The effect of three different methods on pain and anxiety in children during blood sampling procedure in pediatric emergency department: Finger puppet, abeslang puzzle, pinwheel.

Abstract

Purpose: The primary objective of this study is to evaluate the effectiveness of finger puppets, abeslang puzzles, and pinwheels in reducing pain and anxiety in children aged 4-6 years during blood sampling procedures in a pediatric emergency department.

Design and methods: This study was a four-arm parallel group randomised controlled trial design conducted in the pediatric emergency department of a children's hospital in Western Türkiye between June 2023 and June 2024. Children (n = 160) were randomly assigned into four groups in a 1:1:1:1 ratio. The intervention groups consisted of children aged 4-6 years as finger puppet (n = 40), abeslang puzzle (n = 40), pinwheel (n = 40) and control group (n = 40). Data were collected using Personnel Information Form, Wong-Baker FACES Pain Rating Scale, and the Children's Anxiety Meter-State. The participants themselves, their parents, the nurse and the researcher rated the pain and anxiety levels associated with the blood sampling procedure. These trials are registered with ClinicalTrials.gov (NCT05904483).

Results: ANOVA was used to compare the mean Wong-Baker FACES Pain Rating Scale scores among the groups. According to all raters (child, parent, nurse, and researcher), the finger puppet group had the lowest mean score, followed by the pinwheel, abeslang puzzle, and control groups (p < 0.05). According to the nurse and researcher evaluations after the procedure, the finger puppet group had the lowest mean score on The Children's Anxiety Meter-State, followed by the abeslang, pinwheel and control groups (p < 0.05).

Conclusion: Finger puppet, pinwheel and abeslang puzzle methods were effective in reducing pain and anxiety during blood sampling procedure in children.

Practice implications: Pediatric nurses can safely use finger puppet, pinwheel and abeslang puzzle methods to reduce pain and anxiety during blood sampling procedure in preschool children.