The effect of using a dragon-themed nebulizer mask on treatment application duration, adherence, and fear in children presenting to the emergency department: A randomized controlled trial.

BACKGROUND

Nebulizer therapy can be distressing for young children, increasing fear, reducing cooperation, and prolonging treatment. This study examined the effects of a dragon-themed nebulizer mask on treatment duration, adherence, and fear in children receiving inhalation therapy in the pediatric emergency department.

METHODS

This parallel-group randomized controlled trial was conducted between January and March 2026 in the pediatric emergency department of a tertiary hospital in Istanbul. A total of 140 children aged 3-6 years requiring nebulizer therapy were randomized to either the intervention group (dragon-themed nebulizer mask, n = 70) or the control group (standard care, n = 70). Data were collected using the Demographic Information Form, Fear Scale, and Treatment Duration and Adherence Assessment Form. The researcher-nurse recorded outcomes. The study followed CONSORT guidelines and was registered as a clinical trial (Clinical Trial ID: NCT06568120).

RESULTS

Baseline demographic characteristics were comparable between the groups (p > 0.05). The intervention group had significantly lower fear scores (p < 0.001, d = 3.05; 95% CI: 2.56-3.54) and shorter treatment duration (p = 0.012, d = 0.47; 95% CI: 0.14-0.81) than the control group. No significant between-group differences were observed in behavioral responses, including crying, treatment refusal, anger, or mask removal (all p > 0.05).

CONCLUSION

The dragon-themed nebulizer mask reduced fear and shortened treatment duration in preschool children receiving inhalation therapy in the pediatric emergency department. Child-friendly medical equipment may therefore represent a simple, low-cost strategy to improve treatment adherence and the overall treatment experience.