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Distraction Techniques for Children Undergoing Procedures: A Critical Review of Korean Intervention Research

아동기 처치관련 관심전환요법: 국내 아동 중재연구의 비평적 고찰

  • Im, Eun Seon (Department of Nursing, Graduate School of Chosun University) ;
  • Kim, Jin Sun (Department of Nursing, Chosun University)
  • 임은선 (조선대학교 대학원 간호학과) ;
  • 김진선 (조선대학교 의과대학 간호학과)
  • Received : 2014.08.17
  • Accepted : 2014.09.26
  • Published : 2014.10.31

Abstract

Purpose: The purpose of this study was to provide a critical assessment of evidence-based Korean pediatric research that can inform clinical practicability of, and future research on distraction interventions for pediatric procedural pain management. Methods: A critical review of evidence-based Korean pediatric research was conducted. Databases were searched to identify research that included an evaluation of a distraction intervention as an intervention for pediatric procedural pain management. The search yielded 68 studies. Results: From these studies, 14 were included for this review and all were recently published (2003-2014). Quasi experimental designs were most frequently used (n=12) and for 71.4% the focus was preschoolers. Audiovisual techniques were the most common form of distraction. In most studies clinical utility of the distraction intervention was not examined. Fairly consistent reductions in behavioral measures of pain in association with the distraction intervention were found but less consistent results were found for physiological measures. Conclusion: Lack of methodological rigor limits the evidence for distraction interventions to reduce pain and fear experienced by children during painful procedures. Further research to analyze the cost and time-effectiveness and to identify consumer and provider satisfaction with distraction interventions is needed to determine whether distraction interventions are clinically relevant.

목적 본 연구의 목적은 아동의 처치관련 통증을 경감시키기 위한 관심전환중재를 적용한 국내 중재연구들을 분석, 평가하고, 추후 아동의 처치관련 통증을 경감시키기 위한 관심전환중재 연구의 발전방향을 제시하기 위한 근거자료를 제공하고자 함이다. 방법 본 연구는 통증과 관련하여 아동을 대상으로 실시된 관심전환요법의 국내 간호연구 동향을 파악하고 실무 및 연구의 발전방향을 모색하기 위한 비판적 고찰 연구이다. 결과 국내에서 실시된 관심전환을 중재로 적용한 연구는 대부분이 학령전기 및 학령기 초기 아동을 대상으로 실시한 유사실험연구 설계였으며, 시청각 자극을 통해 관심을 전환하는 방법을 가장 많이 사용하였다. 관심전환중재는 아동의 통증과 두려움 등의 행동반응 결과변수의 변화에는 분석 연구의 대부분에서 효과가 있는 것으로 그리고 생리적 반응 결과변수의 변화에는 분석 연구의 46.7%에서 효과가 있는 것으로 나타났다. 그러나 분석에 포함된 논문들의 연구설계, 시행, 보고 등에 있어서 방법론적인 엄격성이 부족하였다. 또한 각 연구들은 시행한 관심전환중재의 절차에 대한 제한된 정보만을 제시하여 다른 연구자들이 반복연구를 시행한다거나 중재를 실무로 중개하는 데 한계가 있었다. 결론 관심전환요법이 아동의 절차관련 통증과 두려움을 경감시키는 데 효과가 있는지에 대한 근거를 좀 더 확실하게 파악하기 위해서는 방법론적 엄격함이 요구된다. 추후 연구에서는 관심전환중재의 임상적 활용성을 파악하기 위해 비용과 시간 효과성 그리고 보호자와 건강관리 제공자의 만족도를 밝히기 위한 연구가 요구된다.

Keywords

References

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