18/11/2018
Children generally hate being hospitalised, and needles and other potentially painful medical procedures just make matters worse for youngsters.

That is why Jade Ferullo, a Clinical Nurse Researcher at Perth Children’s Hospital, is working hard on a research project titled 'At their fingertips'. She wants to figure out how to help kids feel less distressed during such experiences, but without using extra drugs.

Her work in examining how effective "child-led distraction" using a tablet computer, can be in alleviating children's distress and pain during procedures, has earned her several speaking invitations since she started the study two years ago. 

"Hospitalisation can be a highly distressing experience for a child and their parent or caregiver, often exacerbated by pain associated with medical procedures," Jade said.

"Pain is one of the most frequently encountered complications in the hospital setting; therefore effective distress and pain management for the hospitalised child is of major importance. Nurses have a fundamental role in preventing and reducing patients' pain and distress and advocating for patients and families, particularly paediatric patients due to their inability or limited ability to express their feelings and emotions verbally."

 

Jade Ferullo, Clinical Nurse Researcher, is using tablet computers in a study to discover how to relieve stress on children in hospital. Image: Bohdan Warchomij.
 

Jade said children have reported that medical procedures, "particularly those involving a needle", are "one of the most common sources of fear and distress".

"Repeated or unrelieved trauma associated with distress and pain can lead to significant emotional consequences including Paediatric Medical Traumatic Stress," Jade added.

"Pharmacological and non-pharmacological interventions are used in reducing and minimising pain and subsequent distress and have been extensively documented in the literature. But despite an abundance of literature, clinical guidelines and well documented effects about the importance of pain and distress management, there appears to be a gap between theory and practice where the evidence is not incorporated into everyday management.

"Non-pharmacological approaches are a convenient, safe, cost-efficient, feasible and readily available alternative in minimising distress and pain in children effectively and efficiently”.

Jade said with modern technological advances, particularly the introduction of tablet computers, there is now an opportunity to combine various different "developmental level distractions".
 


Dr KC Bear was a guest speaker at one of Jade Ferullo's lectures.


"These include music/sounds, games, virtual reality,, movies and video clips and humour in the one portable and convenient device," she said.

"At present there is limited literature assessing the effectiveness of a tablet computer as child-led distraction in reducing distress and pain, and alleviating health professionals' barriers restricting the management of distress in children undergoing painful medical procedures.”

“My study aim is to see if using a tablet computer - such as an iPad - for distraction during a painful medical procedure reduces children's distress and pain,” said Jade. 
Jade has recently completed a randomised controlled trial, and The Kids’ Cancer Project Bears stepped in to lend a hand.
 
“The Kids’ Cancer Project provided teddy bears for this project since it first started in 2016,” said Jade. “I’m so grateful for the generosity of the donors who have made it possible.”
 

Read more: The Kids' Cancer Project Bear Program.
While the bears weren’t the focal point of her study, Jade said they played an important undercover role.
 
“The teddies were a wonderful addition after the children had completed their proceedure. They were also a good incentive to return the iPad when it’s time for me to go!”

Olivia Bear is Jade's main squeeze and has attended every one of her presentations.

“For ethical reasons during the study, neither the children nor their parents were aware about the bear before the procedure. So, when the children received one, they were often very surprised, delighted and grateful,” she said.

Seeing the pure joy on the faces of her patients made Jade feel very happy, as did knowing the bears gave the children a real sense of comfort after their procedure. But which bears gave the best hugs?
 
Baby Bear was a favourite with the really young children while Sammie and Frankie were a hit with the older children,” said Jade. “But I must especially thank Olivia bear for joining me in all the presentations I have done.”
Source: ANF Western Nurse Magazine, Western Australia’s Australian Nursing Federation.Hero image source: Bohdan Warchomij.

 
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