Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not positive distractions improve pediatric patient satisfaction in children undergoing medical procedures.

STUDY DESIGN: Systematic review compiling data from two randomized controlled trials and one convenience prospective trial between 2012 and 2015, all in the English language.

DATA SOURCES: After a thorough search of PubMed and Cochrane, three pertinent studies were found to include in this review. The selected studies were evaluated to assess the effectiveness of positive distraction techniques in improving pediatric patient satisfaction.

OUTCOMES MEASURED: Decrease in anxiety and pain symptoms measured by the Yale preoperative anxiety scale, behavioral observation and self-reported assessments were assessed.

RESULTS: Each of the selected studies found that the use of positive distraction techniques resulted in lower anxiety, stress and pain levels for children who were given a positive distraction technique, when compared to the children who were not exposed to a distraction technique. Lee et al. observed that children who viewed an animated cartoon exhibited lower anxiety levels in the operating room (p<0.001). Quan et al. concluded the treatment group who did not have a positive distraction technique of lights or visual distractions, exhibited higher stress throughout the radiology procedure (p<0.001). The Downey et al. study assessed there was a significant difference between the children who viewed a cartoon compared to the children who underwent a standard medical procedure, and showed significant with an F value of 5.523, significant at 0.021.

CONCLUSIONS: The results of these studies demonstrated that the use of positive distraction techniques in the pediatric population is an effective method to alleviate stress, pain, and anxiety for children undergoing a medical procedure. These interventions have shown to improve a child’s overall satisfaction towards medical procedures.