Background: Hospitalized pediatric patients experience pain, fear, and distress during intravenous catheterization. This study investigates the effects of a picture book on reducing distress caused by intravenous (IV) catheterization among school-aged children.Methods: seventy four Pediatric emergency room patients age 6-12 years old requiring Iv Infusion were enrolled in this randomized clinical trial. The intervention, providing a description of the IV catheterization procedure using a picture book, was compared to the same description of the procedure without a picture book (standard of care). Subject distress was measured using the Observation Scale of Behavior Distress Revised (OSBD_R) which assigns a score to eight observable behaviors. Before, during, and after the procedure at 15-second intervals (measured using a timer), a trained observer assigned an OSBD_R score of distress. A total score of 22 is considered maximum distress. The primary endpoint for the study was OBSD_R score difference in Phase 3 (Performing catheterization procedure, attaching and infusion therapy). Chi-square, Mann-Whitney and Wilcoxon tests were used for data analysis. Results: The mean distress score in third phases for the intervention group (0.667 ± 0.610) was significantly less than that of the control group (3.218 ± 1.799). A significant difference in distress score was observed before and after the intervention (p< 0.001).Conclusions: Children’s distress due to IV catheterization can be reduced with a simple, nonpharmacological picture book intervention. The children’s orientation on the IV catheterization plays a significant role in controlling and reducing their distress during and after the intervention. We suggested using the picture book to reduce the children distress before Intravenous Catheterization.

Background: Injections are the main factors provoking pain, fear, and anxiety among hospitalized children. The purpose of this study is investigating the Effects of picture book on Reducing Anxiety Caused by Intravenous Catheterization among School-aged Children. Methods: In this randomized control trial study, seventy 6-12 year-old children were randomly assigned to either intervention or control group. Data was collected from 70 patients at Pediatric Emergency Room in the central Hospital in Bushehr- Iran during the summer and autumn, 2017. The subjects’ anxiety was evaluated before, during, and after the procedure by using Observation Scale of Behavior Distress instrument. Chi-square, Mann-Whitney and Wilcoxon tests were used for data analysis. Results: The mean anxiety scores of the intervention group was significantly less than those of control group after intervention. In addition, a significant difference was observed before and after the intervention in terms of anxiety levels. Conclusions: The school-aged children’s orientation on the intravenous catheterization and serum infusion play a significant role in controlling and reducing their anxiety during and after the intervention. Based on the result we suggested using the picture book to reduce the children anxiety before Intravenous Catheterization. Keywords: anxiety, pediatric, Intravenous Catheterization, education, picture book Trial registration: Current Controlled Trials: IRCT2017041712830N22). 2017-05-29