The Effect of Health Riddles on Fear, Anxiety, and Pain in Circumcised Children

Condition(s) studied

Investigational drug(s) / intervention(s)

The Normal Riddles Book: The distribution of the participating children to the experimental and control groups will be carried out by simple random sampling method. Children included in the Normal Riddle Book group will be introduced to a book containing general, entertaining riddles that are not related to health during the pre-circumcision period. The book will be given to the children approximately 1 hour before the circumcision operation and the children will be allowed to read the puzzles, solve them or interact with the researcher/nurse. The application period is planned as approximately 20-30 minutes. The children's fear, anxiety and pain levels will be measured before and after the application. During the application process, the children's attention level, interest in the book and general behavior will be observed and recorded.

Health Riddles Group: The children included in this group will be presented with the Health Riddles Book, which contains health information and is prepared to reduce fear and anxiety before the circumcision. The book will be given to the children approximately 1 hour before the circumcision procedure and the children will be allowed to read the riddles or interact with the researcher/nurse. The application time is planned to be 20-30 minutes. Before and after the application, the children's fear, anxiety and pain levels will be measured with the Introductory Information Form, Child Fear Scale, Child Anxiety Scale-State and Wong-Baker Face Pain Scale. The data obtained from the health riddles group will be compared with the data obtained from the normal riddle and control groups and the unique effect of the riddles containing health information on fear, anxiety and pain will be analyzed.

Study summary

This study was designed as a randomized controlled experimental method to examine the effects of health puzzles on the fear, anxiety and pain levels that occur in the pre- and postoperative periods in children who underwent circumcision.

Eligibility

Primary outcome measure(s)

• Introductory Information Form — Baseline
  The introductory information form prepared by the researchers consists of items related to the child's age, gender, height, weight, place of residence, number of siblings, previous hospitalization, previous surgery, mother's age, education status, father's age, education status and the family's economic status.
• Child Fear Scale (CFS) — Baseline and up to 4 weeks
  This scale was developed by McMurtry and colleagues in 2011 and was adapted to Turkish by Gerçeker and his team in 2018 and validated. Designed for children between the ages of 5 and 10, this scale presents facial muscle changes in fearful expressions with a graphic artist's drawings based on photographs of frightened faces. The scale can be used by the family, child, or researcher to evaluate children. The scale shows the child a scale containing five facial expressions scored between 0 and 4. These expressions are interpreted as follows: 0: Neutral expression (no fear), 1: Very little fear, 2: Some fear, 3: More fear, 4: Highest level of fear. This scale can be used to measure the child's level of fear before and during the procedure.
• Child Anxiety Scale-State (CAS-D) — Baseline and up to 4 weeks
  The "Child Anxiety Scale-State" (CAS-D) scale, developed by Ersig and his colleagues in 2013, is used to measure the situational anxiety of children between the ages of 4-10. Its validity was provided by Gerçeker and his team in 2018. CAS-D is designed in the shape of a thermometer and has a bulb chamber at the bottom and horizontal lines upwards. Each horizontal line represents one point, and there are 10 points in total. The bottom line represents a score of 0 and indicates a situation where there is no anxiety. The anxiety level increases as you go higher, and the top line represents the highest anxiety with a score of 10.
• Wong Baker Pain Rating Scale — Baseline and up to 4 weeks
  The Wong-Baker Faces Pain Rating Scale is an adaptation of the Faces Rating Scale, a picture projection technique that uses 6 pictures of a child's facial expressions in pain to assess the child's level of pain. This scale is used to best describe the child's current level of pain. The child is asked to choose the face that best describes their pain. The descriptions of the faces are as follows: Face 0: Depicts a painless, happy face, meaning "I'm very happy, I'm in no pain." Face 5: Depicts a crying face, meaning "it hurts as much as you can imagine, but you don't have to cry to feel that bad." The responses on this 5-point scale range from 0 (very happy, no pain) to 5 (it hurts as much as you can imagine) and help determine the child's level of pain.

Trial sites (1)

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