Effects of Instructional Therapeutic Play in the Behavior of Children During the First Attempt at Intravenous Catheterization

Objective: To verify the effects of instructional therapeutic play on the behavior of children during the first attempt at peripheral intravenous catheterization.

Method: This is a quasi-experimental post hoc analysis with a non-equivalent control group, secondary to a randomized clinical trial. The convenience sample comprised 193 children, allocated for convenience into an intervention group (preparation for catheterization with a therapeutic play; n=101 children) and a control group (preparation with structured conversation supported by the use of a booklet; n=92 children). The Observation Scale of Behavior Distress was used to evaluate opposing behavior (attacking the professional, whining, crying, getting nervous, screaming, moving until being immobilized, and protesting) and non-opposing behavior (helping and asking for information. We conducted descriptive and inferential analyses of the data.

Results: Statistically significant differences were observed between the intervention and control groups in the variables: nervousness, moving to immobilization, protest and assistance during venipuncture. The use of therapeutic play reduced the risk of being nervous during the procedure by 43%, the risk of moving did so by 51%, and the risk of not protesting by 51%. Furthermore, assistive behavior during the procedure increased by 27%.

Conclusion: The instructional therapeutic play was effective in reducing behaviors competing with intravenous catheterization and favored the child's collaboration in their first attempt.