The Effect of Bubble Machine and Cartoon on Pain and Fear

Ege University123 enrolled

Overview

Aim: This study aimed to compare the effects of cartoon-based audiovisual distraction and bubble-machine-based visual distraction on pain and fear during venipuncture in preschool children. Methods: This randomized controlled trial included 123 children aged 3-6 years who underwent venipuncture between February and April 2026. Participants were randomly assigned to a cartoon-based audiovisual distraction group (n = 41), a bubble-machine-based visual distraction group (n = 41), or a control group (n = 41). Children in the cartoon group watched Oggy Oggy on a tablet, while those in the bubble-machine group were exposed to bubbles generated by an automated bubble machine during venipuncture. The control group received routine care. Pain and fear were assessed by the children, parents, and nurse using the Wong-Baker FACES Pain Rating Scale and Children's Fear Scale.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

123

Conditions

Pain Fear Nurse

Interventions

Implementation of Bubble MachinePROCEDURE

Implementation of Bubble Machine: It is defined as the use of a device called Bubble Machine. Children are exposed to bubbles generated by an automated bubble machine during venipuncture. Researcher operate the bubble machine and generate bubbles within the child's visual field to attract and maintain the child's attention during the procedure. A child-friendly plastic bubble machine is used, and a tear-free baby shampoo suitable for children was used as the bubble solution. The device is positioned at an appropriate distance from the child so that it did not interfere with the nurse's access to the venipuncture site. The bubble machine iss operated throughout the venipuncture procedure. Pain and fear before and during the procedure are evaluated by the researcher, the nurse, and the child's parent.

Implementation of CartoonPROCEDURE

Implementation of Cartoon: It is defined as the use of a called Oggy Oggy. Children watch the predetermined Cartoon-Oggy Oggy on a tablet during venipuncture. The cartoon is selected as an age-appropriate audiovisual distraction and is presented in Turkish. It contains dynamic, colorful, and music-rich scenes intended to attract and maintain children's attention during the procedure. Researcher operate the tablet and ensure that the child could comfortably view the cartoon while the nurse performed venipuncture. The cartoon is played throughout the venipuncture procedure. Pain and fear before and during the procedure are evaluated by the researcher, the nurse, and the child's parent.

Eligibility

Sex: ALLMin age: 3 YearsMax age: 6 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Participants whose child and parents agreed to participate in the study * Children who had successful phlebotomy on the first attempt Exclusion Criteria: * Children with chronic disease, mental disability, or mental retardation * Children who had taken analgesics in the last 24 hours * Children who were hospitalized * Children who had undergone a surgical procedure * Children who did not have successful phlebotomy on the first attempt

Outcomes

Primary Outcomes

Statistical difference between groups about pain scores

Description: Implementation of interventions aimed at reducing pain in experimental groups. Wong-Baker Facial Pain Rating Scale: The Facial Expression Rating Scale is a scale that includes 6 facial expressions and provides a rating between 0-10. This scale, which does not require words, is a reliable and valid measurement tool in the assessment of acute pain. A score of 0 indicates no pain and a score of 10 indicates the highest level of pain. In the scale, it means that as the pain score increases, the pain also increases.

Time frame: Before and during the procedure, approximately 5-10 minutes

Statistical difference between groups about fear scores

Implementation of interventions aimed at reducing fear in experimental groups. Children's Fear Scale: This scale includes 5 different facial expressions. This scale is scored between 0-4 and it is stated to be a reliable and valid measurement tool in the evaluation of fear. This scale does not require words. A score of 0 indicates no fear and a score of 4 indicates the highest level of fear. In the scale, it means that as the fear score increases, the fear also increases.