This study aims to evaluate the effects of acupressure, music listening, and virtual reality applications, which appeal to the senses of touch, hearing, and sight during blood sampling, on pain, fear, and anxiety levels in children.
Two hundred volunteer children aged 5-10 coming for blood collection will be randomly divided into four groups: acupressure, virtual reality, Listening music and control group. Children will be assessed before, during, and after the procedure. Pain related to blood collection will be assessed with the Wong-Baker Faces Pain Scale, fear will be assessed with the Child Fear Scale and anxiety will be assessed with the Child Anxiety Scale - State. In addition, children's demographic data will be recorded in the Information Form.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
120
Acupressure will be administered by a researcher who has completed the Acupressure application course at Ankara Başkent Personal Training Institutions and received their certificate. To determine the child's ability to assess the scale, they will be asked, "Is 8 bigger than 4?". Before the acupressure application, the child's area will be prepared in the blood collection room. Hands will be washed and warmed by rubbing before the acupressure application. Pressure will be applied for 1.5 minutes to point 4 of the large intestine (LI4), located on the radial side of the 2nd metacarpal bone, at the junction of the 1st and 2nd metacarpal bones, on the back of the hand. Then, the blood collection nurse will begin the blood collection procedure from the same arm. Pressure will continue for another 1.5 minutes while the blood collection procedure continues. In total, pressure will be applied to point LI4 for 3 minutes: 1.5 minutes before and 1.5 minutes during the procedure.
Before the procedure, children will be given brief and understandable information, and if possible, calming and age-appropriate music will be chosen according to their musical preferences. The music will start 1-2 minutes before the procedure begins and continue through headphones or speakers during blood collection to distract the child's attention from the needle; it will also be played for another 1-2 minutes afterward to help the child relax and complete the procedure as a positive experience. During this process, the children's pain, fear, and anxiety levels will be measured.
1. Patient Identification Form
The form consists of a total of 7 questions covering the child's age, gender, previous hospital experience (if any), number of hospitalizations, whether their parents prepared them for blood tests beforehand, their experience with blood tests in the last six months, and their reactions to the blood test procedure.
Time frame: Baseline
Wong Baker Face Pain Scale
Children between the ages of three and eight can express many pain areas and their severity. In this study, the Wong-Baker Pain Inventory will be used in combination with the Visual Analog Scale, since face scales are more appropriate. The Wong Baker Face Pain Scale was developed by Donna Wong and Connie Moran Baker in 1981. The scale is suitable for children between the ages of three and eighteen. The scale includes facial expressions that the child can enjoy and enjoy. For this reason, it has been stated that it gives more accurate results. The scale has scores of "0", "2", "4", "6", "8", and "10". A score of "0" indicates no pain and a score of "10" indicates the highest pain. This scale does not have a Cronbach's alpha score. It has been reported that reliability studies have not been conducted on such scales.
Time frame: Baseline and up to 4 weeks
3. Child Fear Scale
The Turkish validity of this scale, developed by McMurtry and colleagues, was done by Gerçeker and colleagues. The changes in the facial muscles of the frightened expression were drawn by a graphic artist from a photograph of a frightened face. It can be used by the parent, child or researcher to scale the child's fear. The scale, which has facial expressions scored from 0 to 4, is shown to the child. A score of 4 indicates that the child is very frightened, and a score of 0 indicates that the child is not frightened. It is accepted that a score of "0" indicates a neutral expression (no fear), a score of "1" indicates a very low level of fear, a score of "2" indicates a little fear, a score of "3" indicates a greater level of fear, and a score of 4 indicates that the level of fear is at the highest level. This scale can be used to measure fear before and during the procedure.
Time frame: Baseline and up to 4 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
In this study, children will be shown cartoons via virtual reality glasses during blood collection. For both boys and girls, the content options will be the 360-degree virtual reality cartoon "Ice Age," chosen by experts in child development and psychology to be age and gender-appropriate. The suitability of "Ice Age" for children was evaluated by five academics specializing in child health, and all experts deemed it appropriate. Children will begin watching the cartoon via VR approximately 3 minutes before blood collection and will continue watching until the procedure is complete.
4. The Child Anxiety Scale-State (CAS-S)
Developed by Ersig et al. in 2013, the Child Anxiety Scale-State measures situational anxiety in children aged 4-10 years. Its validity was established by Gerçeker et al. in 2017. The CAS-S (State) is designed as a thermometer. At the bottom is a bulb, and horizontal lines extend upwards. Each horizontal line represents a score, and the thermometer has 10 points. The bulb at the bottom represents 0 points, indicating no anxiety. As the lines rise, anxiety increases. The peak, worth 10 points, represents the highest level of anxiety.
Time frame: Baseline and up to 4 weeks