Efficiency of Three Different Methods in Reducing Pain in Children During Intravenous Cannulation

Study Overview
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Brief Summary
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Purpose: This study investigates the effects of squeezing a soft ball, using a kaleidoscope, or blowing bubbles during intravenous cannulation on the pain and fear of children between the ages of 4 and 6. Design and Methods: This study is a randomised controlled study. In the study, there were 30 children in the soft ball group, 30 children in the kaleidoscope group, 30 children in the bubbles group, and 30 children in the control group.

Detailed Description
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15 minutes before the intravenous cannulation procedure, the second researcher interviewed the parents and the children in squeezing soft ball, kaleidoscope, blowing bubbles and control groups separately and filled in descriptive information form and Children's Fear Scale. After randomization, the second researcher, the child and the parent went to the blood collection room for the procedure. Children in the Kaleidoscope group were given the kaleidoscope before intravenous cannulation and they were shown how to use it. The children were told to look at the kaleidoscope during the procedure until the procedure ended. The children in the squeezing soft ball group were given the ball before the procedure. They were told to squeeze and loosen the ball with the hand that was not used for the procedure while intravenous cannula was being inserted. The children in the blowing bubble group were shown the bubble blower before intravenous cannulation and they were told how bubbles were formed and how they would blow. During intravenous cannulation, the child blew the blower. Routine procedures were applied on the children in the control group without any interventions. Inserting the intravenous cannula took 3-5 minutes. The procedure was carried out in the same room by the same nurse for four of the groups. After the intravenous cannulation procedure ended, a researcher and parents filled in Faces Pain Scale-Revised and Children's Fear Scale separately and independently to find out the level of pain and fear experienced by the child during the procedure.

Official Title
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Comparison of the Efficiency of Three Different Methods in Reducing Pain and Fear in Children During Intravenous Cannulation: A Randomised Controlled Study

Conditions
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Child, Only

Intervention / Treatment
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* Other: Squeezing a ball
* Other: Blowing bubbles
* Other: Kaleidoscope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: parents who agreed to participate in the study Exclusion Criteria: visually impaired child mentally retarded child speech impaired children

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Squeezing a ball during intravenous cannulation reduces the child's pain and fear.<br>The soft ball has a diameter of about 8-10 cm and can return to its old form when it is squeezed. | Other: Squeezing a ball<br>* The children in the squeezing soft ball group were given the ball before the procedure. They were told to squeeze and loosen the ball with the hand that was not used for the procedure while intravenous cannula was being inserted.<br>|
| Experimental: Using a kaleidoscope during intravenous cannulation reduces the child's pain and fear.<br>Kaleidoscope includes shapes of flowers and mirrors in the shape of triangle placed with an angle of 600. While rotating one of the cylinders, various shapes and colourful eyes are formed when viewed with one eye. When the kaleidoscope is rotated, the patterns look different all the time because the colourful parts are moving, attracting the child's attention. | Other: Kaleidoscope<br>* Children in the Kaleidoscope group were given the kaleidoscope before intravenous cannulation and they were shown how to use it. The children were told to look at the kaleidoscope during the procedure until the procedure ended<br>|
| Experimental: Blowing bubbles during intravenous cannulation reduces the child's pain and fear.<br>Children in this group were shown bubble blower before intravenous cannulation and they were shown how bubbles formed and how to blow. Children blew bubbles during intravenous cannulation | Other: Blowing bubbles<br>* The children in the blowing bubble group were shown the bubble blower before intravenous cannulation and they were told how bubbles were formed and how they would blow. During intravenous cannulation, the child blew the blower<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| assessing fear during intravenous cannula | Children's Fear Scale: The scale was developed by McMurtry et al. to find out the anxiety levels of children between 4 and 10 years of age (McCarthy et al., 2010). There are five face pictures in the scale. Anxiety level is scored between 0 and 4. 0 indicates no anxiety, while a scared face is scored 4 and indicates too much anxiety. After the intravenous cannulation procedure ended, a researcher and parents filled Children's Fear Scale separately and independently to find out fear experienced by the child during the procedure. | 3-5 minutes. | 
| assessing pain during intravenous cannula | Faces Pain Scale-Revised: The scale developed by Bieri et al. is used to evaluate the pain levels of children between the ages of 4 and 17 (Bieri, Reeve, Champion, Addicoat, & Ziegler, 1990). There are pictures of 6 faces in the scale. Level of pain is evaluated as 0,2,4,6,8,10. The face on the leftmost side is given a score of 0 and interpreted as no pain, while the face on the rightmost side is given a score of 10 and interpreted as a lot of pain. Pain severity increases as score increases. After the intravenous cannulation procedure ended, a researcher and parents filled Faces Pain Scale separately and independently to find out pain experienced by the child during the procedure. | 3-5 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Blowing bubbles, child, fear, kaleidoscope, pain, squeezing soft ball