The Effect of Distraction on Pain Management in Children Aged 5 to 12 Years Old With Acute Leukemia Undergoing Bone Marrow Aspiration

Abstract

Background and Aims

Acute leukemia is considered the most common form of cancer in children. Different painful diagnostic approaches may be applied to diagnose acute lymphoblastic leukemia (ALL) in children suspected of having the disease, such as blood tests and bone marrow aspiration (BMA). Several studies reported that distraction strategies could alleviate pain severity in children. Therefore, the current study aimed to investigate the effectiveness of distraction in pain management in children aged 5−12 years old with acute leukemia undergoing BMA.

Methods

In a quasi-experimental study involving 60 participants, using convenience sampling, they were assigned to control (n = 30) and distraction (n = 30) groups. Children in the distraction group watched TV cartoons during BMA, while children in the control group didn't. The children's level of acute pain was measured using Oucher's scale before, 30, and 60 min after the intervention.

Results

The mean pain severity score immediately before the intervention between the intervention and control groups was markedly different (2.33 ± 1.21 vs. 3.60 ± 1.56, p = 0.005). Also, the mean severity score after 30 min of the second BMA illustrated a significant difference between the intervention and control groups (4.20 ± 1.84 vs. 6.6 ± 2.16, p < 0.001). We observed a considerable difference between the intervention and control groups regarding the mean severity score after 60 min of the second BMA (2.06 ± 0.82 vs. 4.8 ± 2.34, p < 0.001).

Conclusion

The design and implementation of well-developed pain management regularly involving sustained and organized distraction can effectively manage the severity of pain in acute leukemia children undergoing BMA.