Document Type : original article

Authors

1 Clinical Supervisor, Dr. Sheikh Children's Hospital, Mashhad University of Medical Sciences, Iran.

2 Master of Nursing, Dr. Sheikh Children's Hospital, Mashhad University of Medical Sciences, Iran.

3 Pediatric Hematology and Oncology Specialist, Department of Pediatrics, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Iran.

4 Nursing Manager, Dr. Sheikh Children's Hospital, Mashhad University of Medical Sciences, Iran.

5 Internist, Medical School, Mashhad University of Medical Sciences, Iran.

10.22038/jpp.2025.86452.5529

Abstract

Background: Pain is an unpleasant sensory and psychological experience. Invasive procedures such as Intravenous (IV) line placement and blood sampling are a major source of pain and fear in hospitalized children. Pain control is one of the important nursing measures. The present study aimed to determine the effect of setting up an IV Access team on reducing pain intensity in children with cancer aged 5 to 7 years.
Methods: This descriptive study was conducted on children hospitalized in the hematology department of Dr. Sheikh Children's Hospital in Iran from 21 July to 21 September 2024. 67 children were selected using a census and purposive sampling method. The data collection tool was the FLACC Pain Scale.
Results: A total of 67 IV line placements were performed in 53 patients. 40 were boys (75.47%) and 13 were girls (24.52%). The number of IV line placements performed by the IV access team was significantly higher in boys (47 cases) than in girls (20 cases). The results of the severity of children's behavioral reactions to pain showed that 7% experienced mild pain, 12% had moderate pain, 37% showed severe pain, 29% reflected very severe pain, and 15% exhibited the worst pain.
Conclusion: Despite the implementation of the IV Access team, no significant reduction in pain severity was observed, suggesting the need for further investigation into alternative pain management strategies.

Keywords

  1. Valizadeh L, HOSSEINPOUR FA, Joonbakhsh F. Comparing the quality of life in children with cancer in Tabriz Children Medical and Training Center reported by themselves and their parents, 2013.
  2. Khalili A, Ghaderi G. The relationship between chronic pain and quality of life children with cancer. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2022;8(1):96-108.
  3. Loeffen EA, Mulder RL, Font-Gonzalez A, Leroy PL, Dick BD, Taddio A, et al. Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline. European Journal of Cancer. 2020 May 1;131:53-67.
  4. Alavi A, Zargham A. Studying the effect of bubble formation on the severity of venipuncture pain in children. Scientific Journal of Kurdistan University of Medical Sciences.2009 (13):77-82 [In Persian].
  5. Nikfarid L, GHAMAR YR, Namazian M, Namdar F, Azam NM. Comparison of emla cream versus local refrigeration for reducing venipuncture-related pain in pediatric patients of children’s medical center, 2008.
  6. Jafarimanesh H, Hajiaghaee R, Mehrabi F, Hasanbig MM, Alimoradian A, Ranjbaran R, et al. Comparative effects of quinine plant and lidocaine on pain of venipuncture. Complementary Medicine Journal. 2017 Jun 10;7(1):1777-90.
  7. Reza Mohammad A, Amir Hooshang B, Abas Ali E, Kahzad J. [< The> effect of different types of transcutaneous electrical nerve stimulations [TENS] on severity of pain related with insertion of intravenous catheter [angiocut]].
  8. Kennedy RM, Luhmann J, Zempsky WT. Clinical implications of unmanaged needle-insertion pain and distress in children. Pediatrics. 2008 Nov 1;122(Supplement_3):S130-3.
  9. Hartman JH, Bena JF, Morrison SL, Albert NM. Effect of adding a pediatric vascular access team component to a pediatric peripheral vascular access algorithm. Journal of Pediatric Health Care. 2020 Jan 1;34(1):4-9.
  10. Whalen M, Maliszewski B, Sheinfeld R, Gardner H, Baptiste D. Outcomes of an innovative evidence-based practice project: building a difficult-access team in the emergency department. Journal of emergency nursing. 2018 Sep 1;44(5):478-82.
  11. Katsogridakis YL, Seshadri R, Sullivan C, Waltzman ML. Veinlite transillumination in the pediatric emergency department: a therapeutic interventional trial. Pediatric emergency care. 2008 Feb 1;24(2):83-8.
  12. Voepel-Lewis T, Merkel S, Tait AR, Trzcinka A, Malviya S. The reliability and validity of the Face, Legs, Activity, Cry, Consolability observational tool as a measure of pain in children with cognitive impairment. Anesthesia & Analgesia. 2002 Nov 1;95(5):1224-9.
  13. Skarbek-Borowska S, Becker BM, Lovgren K, Bates A, Minugh PA. Brief focal ultrasound with topical anesthetic decreases the pain of intravenous placement in children. Pediatric emergency care. 2006 May 1;22(5):339-45.
  14. Kleiber C, McCarthy AM. Evaluating instruments for a study on children's responses to a painful procedure when parents are distraction coaches. Journal of Pediatric Nursing. 2006 Apr 1;21(2):99-107.
  15. Sadeghi T, Shamshiri M, Mohammadi N, Shoghi M. Effect of Distraction on Children's Behavioral Responses to Pain During IV Catheter Insertion. Hayat/Ḥayāt. 2012 Sep 1;18(4).
  16. Willis MH, Merkel SI, Voepel-Lewis T, Malviya S. FLACC Behavioral Pain Assessment Scale: a comparison with the child's self-report. Pediatric nursing. 2003 May 1;29(3).
  17. Walco GA. Needle pain in children: contextual factors. Pediatrics. 2008 Nov 1;122:S125-9.
  18. Tavakolian A, Ebrahimimn M, Ahmadi SR, Foroughian M, Habibzadeh SR. The effect of pharmacological and non-pharmacological methods on reducing the severity of pain when injected in children: A systematic review study. Medical Journal of Mashhad University of Medical Sciences. 2020 Oct 22;63(4):2526-38.
  19. Farion KJ, Splinter KL, Newhook K, Gaboury I, Splinter WM. The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial. Cmaj. 2008 Jul 1;179(1):31-6.
  20. SHAH MP, FOROOGH AG, KAZEMI M, JAHANI Y. YEARS OLD CHILDREN ADMITTED TO HOSPITALS OF RAFSANJAN UNIVERSITY OF MEDICAL SCIENCES, IRAN, IN 2013.
  21. Potter PA, Perry AG. Fundamentals of Nursing: Concepts, Process and Practice. 5th ed. St. Louis: Mosby; 2005.
  22. Urden LD, Stacy KM, Lough ME. Thelan's critical care nursing: diagnosis and management. (No Title). 2006.
  23. Arts SE, Abu-Saad HH, Champion GD, Crawford MR, Juniper KH, Ziegler JB, et al. Age-related response to lidocaine-prilocaine (EMLA) emulsion and effect of music distraction on the pain of intravenous cannulation. Pediatrics. 1994 May 1;93(5):797-801.
  24. Bagherian S, Borhani F, Abbaszadeh A, Tehrani H, Pashandi S. The severity of pain in children with thalassemia during venipuncture and prior to blood transfusion. Health and Development Journal. 2012 Aug 1;1(2):138-46.
  25. Parvizi F, Alhani F, Aghebati N. The nurses’ problems in applying non-pharmacological pain management for children. Iranian Journal of Nursing Research. 2008 Aug 10;3(9):85-92.