A comparison of watching cartoons versus playing games as a distraction method on pain and fear of pain during peripheral intravenous cannula placement in children aged 6-9 years: A randomized experimental study

Purpose: This study aimed to compare the effects of watching cartoons and playing games as a distraction method during peripheral intravenous cannula insertion on pain and fear of pain in children aged 6-9 years.

Design & methods: This RCT with a parallel-group randomized experimental design was conducted between May and July 2024 in the pediatric unit of a university hospital with a tertiary referral centre. Sixty-eight children aged 6-9 years were assigned to two different groups using block randomization method (Cartoon Group = CG; n = 34, Gaming Group = GG; n = 34). The Wong-Bakers FACES® Pain Rating Scale and Children's Fear Scale were used for data collection. The children's pain and fear of pain were evaluated 2 min before, during and 2 min after the procedure.

Results: The mean age of the children (N = 64) was 7.41 ± 1.71 years (min-max = 6-9). Pain scores of GG (n = 32) were higher than CG (n = 32) (MD = 1.46; SE = 0.35; p < 0.001; %95 CI = 0.76-2.15). During the procedure, fear of pain scores of GG were higher than CG (MD = 0.78; SE = 0.32; p = 0.018; %95 CI = 0.13-1.42).

Conclusion: This study revealed that watching cartoons reduced the pain score by approximately 1.5 units and the fear of pain score by approximately 1 unit compared to playing online games during peripheral intravenous cannula placement in children aged 6-9 years.

Practice implication: In children aged 6-9 years planned to undergo peripheral intravenous cannula placement, watching a cartoon, one of the distraction techniques, can be recommended to effectively reduce pain and fear of pain. Tablets that allow watching cartoons and films, which are widely used and accessible in the clinical field, can facilitate the use of distraction techniques.