Non-pharmacological Interventions for Needlerelated Procedural Anxiety in Children with Thalassemia

Background: The purpose of the present study was to assess the efficacy of non-pharmacological interventions on the anxiety among thalassemic children undergoing venipuncture. Patients and Methods: This was a clinical trial on 60 thalassemic children aged 6-12 years undergoing venipuncture. Children were randomly divided into three groups: control, bubble making and regular breathing exercise. The anxiety level was assessed by anxiety self-reported scale before and after of catheter insertion. Kruskal-Wallis and Mann-Whitney U tests were used to compare the mean score of anxiety between groups. Results: The mean anxiety score before venipuncture in control, bubble making, and regular breathing exercise groups was 31.7, 30.78, and 29 respectively. After venipuncture, the mean anxiety score was 41.50, 29.45 and 20.55, respectively. These findings indicated a significant difference in the mean anxiety scores between the three studied groups after the venipuncture. However, there was no significant difference between the mean anxiety score in the two distraction groups (bubble making and regular breathing exercise). Conclusion: Needle-related procedural anxiety can be significantly reduced by using distraction. Bubble making and regular breathing exercise can be effective on the anxiety during venipuncture and might be considered for other minor invasive procedures in children. These non-pharmacological interventions require minimum effort and time and may be cost-effective and convenient nursing interventions that could be used easily in clinical settings.