Efficacy of Finger Puppet as a Distraction Method
Condition: Procedural Pain; Pain; Acute Pain
MeSH terms: Acute Pain; Pain, Procedural
Study type: Interventional

Summary: 
      The study will be conducted with the randomized controlled experimental method. The children
      who attended the pediatric emergency department will divide into two groups via randomization
      in the computer environment. After the randomization, children in the experimental group will
      play with finger puppets under the direction of the researcher during venipuncture. On the
      other hand, no application will perform on the children in the control group during the
      venipuncture. The parents will also be found next to their children in both groups during the
      procedure.
    

Detailed description: 
      Many different non-pharmacological methods are used to cope with negative situations such as
      pain, fear and anxiety caused by invasive procedures in children. One of these
      non-pharmacological methods is the distraction. The American Pain Society recommends the use
      of distraction for pain control in children. With the distraction method, the child's pain is
      controlled and reduced by focusing the child's attention in another direction. Video games,
      virtual reality glasses, listening to music, watching cartoons, blowing balloons, reading
      books, playing with puppet/finger puppets are used as distraction methods. The aim of this
      study is to determine the effect of distraction method applied with finger puppet on the
      child's pain level and emotional indicators in children aged 3-6 years who applied to the
      pediatric emergency department and underwent venous blood collection. The sample size of the
      study has been determined by the power analysis (G*Power 3.1.9.2), in line with the results
      obtained from the studies which have been conducted using a similar research method. The
      sample size was found to be a total of 76 children including minimum of 38 children for each
      group. It was estimated that case losses may occur and therefore, it was decided to conduct
      the study with a total of 80 children including 40 children in two groups. Information Form,
      Face, Legs, Activity, Cry, Consolability (FLACC) Scale, and Children's Emotional
      Manifestation Scale will use for data collection. Children and their parents who applied to
      the pediatric emergency unit will inform about the study. Information about children and
      their parents included in the study will ask by the researcher through face-to-face
      interviews and these data will record in 'Information Form' five minutes before the
      procedure. One minute before the procedure children in the experimental group will start to
      play with finger puppets under the direction of the researcher. The researcher will continue
      to distract the child's attention during the procedure with finger puppets. For distraction
      the researcher will put finger puppets consisting of various animal figures on his finger,
      and will ask the child to imitate these sounds by making animal-specific sounds that he moves
      with his finger. The researcher will also draw the child's attention to finger puppets by
      using methods such as making animals talk to each other and singing. Children in the control
      group will be given routine practices and no distraction method will be applied. Before and
      during venipuncture children's pain will evaluate with the FLACC Scale and their emotional
      status will evaluate with the Children's Emotional Manifestation Scale by the healthcare
      provider who performs the venipuncture procedure.
    

Intervention name(s): Finger puppets
Intervention type(s): Other
Intervention description(s): In the experimental group, for distraction the researcher will put finger puppets consisting of various animal figures on his finger, and will ask the child to imitate these sounds by making animal-specific sounds that he moves with his finger. The researcher will also draw the child's attention to finger puppets by using methods such as making animals talk to each other and singing before and during venipuncture.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Distraction; Finger puppet; pain management; procedural pain