Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: ball squeezing, balloon inflating and distraction cards

Aims and objectives. This study aimed to investigate three different distraction methods (squeezing a soft ball, balloon inflation and distraction cards) on pain and anxiety relief in children during phlebotomy. Background. Needle-requiring medical procedures such as venipuncture, phlebotomy and intramuscular injections are common and significant sources of pain for children, and these cause anxiety, distress and fear. Design. This study was a prospective, randomised controlled trial. Methods. The sample consisted of children (n = 120) who required blood tests. 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. Results. One hundred and twenty children (mean age: 9.64 +/- 2.07 years) were included. No difference was found between the groups in the self-, parent-and observer-reported procedural pain levels (p = 0.446, p = 0.467, p = 0.318 respectively). Furthermore, no significant differences were observed between the groups in procedural child anxiety levels according to the parents and observer (p = 0.323, p = 0.144 respectively). Conclusion. Pain and anxiety relief was seen in the three methods used during phlebotomy; however, no statistically significant difference was observed. Relevance to clinical practice. This study contributes to the literature on nonpharmacologic pain relief methods during phlebotomy in children.