Anxiety, Children, Nursing Care, Pain Management
Conditions
Keywords
Acute pain; Distraction; Bubble blowing; Positive reinforcement, Acute pain, Distraction, Bubble blowing, Positive reinforcement
Brief summary
This study was conducted to compare the effects of two active distraction methods-bubble blowing and a material-free cognitive distraction/positive reinforcement technique-applied during venous blood sampling on pain, fear, and anxiety levels in children aged 7-12 years.
Detailed description
Distraction is an effective non-pharmacological nursing intervention used to reduce pain, fear, and anxiety in children during invasive procedures. This approach aims to decrease the child's emotional distress by diverting attention away from the perceived threat. In particular, among children aged 7-12 years, procedure-related fear and avoidance behaviors may increase due to the impact of previous medical experiences; therefore, there is a need for comparative evaluation of effective distraction strategies tailored to this age group. While sensory-kinesthetic methods such as bubble blowing promote active participation, material-free cognitive techniques can be implemented in any setting and offer easily accessible options. However, studies directly comparing these methods remain limited.
Interventions
OTHERBubble Blowing Group
In the Bubble Blowing Group, children were given a bubble toy during the procedure and asked to blow bubbles. This method, which requires active motor participation, was used to divert the children's attention away from the stress of the procedure.
OTHERPositive Reinforcement Group
In the Positive Reinforcement Group, children performed a non-material cognitive activity of their choice during the procedure (such as counting, reciting a short poem/song, or a word game). At the end of the procedure, verbal positive reinforcement was provided (e.g., Well done, You were very brave).
Sponsors
Kocaeli University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Single (third party blinding- Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
7 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged between 7 and 12 years, * Literate (able to read and write), * Having no diagnosed visual, hearing, intellectual, or neurological disorder, * With no history of analgesic, sedative, or narcotic use within 24 hours prior to admission, * Children who, together with their parent, volunteered to participate.
Exclusion criteria
* Children who do not meet the inclusion criteria, * Children or parents who wish to withdraw from the study at any stage, * Children from whom a blood sample could not be obtained with a single venipuncture attempt.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wong-Baker FACES Pain Rating Scale (WB-FACES) | A total of 2 evaluations will be made: before the procedure starts, the post-test immediately after the end of the procedure. | Developed by Wong and Baker (1988), this scale assesses pain intensity in children aged 3-18 years based on facial expressions, using a 0-5 scoring system. Pain intensity was assessed using the Wong-Baker FACES Pain Rating Scale (0-10; higher scores indicate worse pain). |
| Children's Fear and Anxiety Scale (CFS) | A total of 2 evaluations will be made: before the procedure starts, the post-test immediately after the end of the procedure. | Developed by McMurtry et al. (2011) and adapted into Turkish by Gerçeker et al. (2018), this scale evaluates fear and anxiety during the procedure on a 0-4 rating scale. 0-10; higher scores indicate greater fear and anxiety. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) | A total of 2 evaluations will be made: before the procedure starts, the post-test immediately after the end of the procedure. | The VAS is a valid and reliable scale that measures pain intensity on a 0-10 cm linear line (Wewers & Lowe, 1990). All scales were administered before and after the procedure. |
Countries
Turkey (Türkiye)
Outcome results
None listed