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The Impact of 3 Different Distraction Techniques on the Pain and Anxiety Levels of Children During Venipuncture

A Clinical Trial

Inan, Gamze, MSc*; Inal, Sevil, PhD

doi: 10.1097/AJP.0000000000000666
Original Articles

Objectives: Invasive procedures are important causes of pain and anxiety during hospitalization. This study aimed to evaluate the effect of 3 different distraction methods on the pain and anxiety levels of children during venipuncture.

Methods: This was a randomized controlled trial conducted with 180 children of 6 to 10 years of age; data were collected in the months of August to November 2016. Participants were randomized in 4 groups; the children in group 1 watched cartoon movies (CM), the children in group 2 played video games (VG), the children in group 3 were distracted by their parents’ verbal interactions (PI), whereas no distraction method was used on the children in group 4 (control group). The levels of anxiety and pain perception were evaluated independently based on the feedback from the children, the nurse observer, and the parents. The Children Fear Scale was used to evaluate anxiety levels and the Wong-Baker Pain Scale was used to evaluate the pain levels of the children.

Result: The difference between the groups based on both the anxiety levels and pain scores during venipuncture was statistically significant (P<0.05). The lowest level of anxiety and pain perception was reported in the VG group. The scores observed both in the CM group and the PI group were significantly lower than in the control group (P<0.05).

Discussion: The distraction techniques of playing VG, watching CM, and PI appear to be effective in reducing anxiety and pain perception in children during the procedure of venipuncture. The most effective method was playing VG.

*Göztepe Training and Research Hospital

Midwifery Department, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey

The authors declare no conflict of interest.

Reprints: Gamze Inan, MSc, Göztepe Training and Research Hospital, Istanbul, 34732 Turkey (e-mail:

Received December 25, 2017

Received in revised form September 28, 2018

Accepted October 9, 2018

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