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J Child Health Care. 2016 Sep;20(3):277-85. doi: 10.1177/1367493515587062. Epub 2015 Jun 2.

The effects of three different distraction methods on pain and anxiety in children.

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Department of Pediatric Nursing, School of Health, Karamanoglu Mehmetbey University, Karaman, Turkey
Department of Obstetric and Gynecologic Nursing, School of Health, Karamanoglu Mehmetbey University, Karaman, Turkey.


This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 ± 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 ± 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 ± 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception.


Acute care; evidence-based practice; pain

[Indexed for MEDLINE]

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