Background: Pain is an unpleasant sensory and emotional experience accompanied by fear and anxiety. Pain anxiety can cause resistance, reduce his/her cooperation and cause undesirable mental and psychological complications. The use of non-medical methods in relieving pain is preferable. 
Objective: The purpose of this study was to determine the effectiveness of toys and music on pain and vital signs of children during colonoscopy.
Methods: This clinical trial was conducted on 90 children aged 2-14 years old referred to Ghaem Hospital in Mashhad (Iran) in 2016-2017. Performing colonoscopy on children who were randomly allocated to three equal groups of 30 (Two intervention and one control group): Group 1: toys (a car for boys and a doll for girls), Group 2: a piece of Clayderman music, and a control group. The vital signs of the children before and after colonoscopy, and the pain after it, were measured. Data were analyzed by SPSS version 16, using paired-samples t-test. A p-value of less than or equal to 0.05 was considered statistically significant for examining the hypotheses of the study.
Results: The mean age of children was 9.07±3.22, and 54.4% of them were girls. Heart rate, systolic and diastolic blood pressure increased significantly after colonoscopy in the music and control groups (p<0.001). However, in the toy group, mean heart rate, systolic and diastolic blood pressure decreased after intervention (p=0.147, p=0.213, p=0.246 respectively). The mean score of pain in the toy group was significantly lower than the other two groups (p<0.001).
Conclusion: The results of this study showed that the use of toys and music were effective in reducing pain and accepting colonoscopy for the children, although the positive effects of the toy were more evident on the children’s vital signs and pain. Therefore, the use of non-medication interventions can be considered as an effective way to accept colonoscopy and reduce pain in children.
Clinical Trial Registration: This trial is registered on the Thai Clinical Trials Registry, with the ID: TCTR20180507001
Funding: This project was funded by the research deputy of Mashhad University of Medical Sciences, (Mashhad, Iran).
Keywords: Children, Colonoscopy, Music, Pain, Toy, Vital signs


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