The use of avatars to explain drugs routes administration reduced anxiety in hospital-treated paediatric patients

I Bellido1, MV Bellido2, S Perez-Bertolez2, AM García-Perez3, A Gomez-Luque4. 1University of Malaga, Pharmacology and Clinical Therapeutics, Spain, 2Carlos Haya University Hospital, Malaga, Surgery Service, Spain, 3Carlos Haya University Hospital, Malaga, Anaesthesia Service, Spain, 4Virgen de la Victoria University Hospital, Malaga, Anaesthesia Service, Spain

Background: Drugs’ administration usually causes fear, stress and pain in young children. Explain to the children how the doctor and the nurse are going to administer medications may reduce these symptoms. Virtual-reality might be a very useful tool for social interactions of anxious individuals in highly controlled situations (1, 2). Children like avatars and cartoons (3). Use of avatars to explain the drug routes in young children may reduce children’s anxiety and pain associated with drugs administration (4, 5).

Aims: To evaluate the effect of avatars explaining drug’s administration routes on hospital-treated young children’s anxiety and pain development after drugs administration.Methods: A prospective, aleatorized, controlled study in hospital-treated children (< 6 years old) was done. Clinical stage, diagnostic, surgery, anaesthesia and all treatment procedures were recorded. Anxiety (STAIC test) and pain (VAS scale) were recorded before and 5 h after drugs administration. A 15 minutes film with avatars explaining how the drugs were going to be administered was use in one group (n=120). The children were unable to see the film as many times as they wanted. Another group that could not see the film was considered control group (n=120). Results were analyzed by ANOVA test followed by Bonferroni post-test, Student t test and Chi square test.

Results: 240 children (aged 3-6 years, 4.9 ± 0.7 years old, 54% male) treated in the emergency (51%), surgery (24%) and intensities care unit (25%) were enrolled. The drugs routes administration were oral (25%), intramuscle (33%), intravenous (34%), inhalatory (5%), others (3%). The drugs explained by avatar group of children saw part or the full movie an average of 3.2±1.6 times.

Anxiety was higher (p<0.05) in control than in drugs explained by avatar group, 7.3±2.1 vs. 3.8±1.3 and 5.6±0.5 respectively. Pain, was non-significant higher in control than in drugs explained by avatar group 5.6±0.5 vs. 3.2±0.3, respectively. Children of the control group wept, complained, and called their parents during more time than avatar-drugs explained group.

Conclusion: The use of avatars to explain the drugs routes administration to hospital-treated young paediatric patients reduced children’s anxiety.

References: (1) Wieser MJ et al (2010). Cyberpsychol Behav Soc Netw 13 (5): 547. (2) Hopkins IM et al (2011). J Autism Dev Disord 41 (11): 1543. (3) Lewkowicz DJ & Ghazanfar AA (2012). Dev Psychobiol 54 (2): 124. (4) Dahlquist LM et al (2010). Cyberpsychol Behav Soc Netw 13(5):587. (5) Malloy KM & Milling LS (2010). Clin Psychol Rev 30 (8): 1011.