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Appl Nurs Res. 2017 Feb;33:164-168. doi: 10.1016/j.apnr.2016.11.011. Epub 2016 Nov 25.

Effects of music therapy and distraction cards on pain relief during phlebotomy in children.

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Bandirma Onyedi Eylul University Faculty of Health Sciences, Department of Pediatric Nursing, Bandirma, Turkey. Electronic address:
Karamanoglu Mehmetbey University, School of Health, Department of Pediatric Nursing, Karaman, Turkey. Electronic address:



To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy.


This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale.


Two hundred children (mean age: 9.01±2.35years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p=0.72, p=0.23, p=0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p=0.092, p=0.096, respectively).


Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed.


Distraction cards; Music therapy; Pain management; Phlebotomy; Procedural pain

[Indexed for MEDLINE]

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