Effect of music and toys on reducing pain during colonoscopy and acceptance of colonoscopy by children
A randomized clinical trial
Keywords:
Children, Colonoscopy, Music, Pain, Toy, Vital signsAbstract
Background: Pain is an unpleasant sensory and emotional experience accompanied by fear and anxiety. Pain anxiety can cause resistance, reduce his/her cooperation and cause undesirable mental and psychological complications. The use of non-medical methods in relieving pain is preferable. Objective: The purpose of this study was to determine the effectiveness of toys and music on pain and vital signs of children during colonoscopy. Methods: This clinical trial was conducted on 90 children aged 2-14 years old referred to Ghaem Hospital in Mashhad (Iran) in 2016-2017. Performing colonoscopy on children who were randomly allocated to three equal groups of 30 (Two intervention and one control group): Group 1: toys (a car for boys and a doll for girls), Group 2: a piece of Clayderman music, and a control group. The vital signs of the children before and after colonoscopy, and the pain after it, were measured. Data were analyzed by SPSS version 16, using paired-samples t-test. A p-value of less than or equal to 0.05 was considered statistically significant for examining the hypotheses of the study. Results: The mean age of children was 9.07±3.22, and 54.4% of them were girls. Heart rate, systolic and diastolic blood pressure increased significantly after colonoscopy in the music and control groups (p<0.001). However, in the toy group, mean heart rate, systolic and diastolic blood pressure decreased after intervention (p=0.147, p=0.213, p=0.246 respectively). The mean score of pain in the toy group was significantly lower than the other two groups (p<0.001). Conclusion: The results of this study showed that the use of toys and music were effective in reducing pain and accepting colonoscopy for the children, although the positive effects of the toy were more evident on the children’s vital signs and pain. Therefore, the use of non-medication interventions can be considered as an effective way to accept colonoscopy and reduce pain in children. Clinical Trial Registration: This trial is registered on the Thai Clinical Trials Registry, with the ID: TCTR20180507001 Funding: This project was funded by the research deputy of Mashhad University of Medical Sciences, (Mashhad, Iran).References
Hermann C, Hohmeister J, Demirakça S, Zohsel K, Flor H. Long-term alteration of pain sensitivity in
school-aged children with early pain experiences. Pain. 2006;125(3):278-85. PMID: 17011707. DOI:
1016/j.pain.2006.08.026
Victoria NC, Murphy AZ. Exposure to Early Life Pain: Long Term Consequences and Contributing
Mechanisms. Curr Opin Behav Sci. 2016;7: 61-68. PMID: 27525299. PMCID: PMC4979223. DOI:
1016/j.cobeha.2015.11.015
Aydin D, Sahiner NC. Effects of music therapy and distraction cards on pain relief during phlebotomy in
children. Applied Nursing Research. 2017;33: 164-8. PMID: 28096012. DOI: 10.1016/j.apnr.2016.11.011.
Srouji R, Ratnapalan S, Schneeweiss S. Pain in children: assessment and nonpharmacological management.
International Journal of Pediatrics. 2010; 201:1-11. PMID: 20706640. PMCID: PMC2913812. DOI:
http://dx.doi.org/10.1155/2010/474838.
Lee GY, Yamada J, Shorkey A, Stevens B. Pediatric clinical practice guidelines for acute procedural pain:
a systematic review. Pediatrics. 2014; 133(3):500-15. PMID: 24488733. DOI: 10.1542/peds.2013-2744.
Sahiner NC, Bal MD. The effects of three different distraction methods on pain and anxiety in children.
Journal of Child Health Care. 2016;20(3): 277-85. PMID: 26040282. DOI: 10.1177/1367493515587062.
Van Der Heijden MJ, Araghi SO, Van Dijk M, Jeekel J, Hunink MM. The effects of perioperative music
interventions in pediatric surgery: a systematic review and meta-analysis of randomized controlled trials.
PLoS one. 2015;10(8):e0133608. PMID: 26247769. PMCID: PMC4527726. DOI:
1371/journal.pone.0133608.
Kiani MA, Khodadad A, Mohammadi S, Ghayour Mobarhan M, Saeidi M, Jafari SA, et al. Effect of
peppermint on pediatrics’ pain under endoscopic examination of the large bowel. J HerbMed Pharmacol.
; 2(2): 41-44.
Trevisani L, Zelante A, Sartori S. Colonoscopy, pain and fears: Is it an indissoluble trinomial? World
journal of gastrointestinal endoscopy. 2014;6(6):227-33. PMID: 24932374. PMCID: PMC4055991. DOI:
4253/wjge.v6.i6.227.
Yoshioka S, Takedatsu H, Fukunaga S, Kuwaki K, Yamasaki H, Yamauchi R, et al. Study to determine
guidelines for pediatric colonoscopy. World journal of gastroenterology. 2017;23(31): 5773-9. PMID:
, PMCID:PMC5569292. DOI: 10.3748/wjg.v23.i31.5773.
Pishnamaz Nishaburi R, Hashemian nejad N. Children endoscopic and endoscopic survey of upper and
lower gastrointestinal system in 12 years in 1375 Ghaem Hospital. Pediatric doctoral thesis. Faculty of
Medicine, Mashhad University of Medical Sciences. 2006.
Walsh S. The pediatric colonoscopy. Gastroentrology nursing. 1995; 18(2): 57-61.
Tam WW, Wong EL, Twinn SF. Effect of music on procedure time and sedation during colonoscopy: a
meta-analysis. World J Gastroenterol. 2008; 14(34): 5336-43. doi: 10.3748/wjg.14.5336. PMID: 18785289,
PMCID: PMC2744067.
Rudin D, Kiss A, Wetz RV, Sottile VM. Music in the endoscopy suite: a meta-analysis of randomized
controlled studies. Endoscopy. 2007; 39(6): 507-10. doi: 10.1055/s-2007-966362. PMID: 17554644.
Good M. A comparison of the effects of jaw relaxation and music on postoperative pain. Nurs Res. 1995;
(1): 52-7. doi: 10.1097/00006199-199501000-00010. PMID: 7862546.
Triller N, Erzen D, Duh S, Petrinec Primozic M, Kosnik M. Music during bronchoscopic examination: the
physiological effects. A randomized trial. Respiration. 2006; 73(1): 95-9. PMID: 16293960, doi:
1159/000089818.
Kiani MA, Naghafi M, Jafari SA, Ghayour mobarhan M, Mohammadi Sh, Saeidi M, et al. Effects of Music
on Pain, Anxiety and Vital Signs of Children during Colonoscopy. Life Science Journal. 2013; 10(12): 31-
Najaphi M, Motamed F, Kiani MA, Khakshour A, Saeidi M, Jafari SA, et al. Effect Supermint oil
(peppermint oil) on children's pain during colonoscopy. Journal of North Khorasan University of Medical
Sciences. 2013; 5(2):476.
Garra G, Singer AJ, Taira BR, Chohan J, Cardoz H, Chisena E, et al. Validation of the Wong-Baker
FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med. 2010; 17(1): 50-
doi: 10.1111/j.1553-2712.2009.00620.x. PMID: 20003121.
Hockenberry MJ, Wilson D. Pain Assessment and Management in Children. In Hockenberry, M.J., Wilson,
D. (2015), Wong’s nursing care of infants and children (p. 155). St. Louis, MO: Mosby, an imprint of
Elsevier Inc.
Kotwal MR, Rinchhen CZ, Ringe VV. Stress reduction through listening to Indian classical music during
gastroscopy. Diagn Ther Endosc. 1998; 4(4): 191-7. doi: 10.1155/DTE.4.191. PMID: 18493472, PMCID:
PMC2362603.
Homan M, Mahkovic D, Orel R, Mamula P. Randomized, double-blind trial of CO2 versus air insufflation
in children undergoing colonoscopy. Gastrointest Endosc. 2016;83(5):993-7. PMID: 26363332. doi:
1016/j.gie.2015.08.073.
Tazakori Z, Amani F, Karimollahi M. The Effect of Music Therapy on Patients' Blood Pressure in
Endoscopy Unit in Bou-Ali hospital, Ardebil. Iranian Journal of Nursing and Midwifery Research. 2007;
(1): 10-2.
Harikumar R, Raj M, Paul A, Harish K, Kumar SK, Sandesh K, et al. Listening to music decreases need for
sedative medication during colonoscopy: a randomized, controlled trial. Indian J Gastroenterol. 2006;
(1): 3-5. PMID: 16567885.
Good M. A comparison of the effects of jaw relaxation and music on postoperative pain. Nurs Res. 1995;
(1): 52-7. doi: 10.1097/00006199-199501000-00010. PMID: 7862546.
Tanabe P, Thomas R, Paice J, Spiller M, Marcantonio R. The effect of standard care, ibuprofen, and music
on pain relief and patient satisfaction in adults with musculoskeletal trauma. J Emerg Nurs. 2001; 27(2):
-31. doi: 10.1067/men.2001.114386. PMID: 11275859.
Kwekkeboom KL. Music versus distraction for procedural pain and anxiety in patients with cancer. Oncol
Nurs Forum. 2003; 30(3): 433-40. doi: 10.1188/03.ONF.433-440. PMID: 12719743.
Richards T, Johnson J, Sparks A, Emerson H. The effect of music therapy on patients' perception and
manifestation of pain, anxiety, and patient satisfaction. Medsurg Nurs. 2007; 16(1): 7-14. PMID:
Sabzevari A, Kianifar H, Jafari SA, Saeidi M, Ahanchian H, Kiani MA, et al. The effect of music on pain
and vital signs of children before and after endoscopy. Electronic physician. 2017;9(7):4801-5. PMID:
PMCID: PMC5586996. DOI: 10.19082/4801
Lee DW, Chan K-W, Poon C-M, Ko C-W, Chan K-H, Sin K-S, et al. Relaxation music decreases the dose
of patient-controlled sedation during colonoscopy: a prospective randomized controlled trial.
Gastrointestinal endoscopy. 2002;55(1):33-6. PMID: 11756911. DOI: 10.1067/mge.2002.120387
Bechtold ML, Perez RA, Puli SR, Marshall JB. Effect of music on patients undergoing outpatient
colonoscopy. World J Gastroenterol. 2006; 12(45): 7309-12. PMID: 17143946. DOI: PMC4087488
Ko C-H, Chen Y-Y, Wu K-T, Wang S-C, Yang J-F, Lin Y-Y, et al. Effect of music on level of anxiety in
patients undergoing colonoscopy without sedation. Journal of the Chinese Medical Association.
;80(3):154-60. PMID: 27889459. DOI: 10.1016/j.jcma.2016.08.010
Ovayolu N, Ucan O, Pehlivan S, Pehlivan Y, Buyukhatipoglu H, Savas MC, et al. Listening to Turkish
classical music decreases patients’ anxiety, pain, dissatisfaction and the dose of sedative and analgesic
drugs during colonoscopy: a prospective randomized controlled trial. World journal of gastroenterology:
WJG. 2006;12(46):7532-36. PMID: 17167846. PMCID: PMC4087603.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 knowledge kingdom publishing
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
