Reducing Fear and Anxiety in Electrocardiography Procedures Using Distraction-Enhanced Environments in Pediatric Emergency Care: A Randomized Controlled Study.

Background: Children experience fear and anxiety not only during painful procedural interventions but also during painless procedural interventions such as electrocardiography (ECG). Pediatric nurses should be aware of the emotional changes experienced by children during ECG procedures.

Purpose: The aim of this single-center, single-blinded, randomized controlled intervention study was to investigate the impact of the undersea-themed examination table cover (UTETC) on the levels of fear and anxiety experienced by children during ECG procedures.

Methods: This study was conducted between April 1 and July 31, 2022, in the pediatric emergency department of a training and research hospital in Turkey. The participants included 80 children (experimental group = 40, control group = 40) aged 3-12 years. The experimental group underwent the procedure in the ECG room using the UTETC, while the control group underwent the routine procedure in the examination room. The entire process was video-recorded. Video recordings were watched by two nurses who were not otherwise involved in this study, and the data were collected using the Descriptive Data Form, the Children's Fear Scale, and the Children Emotional Manifestation Scale.

Results: No statistically significant difference was found in the descriptive characteristics of the two groups (p > .05). The experimental group completed the procedure more successfully than the control group with significantly lower levels of procedure-related fear and anxiety (p < .05).

Conclusions/implications for practice: The UTETC was found to be effective in reducing fear and anxiety in children aged 3-12 years during ECG procedures in a pediatric emergency department.