Distraction therapy

This page explains about distraction therapy and what to expect when your child comes
to Great Ormond Street Hospital (GOSH).
When a child or young person shows discomfort by crying or shouting, it is not only
distressing for them, but also parents and caregivers, as well as the staff attempting treatment.
Children and young people can be helped through painful or difficult procedures using
distraction therapy.

What is distraction therapy?

Distraction therapy is a way of helping a child cope with a painful or difficult procedure. It
can also be used if a child is in pain or discomfort. It aims to take the childs mind off the
procedure by concentrating on something else that is happening.
There are various methods of distraction therapy - some very simple to do, and others that
need more practice.

What happens before distraction therapy can start?

At Great Ormond Street Hospital, qualified hospital play specialists usually carry out
distraction therapy, although any member of staff who has had training from the play
specialist can do it.
Before the procedure starts, we will spend time with you and your child, to get to know your
child better. We will explain the procedure, maybe using dolls, DVDs or books to explain
further. It also allows us to find out if there is a particular aspect of the procedure worrying
your child. Some children may be afraid of needles, whereas others are worried about
anaesthetics.
We will also work with your child and the medical team to see if an element of choice can be
brought into the procedure. This could including choosing which hand a blood sample is
taken from or the colour of a plaster cast. Offering choice can allow a child an element of
control over the situation.
It can also be helpful to plan in advance if a reward would be helpful. A reward can be
something small, such as a sticker or balloon, or larger, such as an outing. Rewards can be
useful for providing a focus for after the procedure and thinking about it can be a distraction
in itself.
Once we know a little more about your child, we will be able to tailor the particular type of
distraction therapy to your child.

Types of distraction therapy

There are many different methods of distraction therapy - some are more suitable for younger
children, others work better for teenagers.

Controlled breathing
This can be used for all ages and involves the child blowing an imaginary balloon or feather
up in the area. Other things can also be used, like party blowers or blowpipes. Older children
might want to just concentrate on their breathing.

Books
There are lots of different books that can be used for distraction therapy - the type depends on
your childs ages. For instance, a younger child may enjoy a pop-up book or a musical book,
whereas an older child or teenager may prefer to listen to a CD.

Games and puzzles

These are suitable for all ages, but the game or puzzle will need to be appropriate for your
childs age. Younger children may prefer counting games, whereas older children or teenagers
may be happier with a hand-held computer game.

Music
Listening to or singing along with music can also be used successfully with all age groups.
There are also therapeutic music CDs available that use sounds from nature to give a
calming effect.

Touch and feel toys

These are suitable for all ages and can work very effectively for children with special needs.
Playing with textured toys like squashy plastic balls or their own cuddly toys can be helpful.
Toys that are attractive to look at, such as kaleidoscopes, mirrors or bubbles tubes can also
work well.

Messy play
This can be used to distract a child from pain, for example, after surgery. Manipulating dough
or slime can be very calming.

Make believe toys

These can work very well with younger children who can use them to act out a story during
the procedure. For instance, hand or finger puppets, dolls, soft toys or toy cars can all be
used.

Coaching/talking

Older children and teenagers may prefer to talk through the procedure as it happens, or
otherwise just talk about things that interest them. By concentrating on carrying out the
conversation, their mind might be distracted from the procedure itself.
Guided imagery is another distraction technique used to give the child an element of choice
and control.

During the procedure

Once your child has decided which type of distraction therapy to use, we will start. During
the procedure it is very important we are the only one trying to distract your child. If other
people are also trying to distract your child, it will take his or her concentration away from
us.
After the procedure, we will discuss with you and the team, the type of distraction therapy
used and whether it has worked or not. This will be useful for planning future procedures.

What happens if distraction therapy does not work?

Distraction therapy does not work for every child. If a particular type of distraction therapy
does not work for your child, we can suggest alternative types.
Some children cannot take their mind off the procedure, no matter what else is happening
around them, in which case, a different method needs to be used.
It can help to ask your child before the procedure to plan what they would like to do when it
has finished. The child can then try to focus on that, for example, a trip to the shops, during
the procedure, which may help take their mind off what is happening. If this method is used,
it is very important your child is able to do what he or she planned, or this may make the
situation worse for the next procedure.
Time out, preferably away from the treatment area, will give your child a chance to calm
down before trying distraction again.

How can I help?

You can help by supporting us during distraction. If you are worried about the procedure, for
instance, if you are worried about needles, it can help you to focus on the distraction too. If
you think you may be too upset to help, sometimes it is better that you are not in the room
when the procedure is happening.
After the procedure, your child will need lots of praise. Even if he or she was still distressed,
focus on one aspect that your child did well.
It also helps us if you tell us about any techniques that have worked well previously so that
we can focus on these for future appointments.

Can I use distraction therapy at home?

Yes, you can. Distraction therapy can be very useful if your child needs to have treatment at
home or even before visits to the dentist or other stressful events. Talk to your play specialist
and watch him or her during distraction. He or she will be able to suggest ways you can
incorporate distraction therapy into future hospital visits.
http://www.gosh.nhs.uk/medical-conditions/procedures-andtreatments/distraction-therapy/
Last reviewed by Great Ormond Street Hospital: January 2011
Ref: 2010F0617 GOSH Trust January 2011
Compiled by the Play Department in collaboration with the Child and Family
Information Group.

28 August 2009
Distraction therapy eases pain in sick kids

In the wake of studies showing that children are easier to treat and require less pain relief
when distracted, Sutherland Hospital has expanded the role of distraction therapy in its Child
and Adolescent Unit.
Local artist Annette Barlow has created three child-friendly murals on the walls of the Child
and Adolescent Unit, and according to Director of Nursing Bronwyn Carruthers, it is already
having an impact.
The murals depict a variety of scenes from the Sutherland Shire including an impression of
South Cronulla Park, South Cronulla Beach and Gunnamatta Bay.
Distraction therapy, such as the murals, is a way of helping children cope with being sick
and being in pain, Ms Carruthers said.
It aims to take their mind off their discomfort by concentrating on something else, she said.
Having a more child-friendly environment with the ability to distract children complements
traditional methods of managing procedural pain.
We find when a child is in discomfort their fear and anxiety is now often reduced because
the murals have been so effective in distracting their attention.
The whole effect is to cheer up patients, visitors, staff and even service people who pass
through the ward, Ms Carruthers said.
Funding for one of the murals was kindly provided by the Krouskos family from Yowie Bay,
who were the parents of a recurrent patient of the Child and Adolescent Unit.

Hospitalisation can be a very traumatic experience for children.

Our aim is to try and make the hospital experience for a child and their family as least
traumatic as possible, Ms Carruthers said.

Media Enquiries: Maxine Brennan 9113 2601, 0413 028 776

http://www.sesiahs.health.nsw.gov.au/News_and_Events/2009/20090828_Distract
ionTherapy.asp\
South Eastern Sydney Illawarra , New Soult Wales Health
http://kesehatan.kompas.com/read/2009/09/29/11340132/setengah.juta.anak.set
iap.tahun.alami.efek.samping.obat

Peresepan obat yang irasional sudah tentu merugikan konsumen karena bisa menimbulkan
efek samping yang berbahaya, terutama bagi bayi dan anak-anak kecil. Studi terkini
menunjukkan, lebih dari setengah juta anak di Amerika Serikat setiap tahunnya mengalami
efek samping dari pengobatan yang diterimanya.
Berdasarkan analisis data dari National Center for Health Statistics terhadap pasien rawat
jalan antara tahun 1995-2005 diketahui ada 585.992 pasien anak hingga remaja usia 18 tahun
yang berobat. Kebanyakan memang melakukan rawat jalan, tapi 22 persen di antaranya harus
dirawat di unit gawat darurat akibat efek samping obat tadi.
"Kami menemukan bahwa dari 1000 anak ada 13 pasien yang berobat karena efek samping
obat. Ini mengindikasikan mereka mengalami komplikasi serius," kata ketua peneliti
Dr.Florence Bourgeois dari divisi gawat darurat pediatrik di Children's Hospital Boston,AS.
Mayoritas pasien yang berobat adalah anak berusia 4 tahun ke bawah (43 persen), dan diikuti
dengan remaja usia 15-18 (23 persen). Gejala efek samping yang paling sering dikeluhkan
adalah masalah kulit (45 persen) dan pencernaan (16,5 persen). Sekitar 52 persen anak
dilaporkan juga mengalami reaksi alergi.
Obat antibakteri seperti penisilin merupakan obat yang paling sering menimbulkan efek
samping. Menurut data ada 27,5 persen kunjungan gara-gara obat tersebut dan 40 persennya
adalah anak berusia kurang dari 4 tahun.
Di urutan kedua dalam obat yang paling sering menimbulkan efek samping adalah obatobatan saraf (6,5 persen) dan hormon (6 persen). Dua jenis obat ini biasanya diterima oleh
pasien remaja, yang menggambarkan peningkatan penggunaan obat untuk gangguan
emosional dan kontrasepsi di kalangan remaja.
Hasil studi tersebut dipublikasikan dalam jurnal ilmiah Pediatrics. Dalam laporannya, para
peneliti menyarankan agar para dokter lebih berhati-hati dalam meresepkan obat untuk anakanak hingga remaja. Selain itu. para dokter juga diharapkan bisa memberi informasi yang
mungkin dibutuhkan para orangtua.

"Salah satu cara untuk mengurangi efek samping yang tak diharapkan adalah para dokter
harus punya informasi yang lengkap mengenai efek samping suatu obat dan melakukan
perbandingan efektivitas suatu obat. Informasi ini bisa didapatkan dari data dan bukti nyata
penggunaan obat, bukan hanya dari keterangan di label obat," kata Bourgeois.
Dengan semakin terdidiknya orangtua, seharusnya orangtua juga makin kritis terhadap
rasional tidaknya peresepan yang dilakukan para dokter.
AN/Yahoo! Health - See more at: http://www.kesekolah.com/artikel-danberita/kesehatan/setengah-juta-anak-setiap-tahun-alami-efek-sampingobat.html#sthash.FRx5Mwoz.dpuf
Setengah Juta Anak Setiap Tahun Alami Efek Samping Obat - See more at:
http://www.kesekolah.com/artikel-dan-berita/kesehatan/setengah-juta-anak-setiap-tahunalami-efek-samping-obat.html#sthash.FRx5Mwoz.dpuf
2009
http://www.kesekolah.com/artikel-dan-berita/kesehatan/setengah-juta-anaksetiap-tahun-alami-efek-samping-obat.html

Khasiat dan efek samping merupakan 2 hal yang tidak bisa dipisahkan dalam suatu obat.
Menurut penelitian, tiap obat memiliki rata-rata 70 efek samping dan kemungkinan reaksi
yang tidak dikehendaki meski tidak selalu berarti berbahaya.
Obat yang paling banyak memiliki efek samping adalah obat-obat antidepresi, antivirus dan
obat-obat untuk mengatasi gangguan pada sistem saraf. Sementara itu obat yang paling
sedikit memiliki efek samping umumnya adalah obat-obat untuk penyakit kulit dan mata.
Seorang profesor kedokteran dari Indiana University, Dr Jon Duke mengungkap hal itu
setelah mengamati 5.600 label obat yang mencantumkan sedikitnya 500.000 peringatan efek
samping. Sebagian memiliki lebih dari 100 efek samping, bahkan ada yang mencapai 525.
Menurut Prof Duke, banyaknya efek samping yang tercantum belum tentu menunjukkan obat
tersebut tidak aman. Kadang efek samping tersebut jarang muncul, tapi produsen tetap
mencantumkan untuk mengantisipasi gugatan hukum jika terjadi hal yang tidak diinginkan.
"Justru dengan banyaknya efek samping yang dicantumkan, dokter lebih mudah menimbang
'risk and benefit' dalam meresepkan suatu obat," ungkap Prof Duke mengomentari banyaknya
efek samping dalam label obat seperti dikutip dari MSNBC, Selasa (24/5/2011).
Rasio risk and benefit merupakan perbandingan antara risiko bahaya dalam suatu obat dengan
keuntungan yang diperoleh saat mengonsumsinya. Dokter selalu menggunakan pertimbangan
itu, dengan harapan pasien mendapat manfaat sebesar-besarnya dengan risiko seminimal
mungkin.
Prof Duke mengatakan, label obat saat ini terlalu panjang dan statis sehingga pasien sulit
mengetahui efek samping manakah yang paling mungkin terjadi sesuai kondisinya. Dengan
pemanfaatan teknologi, diharapkan suatu saat nanti label obat bisa lebih mudah dipahami.

Diterbitkan di: 24 Mei, 2011

Sumber: http://id.shvoong.com/medicine-and-health/epidemiology-public-health/2164367khasiat-dan-efek-samping-obat/#ixzz2uyDUUqei

http://id.shvoong.com/medicine-and-health/epidemiology-public-health/2164367khasiat-dan-efek-samping-obat/