0002-9820-3492

DOI:

https://doi.org/10.28982/josam.7497

Keywords:

Infant, Circumcision, Pain, Toy

Abstract

Background/Aim: Circumcision is a common surgical procedure and a cause of pain and stress for infants. Nurses are in a key role for providing pain relief through implementation of non-pharmacological practices for pain management. This study aimed to assess the impact of distraction using a sound- and light-producing toy on pain and physiological parameters in infants regarding circumcision procedure.

Methods: This randomized controlled study was conducted with infants between six months and two years of age who presented to a private circumcision clinic. The sample consisted of 60 infants randomly allocated into intervention (n = 30) and control (n = 30) groups. During the procedure, the mothers of the infants in the intervention distracted the infants with the toy for 15 min. Infants in the control group were accompanied by their mothers during the procedure and did not receive any additional intervention other than the standard care. Data were collected using a questionnaire and the face, legs, activity, cry, consolability (FLACC) pain scale. Data were assessed using descriptive statistical analyses and parametric tests.

Results: Infants in the intervention and control groups were similar in terms of current and gestational ages, lengths, weights, and maternal and paternal ages and showed no differences in terms of physiological parameters before and after the procedure (P > 0.05). Post-operative pain scores were lower in infants exposed to the toy with light- and sound than that in the infants in the control group; however, no significant difference between groups was found (P > 0.05).

Conclusion: Considering the effect of sound- and light-producing toys on causing a reduction in pain severity, it may be recommended to use distracting practices by nurses to reduce/relieve pain associated with circumcision.

Downloads

Download data is not yet available.

References

Morris BJ, Wamai RG, Henebeng EB, Tobian AA, Klausner JD, Banerjee J, et al. Erratum to: Estimation of country-specific and global prevalence of male circumcision. Popul Health Metr. 2016 Apr 4;14:11. doi: 10.1186/s12963-016-0080. DOI: https://doi.org/10.1186/s12963-016-0080-6

Introcaso CE, Xu F, Kilmarx PH, Zaidi A, Markowitz LE. Prevalence of circumcision among men and boys aged 14 to 59 years in the United States, National Health and Nutrition Examination Surveys 2005-2010. Sex Transm Dis. 2013 Jul;40(7):521-5. doi: 10.1097/01.OLQ.0000430797.56499.0d. DOI: https://doi.org/10.1097/01.OLQ.0000430797.56499.0d

Yavuz M, Demir T, Doğangün B. The effect of circumcision on the mental health of children: A review. Turkish Journal of Psychiatry. 2012 Spring;23(1):63-70. doi: 10.5080/u6508. DOI: https://doi.org/10.5080/u6508

Şahin F, Beyazova U, Aktürk A. Attitudes and practices regarding circumcision in Turkey. Child Care Health Dev. 2003 Jul;29(4):275-80. doi: 10.1046/j.1365-2214.2003.00342.x. DOI: https://doi.org/10.1046/j.1365-2214.2003.00342.x

Blank S, Brady M, Buerk E, Carlo W, Diekema D, Freedman A, et al. American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012 Sep;130(3):e756-85. doi: 10.1542/peds.2012-1990. DOI: https://doi.org/10.1542/peds.2012-1990

Tuncay S. The effect of therapeutic game and animation initiative on the fear, anxiety and pain of children with circumcision surgery and anxiety of parents. Atatürk Unıversty Health Science Institute, Erzurum 2021.

Frizzell KH, Cavanaugh PK, Herman MJ. Pediatric perioperative pain management. Orthop Clin North Am. 2017 Oct;48(4):467-80. doi: 10.1016/j.ocl.2017.06.007. DOI: https://doi.org/10.1016/j.ocl.2017.06.007

Freitas DMO, Spadoni VS. Is virtual reality useful for pain management in patients who undergo medical procedures? Einstein (Sao Paulo). 2019 May 20;17(2):eMD4837. doi: 10.31744/einstein_journal/2019MD4837. DOI: https://doi.org/10.31744/einstein_journal/2019MD4837

Frieden TR, Houry D. Reducing the risks of relief--The CDC opioid-prescribing guideline. N Engl J Med. 2016 Apr 21;374(16):1501-4. doi: 10.1056/NEJMp1515917. DOI: https://doi.org/10.1056/NEJMp1515917

Özveren H, Uçar H. The knowledge of student nurses on some non-pharmacological methods used in the pain control. Hacettepe University Faculty of Health Sciences Nursing Journal. 2009;16(3):59-72.

He HG, Jahja R, Sinnappan R, Ang EN, Lee TL, Chan MF, et al. Singaporean nurses' provision of guidance to parents on non-pharmacological postoperative pain-relief methods: An educational intervention study. Nurs Health Sci. 2011 Sep;13(3):344-51. doi: 10.1111/j.1442-2018.2011.00624.x. DOI: https://doi.org/10.1111/j.1442-2018.2011.00624.x

Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: a clinical practice guideline from the american pain society, the american society of regional anesthesia and pain medicine, and the american society of anesthesiologists' committee on regional anesthesia, executive committee, and administrative council. J Pain. 2016 Feb;17(2):131-57. doi: 10.1016/j.jpain.2015.12.008. DOI: https://doi.org/10.1016/j.jpain.2015.12.008

Hua Y, Qiu R, Yao WY, Zhang Q, Chen XL. The effect of virtual reality distraction on pain relief during dressing changes in children with chronic wounds on lower limbs. Pain Manag Nurs. 2015 Oct;16(5):685-91. doi: 10.1016/j.pmn.2015.03.001. DOI: https://doi.org/10.1016/j.pmn.2015.03.001

Hillgrove-Stuart J, Pillai Riddell R, Horton R, Greenberg S. Toy-mediated distraction: clarifying the role of agent of distraction and preneedle distress in toddlers. Pain Res Manag. 2013 Jul-Aug;18(4):197-202. doi: 10.1155/2013/392125. DOI: https://doi.org/10.1155/2013/392125

Ristia A, Mardiyah A, Setiabudi D. The effect of parent distraction coaching used the toy on pain ıntensity of 1-5 year-old children during IV (Intravenous) Insertion. Jurnal Keperawatan Padjadjaran. 2018;6(2):146-56. doi : 10.24198/jkp. DOI: https://doi.org/10.24198/jkp.v6i2.391

Taddio A, McMurtry CM, Shah V, Riddell RP, Chambers CT, Noel M, et al. Reducing pain during vaccine injections: clinical practice guideline. CMAJ. 2015;187(13):975-82. doi:10.1503/cmaj.150391. DOI: https://doi.org/10.1503/cmaj.150391

World Health Organization. Weekly Epidemiological Record. 2015;90(‎06)‎:33-44. https://apps.who.int/iris/handle/10665/242317.

Kanık EA, Taşdelen B, Erdoğan S. Randomization in clinical trials. Marmara Medical Journal. 2011;24:149-55. doi: 10.5472/MMJ.2011.01981.1 DOI: https://doi.org/10.5472/MMJ.2011.01981.1

Kundt G. A new proposal for setting parameter values in restricted randomization methods. Methods Inf Med. 2007;46(4):440-9. doi: 10.1160/me0398. PMID: 17694238. DOI: https://doi.org/10.1160/ME0398

Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-7.

Şenaylı Y, Özkan F, Şenaylı A, Bıçakçı Ü. Evaluation of postoperative pain in children with FLACC pain scale in Turkish translation. Türkiye Klinikleri J Anest Reanim. 2006;4(1):1-4.

Logan DE, Breazeal C, Goodwin MS, Jeong S, O'Connell B, Smith-Freedman D, et al. Social robots for hospitalized children. Pediatrics. 2019 Jul;144(1):e20181511. doi: 10.1542/peds.2018-1511. PMID: 31243158. DOI: https://doi.org/10.1542/peds.2018-1511

Ateş Beşirik S, Gözen D. Reducing the pain of ınfants due to vaccine ınjection: a randomized controlled trial. Clinical and Experimental Health Sciences. 2022 Jun;12(2):337-45. doi:10.33808/clinexphealthsci.797356. DOI: https://doi.org/10.33808/clinexphealthsci.797356

Dabas P. Effectiveness of distraction techniques on pain ıntensity during ımmunization among ınfants. Internaional Journal of Nursing Education. 2019 Jan;11(1):5-9. doi: 10.5958/0974-9357.2019.00002.3. DOI: https://doi.org/10.5958/0974-9357.2019.00002.3

Gedam DS, Verma M, Patel U, Gedam S. Effect of distraction technique during immunization to reduce behaviour response score (FLACC) to pain in toddlers. Journal of Nepal Paediatric Society. 2013;33(1):25-30. doi: 10.3126/jnps.v33i1.7017. DOI: https://doi.org/10.3126/jnps.v33i1.7017