Watching cartoons can reduce pain and distress in children undergoing immunisation before, during and after the procedure, a study in Italy has found.
The randomised controlled trial, reported in the journal Nursing Children and Young People, looked at two groups of six-year-old children.
The experimental group consisted of children who underwent immunisation while distracted by watching cartoons.
Before the procedure, the child was placed in front of a laptop computer and asked to concentrate on watching the cartoon of their choice, which was either Cinderella or Toy Story.
The control group consisted of children who underwent immunisation and a standard technique of verbal distraction by experienced nurses.
The distress of the children was measured on an amended observation scale of behavioural distress and pain was recorded on the Wong-Baker FACES pain rating scale, a visual-numerical scale.
The researchers said results showed that levels of distress were lower in children distracted with cartoons, compared with those distracted using the standard procedure. They added that these results concurred with previous studies, especially in showing that children younger than seven years typically report more distress and pain from needles than older children.
All children undergoing the immunisation procedure received two injections, the first subcutaneously and the second intramuscularly.
The level of distress was lower in the group distracted by watching cartoons during both injections. In particular, the levels of distress detected after the subcutaneous injection and during the intramuscular injection were lower to a statistically significant degree, and were marginally significant after intramuscular injection.
'From an organisational point of view, it would be appropriate to provide a structured setting, equipped with all the tools necessary to implement strategies of distraction - particularly the use of cartoons - during invasive procedures,' the authors said.
'The use of a simple procedure that is easily and economically executed can enable nurses to ensure that children's first contacts with the health service are positive experiences, and help decrease the number of patients who may develop pre-procedural anxiety or needle phobia, leading them to refuse to undergo medical procedures in adulthood.'