Cardiac catheterization and angiography is an invasive interventional cardiology method that helps diagnose coronary artery diseases by revealing the anatomy, physiology and pathophysiology of the heart and circulation. It can be performed for diagnosis and treatment purposes. Although the usefulness of diagnostic cardiac catheterization in the clinical setting has diminished in recent years with the advent of non-invasive imaging modalities such as echocardiography, magnetic resonance imaging, and computed tomography, diagnostic catheterization is still a valuable tool in the evaluation of pediatric heart disease. Cardiac catheterization and angiography are preferred over noninvasive methods in cases where it is important to precisely determine the disease anatomy (pulmonary atresia, fallot tetralogy, etc.). Since the procedure can typically be performed with minimal invasion, its use is common in pediatric patients. In addition to the presence of chronic disease in children, the fear of hospitalization and surgical operation for cardiac catheterization and angiography constitutes a serious source of stress. Studies show that children experience pain, anxiety, fear and stress during these medical procedures. These fears are a cause for anxiety for both the child and the family. In addition, the experience directly affects the child's hospital process, treatment and care experience in the future, so it is of great importance to control fear and anxiety in children. For a child and parent with a chronic disease, returning to the hospital causes the child to fear and feel anxious about factors such as illness and medication. For this reason, not only a child-centered approach but also a family-centered holistic nursing approach should be followed in the nursing care of a child with a chronic disease. It is reported in the literature that children with congenital heart disease experience physical, emotional, behavioral and neurodevelopmental problems. The process of chronic heart disease includes accepting the existing situation, tolerating difficulties, and making life easier by arranging daily activities. Since the cardiac catheterization and angiography process consists of a process, the nurse plays an important role in shortening the treatment time and increasing the comfort level as a result of the correct interventions that follow the patient before, during and after the procedure. The nurse, who is with the child at almost every stage of the procedure, is in an important position to monitor and manage the children's fear, anxiety and pain symptoms.
In recent years, nursing research has focused on the management and reduction of procedural pain in children and the use of non-pharmacological methods to relieve anxiety and stress. The most common of these methods are massage, distraction, positioning, and watching videos. For example, Karakul et al. It reveals that musical intervention applied during pediatric cardiac catheterization in children affects the reduction of pain, fear and anxiety levels and the stabilization of vital signs.
Kim et al. According to a study conducted by Kim et al., it was observed that hearing the recorded mother's voice reduced anxiety, agitation on awakening, and the need for anesthesia in children undergoing cardiac catheterization and angiography. Agüero et al. suggested that short-term interventions performed by nurses before urological surgery in children could reduce preoperative anxiety. Wang et al. It has been suggested that music and animation strategies can significantly reduce anxiety in children before tonsillectomy or adenoidectomy surgery and improve surgical cooperation during anesthesia induction.
As a result, when the literature was scanned, it was determined that cardiac catheterization and angiography caused fear and anxiety in children because they were invasive procedures, and it was seen that additional non-pharmacological studies were needed to reduce fear and anxiety in children. The aim of the study was to evaluate the effect of the Quilling set on fear and anxiety in children as it could be a new non-pharmacological intervention, as the Quilling set study to be applied to children with cardiac catheterization and angiography is not included in the literature.
