The efficacy of audiovisual distraction as an anxiety-minimizing technique during echocardiography in preschool children

Background Echocardiography procedures can cause fear and anxiety in children, especially at preschool age. Audiovisual dis-traction is a simple, harmless, and low-cost technique that does not interfere with the procedure.Objective To assess the effect of audiovisual distraction on the anxiety levels of children aged 2-5 years during echocardiography.Methods This quasi-experimental study included children aged 2-5 years who were admitted for echocardiography. Patients with hearing or visual impairment, Down syndrome, autism, or attention-deficit/hyperactivity disorder were excluded. We ad-ministered anxiety-reducing intervention in the form of cartoon audiovisual media shown on a ceiling-mounted television during the echocardiography procedure. Anxiety levels were assessed us-ing the Visual Analogue Scale -Anxiety (VAS-A) before and after the intervention was given. We compared the subjects' pre-and post-procedure VAS-A scores and heart rates.Results Of the 43 subjects who underwent echocardiography dur-ing the study period, the mean age was 3.2 (SD 0.9) years, with an equal sex distribution. Most subjects had a history of repeated echocardiography procedures and hospitalizations. Thirty-nine (90.6%) of subjects demonstrated anxiety during the echocar-diography procedure. There was a significant mean difference of 11.9 (SD 13.2) bpm (95%CI 7.8 to 15.9 bpm, P<0.001) in heart rate pre-vs. post-intervention. Median pre-and post-intervention VAS-A scores were 5 (range 0-10) and 1 (range 0-4), respectively (P=0.001). Post-intervention, almost all (97.7%) subjects had no or mild anxiety.Conclusion Audiovisual content presented on television serves as an effective distraction method to reduce children's anxiety during echocardiography.