Comparison of the Effect of Visual and Auditory Distractions on the Physiological Parameters during the Dressing Change Procedure in 6-12-Year-Old Children

Background and Objective: As pain impulses ascend from the spinal cord, the autonomic nervous system is stimulated and leads to changes in physiological parameters. This study aimed to compare the effect of visual and auditory distractions on the physiological parameters during dressing change procedure in children aged 6-12 years. Materials and Methods: This blinded clinical trial was conducted using a three-group design. In total, 120 children aged 6-12 years met the inclusion criteria and were randomly assigned to a control, as well as two visual and auditory distraction groups using the randomized block method. The data were collected using the physiological index record sheet and pulse oximetry device. A cartoon and a rhythmic melody were played for each child in the visual and auditory distraction groups, respectively, two minutes before the onset of the dressing to the end of the dressing change. In all three groups, the heart rate and arterial blood oxygen saturation percentage were measured and recorded during and 5 minutes after dressing change. The obtained data were analyzed using SPSS software (version 16) through one-way analysis of variance, repeated measures analysis of variance, and Bonferroni post hoc test. Results: There was a statistically significant difference among the visual, auditory, and control groups regarding the mean heart rate of the children during the dressing changing and 5 minutes later (P˂0.001). Furthermore, the analysis of variance with repeated measures showed a significant difference between the visual and auditory groups in terms of the mean heart rate between the measurement times (P˂0.001). A significant difference was also observed among the visual, auditory, and control groups regarding the mean percentage of arterial blood oxygen saturation in children during dressing change and 5 minutes later (P˂0.001). Analysis of variance with repeated measures revealed a significant difference among the visual, auditory, and control groups in terms of the mean percentage of arterial blood oxygen saturation between the measurement times (P˂0.001). Conclusion: The use of visual and auditory distractions is a suitable method to reduce the intensity of fluctuations in physiological parameters during dressing change in children with burns. It should be mentioned that out of these two methods, visual distraction was more effective in reducing the intensity of heart rate fluctuations, compared to auditory distraction.