Children's Fear Research Articles

Formation of Stereotypes of Human Behaviour under the Influence of Childhood Fears

The relevance of the study is due to the presence of a relationship that occurs between the emotional and intellectual development of the individual. Negative changes in the process of emotional development of a person lead to the fact that they are unable to use other structures, in particular, intelligence, and therefore develop harmoniously. As a basic emotion, fear is an integral part of the emotional field, as is the emotion of joy, sadness, and anger. Fear performs a protective function, but it also destroys the individual if it is irrational. The emotion of fear, arising in childhood, can be fixed and transformed into more acute manifestations, that is, into phobic disorders. Personality is formed under the influence of society, so a very important role in its development is played by models of upbringing in the family and those attitudes and prescriptions that a person learns from childhood. In adulthood, these patterns are manifested in the form of stereotypical behaviour, which substantially affects a person’s quality of life. Therefore, it is important to clarify how childhood fears can affect the individual in adulthood. The purpose of this study is to establish a link between childhood fears and stereotypical behaviour. A number of methods and techniques were used to achieve this goal, including theoretical (analysis, synthesis, generalisation) and practical (D. McLain’s general tolerance for uncertainty scale; tolerance-intolerance of ambiguity questionnaire by T.V. Kornilova; questionnaire of childhood fears). The results of the study show that in the case when a person cannot safely live through fears as a child, they have an impact on the psychological well-being of the individual, which encourages the formation of psychological problems. It is proved that as a result of gender stereotypes in education, male and female fears formed in childhood differ markedly. Therewith, it is noted that certain stereotypes have a positive meaning in a person’s life if they do not suppress their psychological development. The research materials will be useful for practical psychologists in the education and social fields, and teachers

Effects of artificial intelligence aibo intervention on alleviating distress and fear in children

BackgroundProcedures and actions such as injections and immobilization cause distress to children. In the pediatric field, there is a need for interventions and support to alleviate the pain and distress caused by such medical procedures. In recent years, the introduction of robots as a means of distraction has begun to be attempted.MethodsIn this study, we conducted a non-randomized controlled trial to examine the effect of intervention using ‘aibo’, a dog-like robot which has artificial intelligence (AI), to promote distraction in children after vaccination. Children between the ages of 3 and 12 years old eligible for the Japanese encephalitis vaccine, and their caregivers were assigned to intervention group or control group. Then, children evaluated their pain and children’s behavior were observed by observer. The mean values of Faces pain rating scale scores and observer pain scale scores were compared between groups using an unpaired t-test.ResultsFifty-seven children (32 in the intervention group) participated in the study. Results of a t-test with the control group showed that the intervention group using aibo had significantly less pain following the post-vaccination intervention than the control group using stuffed dog (Face Scale, t(55) = 2.582, p = .0125; Behavioral Observation Scale, t(55) = 2.772, p = .00759). The results support the hypothesis that the aibo intervention group will be less distressed and able to calm down more quickly after vaccination than the control group.ConclusionInteractive communicative play intervention by an artificially intelligent aibo before and after painful and frightening medical procedures may alleviate fear and anxiety and prevent medical trauma in children.

The effects of goldfish on anxiety, fear, psychological and emotional well-being of hospitalized children: A randomized controlled study

AimThis study aimed to determine the effect of goldfish intervention on anxiety, fear, psychological and emotional well-being of hospitalized children. Materials and methodsBetween November 2020 and August 2021, an open-label, single-center randomized controlled experimental study was conducted in Türkiye's Eastern Anatolia region. The study included 112 children aged 8 to 10 years old (56 in the study group and 56 in the control group). The study and control groups were randomly assigned to strata using a table of random numbers. The children in the study group observed after goldfish intervention for three days. As data collection tools, the State-Trait Anxiety Inventory for Children, Child Fear Scale, and the Stirling Children's Well-being Scale were used. ResultsThe mean state anxiety scores of the children in the study group who looked after goldfish intervention decreased significantly compared to the control group. When the two groups were compared, the difference between the post-test measurements were significant (p < 0.05). The mean score of the fear scale in the post-test measurements of the study group children was significantly lower than the control group (p < 0.05). Finally, the emotional, and psychological well-being post-test scale mean scores of the study group children were higher than the control group (p < 0.01). ConclusionGoldfish intervention was found to be effective in decreasing the state anxiety and fear levels and increasing the psychological and emotional well-being levels of the children in the study group.

The Effect of Virtual Reality and Buzzy on First Insertion Success, Procedure-Related Fear, Anxiety, and Pain in Children during Intravenous Insertion in the Pediatric Emergency Unit: A Randomized Controlled Trial

IntroductionDistraction methods such as virtual reality and cold vibration device are recommended during intravenous interventions. Few studies have focused on the impact of nonpharmacological interventions on intravenous insertion success. MethodsA randomized controlled study evaluated effect of virtual reality and cold vibration device application on first-attempt intravenous insertion success and procedure-related pain, fear, and anxiety during intravenous insertion in children. Children aged 4 to 10 years (N = 150) undergoing peripheral intravenous catheterization insertion in the pediatric emergency department were randomized to 1 of 3 groups: virtual reality, cold vibration (Buzzy), and control group. Distraction technique of talking and asking questions of children was used in control group. Primary outcome was first-attempt intravenous insertion success; secondary outcomes were procedure-related pain, fear, and anxiety. Study data were collected using Difficult Intravenous Access score, Emotional Appearance Scale for Children, Wong-Baker Faces Pain Rating Scale, Color Analog Scale, Children's Anxiety Meter-State, and Child Fear Scale. Data were analyzed using chi-square test, Fisher exact test, and Kruskal–Wallis test. ResultsThere were no significant differences in first-attempt intravenous insertion success rates (virtual reality = 47.2%, Buzzy® = 50%, control = 46.9%), preprocedural emotional appearance scores, and procedure-related pain and anxiety scores. There was no difference between groups for vital signs before, during, and at fifth minute of procedure. DiscussionVirtual reality and Buzzy may decrease procedure-related fear in children during intravenous insertion. This research has shown that pediatric emergency nurses can reduce pain and anxiety by talking to children, and simple distractions such as asking questions are as effective as more technological ones.

Qualities of Children's Fear in Therapeutic Action Groups Addressing Post-separation Parental Stalking.

This paper examines the way in which parental stalking - as a form of domestic abuse - raises fear in children and affects their sense of safety. The study draws on three therapeutic action groups involving 13 children who have experienced stalking by their fathers/stepfathers after the parents' separation. The research question is as follows: How does children's sense of fear manifest in therapeutic action groups? The qualitative analysis revealed three qualities of fear among the children: (1) internalised, (2) constant and (3) episodic. Internalised fear appeared as a child's mental state that materialised as an overwhelming sentiment in the group sessions and elsewhere. Constant fear activated at times, and the senses of fear and security alternated both in the sessions and elsewhere. Episodic fear related to the children's memories of violent events and father's stalking behaviour. The children were able to sense security in the group and in daily life owing to a temporal distance to their father's stalking. Our findings underscore the importance of professionals' awareness of the qualities of children's fear and the significance of assessing their fear and sense of safety in a child-centered manner in therapeutic practices.

"It bites!": The transmission of negative information about snakes and spiders through a naturalistic picture book interaction.

Snakes and spiders are two of the most commonly feared animals worldwide, yet we know very little about the mechanisms by which such fears are acquired. We explored whether negative information about snakes and spiders from parents shapes children's fear beliefs. Study 1 included 27 parents (22 mothers, five fathers) and children (12 female, 15 male, Mage = 5.33 years, 18 White, one Hispanic, eight more than one race). Most parents reported having an advanced degree (78%) and an annual household income of above $100,000 (74%). Participants read an animal picture book and then rated their fear toward each animal. Study 2 included 54 parents (44 mothers, eight fathers, two legal guardians) and children (27 female, 27 male, Mage = 5.52 years, 30 White, one Hispanic, seven Asian/Pacific Islander, four South Asian/Indian, 12 more than one race). Most parents reported holding an AA/BA degree (28%) or an advanced degree (59%) and reported an annual household income of $60,000-$100,000 (28%) or above $100,000 (59%). In Study 2, half of the parents were primed about how their conversations might shape children's fear prior to reading the book. Across both studies, we found that participants provided more negative than positive information about snakes and spiders and provided less positive (Study 1) and more negative (Study 2) information compared to other animals. Our results highlight the prominence of negative information in conversations about snakes and spiders and suggest that the way parents talk about these animals may shape the development of children's fears. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparison of Fear of Dentistry between Children with Molar-Incisor Hypomineralization and Children with Permanent First Molars without Hypoplasia

Background: Molar incisor hypomineralization (MIH) is a developmental enamel defect of the incisor and molars that can lead to fear of dentistry in children. This study aimed to compare the dental fear of children aged 8 to 12 years with MIH and children with permanent first molars without hypoplasia in 2020 in Isfahan, Iran.Methods: In this descriptive-analytical cross-sectional study, the participants included 200 students aged 8-12 years old in Isfahan, who were randomly selected from the second to sixth- grade students referred to the clinics. The examination was performed by a dentistry intern using a disposable dental mirror and dental probe on the unit. Fifty-two children with MIH and 148 children with permanent first molars without hypoplasia were enrolled. The Dental Subscale of the Children’s Fear Survey Schedule (CFSS-DS) questionnaire was used to collect information, which includes two sections: demographic information and 15 questions on different areas of fear of dental treatment in children. Data were analysed through SPSS 20 software and using descriptive-statistical tests (frequency and percentage, mean), t test, chi-square test, and logistic regression test. P < 0.05 was defined as a statistically significant level.Results: The mean score of dental fear was 15 ± 35 (ranged from 15 to 75) which indicated moderate level of dental fear in the participating children. In whole, 62.5% of children were afraid of dentistry. The rate of dental fear in girls was 9 times higher than in boys (P < 0.05). Also, the rate of dental fear in children with MIH was 46 times higher than in children who did not have this disorder (P < 0.05). The frequency of dental fear in children with severe disorders was significantly higher than in children with mild defects (P = 0.000). There was no statistically significant difference in terms of dental fear among different age groups (P = 0.313). Also, with increasing the number of dental visits, dental fear increased by 1.2 times (P < 0.05), which was statistically significant.Conclusion: Fear of dentistry in children with MIH was significantly higher than in children with molar teeth without hypoplasia.

"Covid-19 is dangerous": The role of parental verbal threat information on children's fear of Covid-19.

Theoretical and empirical evidence suggests that the effect of parental verbal threat information on the offspring's fear acquisition of novel stimuli may be causal. The current study investigated this verbal fear acquisition pathway from parents to children in the unique context of Covid-19 as a novel environmental threat for parents and children. Using an online cross-sectional survey, we collected data about fear of Covid-19, parent-child communication, parental anxiety, and child temperament, in the period between June 11th 2020 and May 28th 2021. Participants were 8 to 18-year-old children (N = 195; Mage = 14.23; 113 girls) and their parents (N = 193; Mage = 47.82; 146 mothers) living in the Netherlands. Children of parents with stronger Covid-19 fears also reported stronger Covid-19 fears. Moreover, parents who were more fearful of Covid-19 provided more threat-related information about the virus to their children. More parental threat information in turn was related to stronger fear of Covid-19 in their children, and partly mediated the link between parent and child fear of the virus. The link between parental threat information and children's fear of Covid-19 was not moderated by child temperament or parental anxiety. Parental communication about Covid-19 may play a role in children's fear acquisition of Covid-19. The lack of moderation of this link by parental anxiety and child temperament may reflect the potentially adaptive nature of verbal fear transmission during the first year of the pandemic and the nonclinical levels of fear in this community sample.

98 The impact of music, play, pet, and art therapies in managing pain and anxiety in paediatric patients in hospital: a systematic review

Abstract Background The hospital can provoke significant feelings of pain, fear, and anxiety in children. Being in a new setting, often separated from loved ones and undergoing multiple medical procedures may elicit negative emotions. Complementary treatments may minimize these feelings and facilitate a more positive experience for children in hospital. Objectives This systematic review aims to explore the impact of music, play, pet, and art therapy on pain and anxiety in paediatric patients in hospital. Design/Methods Databases MEDLINE, CINAHL, Cochrane Library, and EMBASE were searched from database inception to November 2020 and reference lists were screened. Randomized control trials (RCTs) of paediatric patients evaluating the impact of music, pet, play, and/or art therapy on pain and/or anxiety were eligible for inclusion. Study setting was limited to the hospital (inpatient/outpatient) and/or emergency department. No restrictions were placed on the comparator. Duplicate studies were removed, and abstract and full-text screening was completed independently and in duplicate by reviewers. Reviewers extracted data from eligible studies into predeveloped REDCap forms independently and in duplicate. A narrative synthesis was used to summarize study findings using the synthesis without meta-analysis (SWiM) guidelines. Quality of evidence was then assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) across studies for each intervention and outcome. Results 761 documents were identified and 30 RCTs were included, covering music (n=15), play (n=13), and pet (n=3) therapy. One study examined music and play therapy. No art therapy studies were identified. Studies took place in the inpatient setting (n=18), outpatient setting (n=5), a combination of both inpatient and outpatient (n=3), and the emergency department (n=4). Most studies (n=25, 83%) evaluated patients’ pain and/or anxiety before, during, and/or after undergoing procedures in hospital such as surgery, venipuncture, and imaging. There was high certainty of evidence for play therapy in reducing pain and moderate certainty for music and pet therapy. Moderate certainty of evidence supported music and play therapy in reducing anxiety; however, pet therapy was found to have little to no significant difference. None of the interventions were found to increase pain or anxiety. Conclusion Complementary therapies such as music, play, and pet therapy should be utilized in parallel to medical treatments in paediatric patients receiving care in hospital to mitigate pain and anxiety in addition to promoting a positive hospital experience.

65 XyloFUNS: Xylocaine to Freeze during Unpleasant Nasopharyngeal Swabs in Children – A Randomized Controlled Trial

Abstract Background Nasopharyngeal (NP) swabs have been recommended to detect SARS-CoV-2 since the beginning of the COVID-19 pandemic, but are reported to be at least moderately painful. Objectives To evaluate the efficacy of intranasal vaporized lidocaine compared to a sham treatment in reducing pain in children undergoing a NP swab in the Emergency Department (ED). Design/Methods A randomized double-blinded clinical trial was conducted in a pediatric ED. Both participants and the researcher evaluating the primary outcome were blinded. Children 6 to 17 years old requiring a NP swab were eligible. Participants were randomly allocated to receive intranasal lidocaine or a sham treatment prior to their NP swab. The primary outcome measure was pain during the swab as assessed by the visual analog scale. Secondary outcome measures were pain using the verbal numeric rating scale, fear using the children fear scale, and side effects of the intervention. Results Eighty-eight participants were enrolled: 45 to the lidocaine group and 43 to the control group. The mean visual analog scale scores for pain were 46 mm in the lidocaine group and 53 mm in the control group (mean difference 7 mm; 95%CI -5 to 19 mm). The numeric rating scale and children fear scale were not statistically different between groups. No serious adverse events were observed. Fear prior to the test and younger age were associated with higher pain scores. Conclusion Intranasal lidocaine administered prior to NP swabs in the ED did not lower pain scores for school-aged children and youth.

The Causes and Role of Antinatalism in Poland in the Context of Climate Change, Obstetric Care, and Mental Health.

Antinatalism is an umbrella term for numerous moral dilemmas associated with procreation. In the past few years, the deterioration of environmental conditions, social difficulties, global worsening of people’s mental health, and pandemics have induced discussion about antinatalism. Therefore, we aimed to characterize antinatalists in the Polish population in terms of the frequency and description of the main reasons behind this phenomenon. The cross-sectional study was performed in the Polish population. An online, four-part survey was performed between 19 and 25 January 2022. The study group comprised 1240 respondents. Antinatalists (n = 472, 38%) were defined as people who do not have children and want to be childless in the future, whereas pronatalists (n = 768, 62%) consisted of people who want to have offspring in the future and/or already have children. The opinion that climate change is a significant reason not to have a child appeared twice as often among antinatalists. Additionally, the performed binary logistic regression model highlighted the importance of the fear of climate change as an independent factor facilitating an antinatalistic attitude. Regarding females, the following factors discouraging them from having a child were observed: fear of child’s congenital diseases, pregnancy complications, dissatisfaction with medical services, and fear of exacerbation of maternal chronic diseases. Anxiety, depression, and stress were not found to be statistically different between pro- and antinatalist groups. However, further analysis revealed that female antinatalists were significantly more depressive and anxious. Our study helps us to understand why, as mentioned beforehand, around 38% of respondents prefer to stay childless. In conclusion, antinatalism views have become relatively prevalent in society, and its reasons include environmental antinatalism and medical factors, including depression and anxiety. However, better access to medical services and changes in climate politics were not found to be significant factors in encouraging society to decide to have offspring.

Urban-Rural Distinction or Economic Segmentation: A Study on Fear and Inferiority in Poor Children's Peer Relationships.

Peer relationships play an important role in the growth of children. This study offers insights about feelings of fear and inferiority in children’s peer relationships. Based on a national survey, the 2018 Construction for Social Policy Support System for Urban and Rural Poor Families in China, initiated by the Ministry of Civil Affairs, and using multiple regression models and a structural equation model, this study discusses whether and how having a rural household registration or being from a poor (dibao) family has an isolation effect on fear and inferiority in children’s peer relationships. The research findings indicate that children with a rural household registration or those from a dibao family are at a disadvantage in peer interactions. Moreover, rural resident identity has an indirect effect on children’s fear of peers and inferiority, mainly through psychological resilience, anxiety and depression, and mobile phone dependence. Being from a dibao family directly influences children’s fear and inferiority in their peer relationships; it also indirectly influences fear of peers and inferiority through psychological resilience. This study suggests that more attention should be paid to fear of peers and inferiority in rural children or children from a dibao family.

The Shared Regressive State and Understanding‐without‐Reflection in Supervision

One of the transformational therapeutic experiences is the therapeutic dyad's immersion in and recovery from shared regressive states that are often provoked by an awakened childhood fear of breakdown. I suggest that the supervisory dyad has parallel transformational experiences – the shared regressive states that follow continuous incomprehension of the unfolding therapeutic reality. Moreover, when the supervisory partners immerse themselves in a shared regressive state, a unique, inclusive, embodied, unsymbolized, and procedural understanding‐without‐reflection emerges spontaneously. Analytic writers describe such an understanding as an unconscious knowledge, and existentialist writers describe it as prereflective consciousness. Before translating this unique understanding into a therapeutic narrative, the supervisor needs to recover from the regressive state and organize it according to discursive and logical analytic principles. From this perspective, the already existing experiential and analytic theoretical knowledge serves as a platform for creating new perceptions and analytic discourses.

Selective Amygdala Hypoactivity to Fear in Boys With Persistent Conduct Problems After Parent Training

BackgroundParenting interventions reduce antisocial behavior (ASB) in some children with conduct problems (CPs), but not others. Understanding the neural basis for this disparity is important because persistent ASB is associated with lifelong morbidity and places a huge burden on our health and criminal justice systems. One of the most highly replicated neural correlates of ASB is amygdala hypoactivity to another person’s fear. We aimed to assess whether amygdala hypoactivity to fear in children with CPs is remediated following reduction in ASB after successful treatment and/or if it is a marker for persistent ASB. MethodsWe conducted a prospective, case-control study of boys with CPs and typically developing (TD) boys. Both groups (ages 5–10 years) completed 2 magnetic resonance imaging sessions (18 ± 5.8 weeks apart) with ASB assessed at each visit. Participants included boys with CPs following referral to a parenting intervention group and TD boys recruited from the same schools and geographical regions. Final functional magnetic resonance imaging data were available for 36 TD boys and 57 boys with CPs. Boys with CPs were divided into those whose ASB improved (n = 27) or persisted (n = 30) following the intervention. Functional magnetic resonance imaging data assessing fear reactivity were then analyzed using a longitudinal group (TD/improving CPs/persistent CPs) × time point (pre/post) design. ResultsAmygdala hypoactivity to fear was observed only in boys with CPs who had persistent ASB and was absent in those whose ASB improved following intervention. ConclusionsOur findings suggest that amygdala hypoactivity to fear is a marker for ASB that is resistant to change following a parenting intervention and a putative target for future treatments.

Features of self-esteem in anxious children of senior preschool age

The work is aimed at studying the manifestation of self-esteem in anxious children of older preschool age. The materials of an empirical study obtained on a sample of children of senior preschool age from kindergartens in Ulyanovsk are presented. The study involved children aged 6,5 to 7 years. The study included psychological diagnostics using the following methods: “The Train Engine Method” (Velieva S.V.), the method for identifying children's fears by A.I. Zakharov and M.A. Panfilova “Fears in houses”, Test “Fairy tale” (L. Duss), Method “Ladder” V.G. Schur. The results obtained make it possible to say that among the sample of children of older preschool age, signs of anxiety in one form or another were detected in 40 % of the subjects. Anxiety manifests itself both in a general negative emotional state and in the presence of certain fears. The most prominent are the fear of loneliness and the fear of punishment from parents. In anxious children, inflated self-esteem is less common than in children who are not prone to anxiety. In children with a normal level of anxiety, their own assessment of themselves is higher than the assessments of others (mother and teacher). In anxious children, the situation is reversed, they tend to evaluate themselves lower than the surrounding adults. One of the hypotheses of such results of the study is that the increased level of anxiety and fears in children of older preschool age may be the result of a strict and critical attitude towards them from their parents. In general, the study is intended to prove the fact that the structure of self-esteem in anxious children is characterized by inadequate perceptions of themselves and their achievements (the cognitive component of self-esteem) and low self-satisfaction.

Inhibitory control moderates the association between fear and attention bias to snakes in middle childhood

Fear and inhibitory control interact to affect the attention allocated to threats in clinically anxious populations. We examined whether fear and inhibitory control impact attention bias to threat in a community sample of 6- to 8-year-old children (n = 102). A visual search task used color photographs of snakes and caterpillars as targets and flowers as the distractors. Parents completed questionnaires about their child’s fear and inhibitory control. Results showed that the children exhibited an attentional bias to snakes. Child fear predicted for the attention bias, whereas fear and inhibitory control interacted to predict attention bias. Simple slopes analysis showed the association between fear and attention bias was significant only for children who had high inhibitory control and not significant for those who had low inhibitory control. Models of child anxiety focus on links between fear and inhibitory control; our work extends the occurrence of this phenomena to community, non-clinical populations. • Child fear was positively related to attention bias to snakes 6-to-8-year-olds. • Fear predicted the attention bias only for children with high inhibitory control. • Findings extend models of inhibitory control and fear to non-clinical populations.

XyloFUNS: Xylocaine to freeze during unpleasant nasopharyngeal swabs in children-a randomized controlled trial.

To evaluate the efficacy of intranasal vaporized lidocaine in reducing pain for children undergoing a nasopharyngeal (NP) swab in the Emergency Department (ED). A randomized blinded clinical trial was conducted in a paediatric ED. Both participants and the researcher evaluating the primary outcome were blinded. Children aged 6 to 17 years old requiring a NP swab were eligible. Participants were randomly allocated to receive intranasal lidocaine or a sham treatment prior to their NP swab. The primary outcome measure was pain during the swab as assessed by the visual analog scale. Secondary outcome measures were pain using the verbal numeric rating scale, fear using the children fear scale, and adverse effects of the intervention. Eighty-eight participants were enrolled-45 in the lidocaine group and 43 controls. The mean visual analog scale scores for pain were 46 mm in the lidocaine group and 53 mm in the control group (mean difference 7 mm; 95% CI: -5 to 19 mm). No serious adverse events were observed. Intranasal lidocaine administered prior to NP swabs in the ED failed to show an improvement in pain scores for school-aged children and youth.

The effect of buzzy and cold spray on pain, anxiety, and fear of children during venipuncture in pediatric emergency department in Turkey; A randomized controlled study

PurposeIt was aimed to evaluate the efficacy of Buzzy and cold spray in reducing pain, anxiety, and fear of children during venipuncture in the emergency department (ED). MethodsThis study is an experimental, parallel-group (intervention-control), randomized controlled, single-blind design. The study was conducted with 161 children aged 5–12 years in pediatric ED. Data were collected by the ‘Personal Information Form’, ‘Wong Baker-Facial Expression Rating Scale’, ‘Child Anxiety Statement Scale’, and ‘Child Fear Inventory’. Data were analyzed with descriptive statistics, Mann Whitney U test, Kruskal Wallis H test, and Intraclass Correlation. ResultsDescriptive features of the children were homogeneous. ‘Wong Baker-Facial Expression Rating Scale’, ‘Child Anxiety Statement Scale’, and ‘Child Fear Scale’ score averages of the children in the control group were higher than the children in the Buzzy group and the cold spray group (p < 0.001). The pain scores of the Buzzy group were higher than those in the cold spray group (p < 0.001). The anxiety and fear mean scores of the children in the Buzzy and cold spray groups were similar (p > 0.05). ConclusionIt was determined that Buzzy and cold spray were more effective than standard care in reducing the level of pain, anxiety, and fear in children ages 5–12 years during venipuncture in the pediatric emergency. The cold spray was more effective in reducing pain than Buzzy. Practice implicationsNurses can use Buzzy and cold sprays to manage the fear, anxiety, and pain associated with venipuncture.

Promethazine hydrochloride reduces children's agitation during ocular examination for trauma.

Examination and intervention are always the causes of agitation, anxiety, and fear in children's lives. This study aimed to investigate the effectiveness of promethazine hydrochloride in reducing children's agitation during the ocular examination for trauma. In this interventional-clinical trial study, a total of 62 children referred to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, were evaluated in two matched groups (case (n = 31) and control (n = 31)) for an initial examination of ocular trauma. Finally, the intervention was performed (giving placebo or promethazine hydrochloride cough syrup 20 minutes before the initial ocular examination at 0.5 mg/kg), and the demographic information form and researcher-made questionnaire modeled on the Cohen-Mansfield Agitation Inventory (CMAI) were completed. The obtained results revealed that the mean scores of physical/aggressive behaviors (p ˂ 0.001), physical/nonaggressive behaviors (p = 0.013), verbal/aggressive behaviors (p ˂ 0.001), and hiding behaviors (p ˂ 0.001) were significantly lower in the promethazine hydrochloride-receiving group than the placebo group. These findings demonstrated that promethazine hydrochloride cough syrup facilitated the examination among the pediatric patients who suffered from traumatic ocular injuries. However, further studies in this field need to be carried out through randomized controlled trials.

The Effect of External Cold and Vibration on Infiltration-Induced Pain in Children: A Randomized Clinical Trial.

Introduction Children's fear of and anxiety about dental treatments are important problems in maintaining health. The anesthetic injection is the main cause of dental fear. One of the methods to reduce the infiltration-induced pain is to use external cold or vibration using the gate control system. Various devices have been used to apply cold and vibration, including the BUZZY device (BUZZY Company, Arizona). Studies have shown contradictory results for the effectiveness of cold and vibration. This study aimed to investigate the effect of cold and vibration versus cold alone on maxillary infiltration-induced pain and stress. Methods Thirty children aged 6–12 years who required profound restoration of deciduous or permanent first molars were recruited in this randomized double-blind clinical trial. The anesthetic gel and BUZZY device were used in half of the children's jaws, and the anesthetic gel and the cold alone were used in the other half of the jaws. To measure stress from the heart rate, the Wong–Baker scale was used as the subjective scale, and the face, legs, activity, cry, consolability (FLACC) scale was used as the objective scale. Results The FLACC score was significantly lower in the BUZZY group than in the cold-alone group, but the Wong–Baker scale and heart rate did not show a significant difference between the two groups. Conclusions The BUZZY device can be effective in reducing infiltration-induced dental pain.