Effect of AI(Artificial Intelligence)-Based Storytelling Video on Anxiety and Fear During Skin Prick Test in Children

Skin Prick Testing (SPT) is a common diagnostic procedure in pediatric allergy clinics that often induces significant pre-procedural anxiety and acute needle fear in children. While digital distraction tools are becoming common during procedures, pre-procedural cognitive preparation strategies are limited. This randomized controlled trial investigates the impact of cognitive preparation using an AI-assisted therapeutic storytelling video.

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The study utilizes a prospective, single-blind, randomized controlled design. A total of 100 children (aged 4-10) with suspected respiratory allergies undergoing their first SPT will be randomized (1:1 ratio) into intervention and control groups.

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• Intervention Group: Children will watch an AI-generated therapeutic storytelling video at home (the evening the appointment is made and the night before the procedure). The video, featuring characters "Ilay and Doctor Ipek", is designed to cognitively prepare the child for the procedure using age-appropriate metaphors without traumatizing elements.
• Control Group: Children will receive the clinic's standard routine care and verbal information.
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Baseline anxiety is assessed using the Spence Preschool Anxiety Scale or Spence Children's Anxiety Scale. Procedural fear and pain are evaluated using the Children's Fear Scale (CFS) and the Wong-Baker FACES Scale. Behavioral responses during the procedure are observed and scored by a blinded nurse using the Children's Emotional Manifestation Scale (CEMS). The primary hypothesis is that AI-based cognitive preparation will significantly reduce pre-procedural anxiety and fear, and improve procedural compliance compared to standard care

Inclusion criteria

• Children aged between 4 and 10 years (from 4th birthday to 11th birthday).
• Children undergoing a Skin Prick Test (SPT) for the first time.
• Presence of suspected Allergic Rhinitis and/or Asthma.
• Cognitive ability to understand Turkish, follow the video story, and interpret visual assessment scales.
• Parents with internet access to view the digital content.
• Obtained parental informed consent and child assent (for ages 7 and above)

Exclusion criteria

• Previous experience with Skin Prick Testing or a history of frequent medical procedures (e.g., frequent blood draws, surgeries) due to chronic illness.
• Diagnosed with Autism Spectrum Disorder, severe ADHD(attention deficit hyperactivity disorder), intellectual disability, or severe psychiatric conditions preventing cooperation.
• Significant visual or hearing impairments that prevent engagement with the video content.
• Use of anxiolytics, sedatives, or medications affecting cognitive functions within the last 24 hours.
• Chronic health problems (e.g., malignancy, immunodeficiency) that may elevate baseline anxiety levels.
• Patients undergoing SPT for suspected Food Allergy, Drug Allergy, or Bee Venom Allergy.
• For the intervention group: Failure to watch the video or answering the three "validation questions" incorrectly on the procedure day.