The Effect of Hand Ball Used During Venous Blood Collection on Pain and Fear Level in Children
The Effect of Hand Ball Used During Venous Blood Collection on Pain and Fear Level in Children
Pain causes many physiological and psychological changes in the body, increases the level of
 anxiety in children and causes prolongation of examination and other procedures. The pain
 should be evaluated separately for each child, taking into account the level of pain and the
 individual differences in the response to pain. Mankind has been exposed to many invasive
 interventions throughout his life from birth and experiences pain and anxiety in relation to
 this. Experiences with childhood pain shape the future pain responses of children.

 This study, which was planned to stimulate the touch receptors of two different balls used
 during venous blood collection, to determine the effect of children between the ages of 6-12
 on pain and fear levels, is a randomized controlled study. A total of 200 children will be
 included in the research. The experimental groups to be included in the research will be
 asked to grasp the balls with their hands in accordance with their groups, and no attempt
 will be made to the control group. The research data will be obtained with the Wong-Baker
 Faces Pain Rating Scale and Child Fear Scale, which will be used to evaluate before and after
 the procedure. In addition, oxygen saturation and heart rate will be evaluated immediately
 before and after removal of the tourniquet.
Attempt During the trial, all blood collection procedures will be performed by the same nurse
 working in the hospital's blood collection unit. The nurse who will perform the procedure
 works as a pediatric nurse for 15 years.

 Control Group;

 -  Data on the child and his parents will be collected by the researcher using face-to-face
 interview technique and recorded in the "Information Form".

 -  The child and parent will be informed by showing the Wong-Baker Faces Pain Rating Scale,
 the Child Fear Scale, and the pulse oximeter.

 -  Disinfectant will be poured on the child's and parent's hands.

 -  Before the blood draw, the child will be given the Wong-Baker Faces Pain Rating Scale,
 the Child Fear Scale, and a pen, and will be asked to mark the facial expression
 appropriate to his current situation.

 -  The child who filled out the form will be taken to the blood collection room with his
 parents, and the child will be seated on the blood collection chair. The child and
 parent will be informed about the blood collection procedure according to the hospital
 procedure.

 -  Due to the pandemic, in accordance with the hospital procedure, the tourniquet will be
 disinfected and used after each blood collection.

 -  The nurse will determine the child's extremity suitable for vascular access.

 -  Standard hospital procedures will be applied throughout the blood collection procedure.

 -  Immediately after the procedure, the child will be asked to mark the appropriate facial
 expression on the Wong-Baker Faces Pain Rating Scale and the Child Fear Scale during the
 procedure.

 -  Disinfectant will be poured on the child's and parent's hands.

 -  The child whose blood collection process is completed, and his parents will be thanked
 for their acceptance to participate in the research and will be ensured to leave the
 room.

 Experimental Groups;

 -  Data on the child and his parents will be collected by the researcher using face-to-face
 interview technique. It will be saved in the "Information Form".

 -  The child and parent will be informed by showing the Wong-Baker Faces Pain Rating Scale,
 the Child Fear Scale, and the pulse oximeter.

 -  Disinfectant will be poured on the child's and parent's hands.

 -  Before the blood draw, the child will be given the Wong-Baker Faces Pain Rating Scale,
 the Child Fear Scale, and a pen, and will be asked to mark the facial expression
 appropriate to his current situation.

 -  The child who filled out the form will be taken to the blood collection room with his
 parents, and the child will be seated on the blood collection chair. The child and
 parent will be informed about the blood collection procedure according to the hospital
 procedure.

 -  Due to the pandemic, in accordance with the hospital procedure, the tourniquet will be
 disinfected and used after each blood collection.

 -  The nurse will determine the child's extremity suitable for vascular access.

 -  According to randomization, the child was able to hold the ball according to the group
 (Group 1, Group 2, Group 3, Group 4).

 -  Group 1: Serrated ball + extremity group from which venous blood will be taken

 -  Group 2: Serrated ball + hand group on the opposite side of the extremity from
 which venous blood will be taken

 -  Group 3: Straight ball + extremity group from which venous blood will be taken

 -  Group 4: Flat ball + hand group on the opposite side of the extremity from which
 venous blood will be taken

 -  Control group: Group to be applied standard hospital blood collection procedure

 -  Standard hospital procedures will be applied throughout the blood collection procedure.

 -  Immediately after the procedure, the child will be asked to mark the appropriate facial
 expression on the Wong-Baker Faces Pain Rating Scale and the Child Fear Scale during the
 procedure.

 -  Disinfectant will be poured on the child's and parent's hands.

 -  The child whose blood collection process is completed, and his parents will be thanked
 for their acceptance to participate in the research and will be ensured to leave the
 room.
Inclusion Criteria:

 -  - The volunteerism of the child and the parent to participate in the research,

 -  The child is between the ages of 5-12,

 -  The child and the parent speaks Turkish, Taking blood from the cephalic vein,

 -  Turnstile not being tied for more than 30 seconds,

 -  Not taking any analgesic (systemic or topical), antipyretic, anti-inflammatory drugs
 in the last 12 hours,

 -  Body temperature between 36.5-37.2 ⁰C,

 -  Not having a disease that can cause chronic pain,

 -  No acute pain or anxiety during the procedure,

 -  Absence of skin integrity problems,

 -  No obstacle to grip the balls in hand,

 -  Children who do not have regular invasive interventions (no chronic diseases that
 require blood control such as cancer, diabetes),

 -  Blood collection was performed at the first attempt,

 -  The child does not have any auditory, mental or neurological disability that will
 affect his participation in the research.

 Exclusion Criteria:

 -  - The child and the parents are not willing to participate in the research,

 -  The child is not between the ages of 5-12,

 -  The child and the parent do not speak Turkish, Inability to take blood from the
 cephalic vein,

 -  Turnstile remaining tied for more than 30 seconds,

 -  Taking any medication with analgesic (systemic or topical), antipyretic or
 anti-inflammatory effects in the last 12 hours,

 -  Body temperature lower than 36.5 C-37.2 ⁰C,

 -  Having a disease that can cause chronic pain,

 -  Children who undergo regular invasive interventions (having chronic diseases that
 require blood control such as cancer, diabetes), Failure to take blood at the first
 attempt,

 -  Any acute pain or anxiety during the procedure,

 -  Problems with skin integrity,

 -  It has an obstacle to grip the balls,

 -  Having an auditory, mental or neurological disability that will affect the child's
 participation in the research,

 -  Children in the control group want or involuntarily hold their parent's hand or
 something else during the procedure.