Fear, Emotional Behaviors and Parental Care Satisfaction Related to Inhalation Therapy

February 26, 2026 updated by: Vildan Apaydın Cırık, Karamanoğlu Mehmetbey University

Effects of Finger Puppet, Video Game and Stress Ball on Fear, Emotional Behaviors and Parental Care Satisfaction Related to Inhalation Therapy in 4-6 Year Old Children

This study aim to determine the effect of finger puppet, video game or stress ball methods on the fear levels, emotional behaviors and parental care satisfaction of children aged 4-6 years due to inhaler treatment.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study was conducted in a randomized, experimental research design. The study was conducted in the pediatric emergency unit of a public hospital with 120 children between January 2024-2025. The finger puppet, stress ball, and video game groups each have 40 children. The inclusion criteria are: the child must be between 4-6 years old, receive inhaler treatment via mask, not have received inhaler treatment for the last 6 months, receive bronchodilator medications as part of inhaler treatment, have no vision or speech problems, have no hearing problems, both the child and the parent must speak and understand Turkish fluently, and the child must be willing to participate in the study, with the families agreeing to participate in the research and signing the informed consent form. Data were collected using the descriptive information form, child fear scale, children's emotional manifestation scale and PedsQL health care satisfaction scale. It was found that finger puppet and video game were more effective on emotional values during inhaler treatment procedure in children compared to stress ball.

Study Type

Interventional

Enrollment (Actual)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • the child being between 4-6 years old,
  • receiving inhaler treatment via mask,
  • not having received inhaler treatment for the last 6 months,
  • receiving bronchodilator medications as part of inhaler treatment,
  • having no vision or speech problems,
  • having no hearing problems,
  • the child and parent being able to speak and understand Turkish fluently,
  • being willing to participate in the study, and the families agreeing to participate in the research and signing the informed consent form.

Exclusion Criteria:

  • the child receiving medications other than bronchodilators as part of inhaler treatment,
  • the child and parent not being able to speak or understand Turkish fluently, and not being willing to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Finger Puppet

A "Finger Puppet Scenario Text" was prepared for use with children during inhaler treatment. The finger puppets used in the study were designed specifically for this research, being colorful and wearable on the finger for both boys and girls. This scenario text and the puppets were evaluated by experts.

In the finger puppet application, the researcher introduced the finger puppets to the children before inhaler treatment. Then, the finger puppet scenario was implemented by the researcher. This stage lasted approximately 10 minutes. During inhaler treatment, as outlined in the finger puppet scenario text, the puppet remained silent and in a sleep mode (silent play) throughout the treatment, depending on the cooperation between the child and the puppet.

The Child Fear Scale and the Emotional Indicators Scale were evaluated and recorded before, during, and after inhaler treatment. The PedsQL Healthcare Satisfaction Scale was evaluated at the end of inhaler treatment.
Other: Finger Puppet
Finger Puppet
Experimental: Video Game
The video game used in the study was selected from among the children's parent's mobile phones and chosen by the child themselves. Ten minutes before the start of inhaler treatment, the video game was introduced and explained, and the child was asked to start playing and continue playing the video game throughout the inhaler treatment. The video game playing time lasted approximately 10 minutes. During inhaler treatment, children in the video game group were allowed to play the video game. The mask remained on the child while playing the video game. The Child Fear Scale and Emotional Indicators Scale were evaluated and recorded before, during, and after inhaler treatment. The PedsQL Healthcare Satisfaction Scale was evaluated at the end of inhaler treatment.
Other: Video Game
Video Game
Experimental: Stress Ball
In this study, a stress ball was chosen that was soft and sized appropriately for the child's hand. Children in the stress ball group were given a stress ball before the procedure and asked to squeeze it during the procedure. Ten minutes before the start of inhaler treatment, the child was given the stress ball, introduced to it, and asked to squeeze, release, and play with it. The Child Fear Scale and the Emotional Indicators Scale were evaluated and recorded before, during, and after inhaler treatment. The PedsQL Healthcare Satisfaction Scale was evaluated at the end of inhaler treatment.
Other: Stress Ball
Stress Ball

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
child fear scale
Time Frame: The child was assessed 5 minutes before inhaler treatment. The child was assessed during inhaler treatment. The child was also assessed immediately after inhaler treatment was completed.
The scale can be used to determine the level of fear in children aged 4-10 years. It is administered by showing the child five facial expressions, ranging from a neutral expression ("0") to a frightened face ("4").
The child was assessed 5 minutes before inhaler treatment. The child was assessed during inhaler treatment. The child was also assessed immediately after inhaler treatment was completed.
children's emotional manifestation scale
Time Frame: The child was assessed 5 minutes before inhaler treatment. The child was assessed during inhaler treatment. The child was also assessed immediately after inhaler treatment was completed.
The scale can evaluate children's emotional indicators based on five parameters. These five parameters are: facial expression, vocal activity, interaction, and level of cooperation.
The child was assessed 5 minutes before inhaler treatment. The child was assessed during inhaler treatment. The child was also assessed immediately after inhaler treatment was completed.
PedsQL health care satisfaction scale
Time Frame: Parents were asked to evaluate and record their satisfaction with the PedsQL Healthcare Satisfaction Scale immediately after the inhaler treatment was completed.
The scale includes six main categories: information, family involvement, communication, technical skills, emotional needs, and overall satisfaction. The scale is evaluated based on the understanding that higher scores indicate higher satisfaction levels.
Parents were asked to evaluate and record their satisfaction with the PedsQL Healthcare Satisfaction Scale immediately after the inhaler treatment was completed.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Karamanoğlu Mehmetbey University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2024

Primary Completion (Actual)

January 1, 2024

Study Completion (Actual)

January 1, 2025

Study Registration Dates

First Submitted

February 20, 2026

First Submitted That Met QC Criteria

February 26, 2026

First Posted (Actual)

March 2, 2026

Study Record Updates

Last Update Posted (Actual)

March 2, 2026

Last Update Submitted That Met QC Criteria

February 26, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • KMU-SBF-VAC-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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