Comparison of the Effectiveness of Two Active Distraction Techniques During Venipuncture in Children

Kocaeli University

Status: Completed

Conditions: Pain Management; Children; Anxiety; Nursing Care

Treatments: Other: Bubble Blowing Group; Other: Positive Reinforcement Group

Study type: Interventional

Funder types: Other

Identifiers

NCT07249723

18.11.2025

2209 (Other Grant/Funding Number)

Details and patient eligibility

About

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.

Full 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.

Enrollment: 207 patients

Sex: All

Ages: 7 to 12 years old

Volunteers: Accepts Healthy Volunteers

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.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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207 participants in 3 patient groups

Bubble Blowing Group

Experimental group

Description:

Before the procedure, each child was given a bubble toy and instructed to blow bubbles throughout the procedure. The procedure duration was recorded with a stopwatch. Post-procedural pain and anxiety were assessed using standardized scales. A single-use bubble toy was used for each child.

Treatment:

Other: Bubble Blowing Group

Positive Reinforcement Group

Experimental group

Description:

Before the procedure, the researcher established communication with the child, and a short cognitive activity chosen by the child (e.g., counting numbers, word game) was implemented throughout the procedure. The parent provided physical and verbal support to the child. After the procedure, the child received verbal positive reinforcement.

Treatment:

Other: Positive Reinforcement Group

Standard Procedure Blood Sampling Group

No Intervention group

Description:

Children in the control group underwent the standard blood sampling procedure in accordance with routine clinical practice. Outcome measurements were conducted after the procedure. Once data collection was completed, children in this group also received verbal feedback. All measurements were performed immediately before and after venipuncture. A single-needle insertion technique was used, and all blood draws were performed by the same pediatric nurse, who was permanently assigned to the unit, to ensure procedural standardization.