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Pain Research and Treatment
Volume 2015, Article ID 478503, 6 pages
Research Article

Using Picture and Text Schedules to Inform Children: Effects on Distress and Pain during Needle-Related Procedures in Nitrous Oxide Sedation

1Södra Älvsborg Hospital, 504 55 Borås, Sweden
2DART-Center for AAC and AT, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 411 04 Gothenburg, Sweden
3Faculty of Caring Science, Work Life and Social Welfare, University of Borås, 501 90 Borås, Sweden
4Institute of Health and Care Sciences, University of Gothenburg, 405 30 Gothenburg, Sweden

Received 17 September 2015; Accepted 11 November 2015

Academic Editor: Anna Maria Aloisi

Copyright © 2015 Merja Vantaa Benjaminsson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


During hospital visits, children often undergo examinations and treatments that may involve an experience of pain and distress that is also connected to the staff’s treatment. The United Nation’s Convention on the Rights of Persons with Disability advocates the use of Universal Design. One way of implementing this idea within paediatric nursing is to increase the use of pictorial supports, and the few studies that have been published show promising results. The aim of this study was to do a comparison between two groups of children in regard to the pre- and postconditions of implementing an intervention including staff instruction and the use of pictorial support. The support consisted of a visual schedule with pictures and text, used both preparatory to and during the hospital visit. One hundred children aged 5–15 (50 children during the preinterventional data collection and 50 children postinterventionally) reported pain intensity and distress during needle-related procedures in nitrous oxide sedation. The results showed that the intervention had a positive effect in significantly lowering the level of preprocedural distress. The results showed that the pain intensity was also lowered however not reaching statistical significance. This confirms other positive research results on the use of visual supports within paediatric care, a topic that has to be further studied.