Children's Fear, Pain, and Anxiety Before and After Enema: a Descriptive, Cross-Sectional Study

Abstract

Aims and objectives: The study aimed to determine the fear, pain, and anxiety levels of children aged 7–18 years before and after enema. Method: This descriptive and cross-sectional study was conducted between January 8 and May 3, 2024. STROBE guidelines were followed in the study. The sample of the study consisted of 160 children between the ages of 7–18 who underwent enema. The data were collected using the Children's Fear Scale (CFS), Wong-Baker FACES® Pain Rating Scale (WBS) and Children's Anxiety Meter-State (CAM[sbnd]S) for Children. p-value less than 0.05 was considered statistically significant. Descriptive statistics tests, independent sample t-tests, and repeated measures ANOVA were used. Result: Before the enema, children's fear (2.19 ± 1.09) and pain scores (2.94 ± 1.08) were high and anxiety scores (3.60 ± 1.81) were low. There was no statistical difference between fear, pain, and anxiety levels according to some sociodemographic and clinical characteristics (p > 0.05). After the enema, children's fear (2.49 ± 1.34), pain (2.94 ± 1.35) and anxiety scores (3.88 ± 2.22) increased. However, only the increase in fear level was statistically significant (p > 0.05). There was a negative correlation between the child's age and the level of fear, pain, and anxiety. Conclusions: An enema is a medical procedure that causes negative emotions for children, such as fear and pain, before and after it is administered. Nursing interventions are needed before and during the enema. Practice implications: The high levels of fear, pain, and anxiety associated with enemas suggest the need for routine assessment and nursing interventions to control these negative emotions. © 2025 Elsevier Inc.