The Effect of Distraction Techniques, Ball Squeezing and Immersive Cartoon Projection, on Pain in Children During Venipuncture

Abstract

Since venipuncture is a common procedure for obtaining blood samples and establishing intravenous access, these activities can be painful and frightening for children. The majority of children aged 3-6 years who underwent venipuncture procedures reported being traumatized by the experience. It is widely recognized that fear and anxiety are frequently associated with needles. This study employed a randomized controlled trial (RCT) design. Data collection occurred between February 28, 2026, and May 2, 2026. A non-probability convenience sample (N=140) of preschool children was divided into two study groups: the ball-squeezing group (n=70) and the immersive cartoon projection group (n=70). Participants were selected using a convenience sampling technique. Data were collected using the FFLC pain scale, and statistical analysis was performed using descriptive and inferential techniques. The results indicated that ball squeezing helped reduce pain levels to mild, whereas immersive cartoon projection was successful in reducing moderate pain levels. A statistically significant correlation was established between immersive cartoon projection and a history of venipuncture (P=.046). Furthermore, there was a statistically significant inverse correlation between the efficacy of the pain-reduction technique and the child’s weight (r= −.262, P=.028). No statistically significant relationship was established between age, gender, residential location, or family size. The study concludes that the application of ball squeezing effectively reduced venipuncture-related mild pain, while the application of immersive cartoon projection effectively reduced venipuncture-related moderate pain. Based on these findings, this study represents a novel contribution to the field of venipuncture. It advocates for replicating the study on a national level to validate these findings and ensure broader applicability across different healthcare settings. Additionally, it is suggested that future studies incorporate an anxiety and fear scale to further refine these initial findings.