Distraction Methods for Reducing Pain and Fear During Blood Draw in Children (PED-DISTRACT)

August 14, 2026 updated by: Gülsev Kutman

Effects of Pinwheel Blowing, 3D Hologram Viewing, and Gum Chewing on Pain and Fear During Blood Draw in Children: A Randomized Controlled Trial

Blood draw is a common invasive procedure that can cause pain and fear in children. This randomized controlled trial aims to compare the effects of pinwheel blowing, 3D hologram viewing, and sugar-free gum chewing on pain and fear during blood draw among children aged 5-10 years. Parental satisfaction with the care provided during the procedure will also be evaluated.

A total of 164 children will be assigned in a 1:1:1:1 ratio to the pinwheel blowing, 3D hologram viewing, gum chewing, or control group using block randomization stratified by age and sex. The interventions will begin one minute before the blood draw and continue until the procedure is completed. Children in the control group will receive the routine blood draw procedure without any additional nonpharmacological intervention.

Immediately after the blood draw, the child's pain and fear during the procedure will be independently evaluated by the child, the accompanying parent, and an independent observer nurse. Parental satisfaction will also be assessed after the procedure.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a four-arm, parallel-group randomized controlled trial involving children aged 5-10 years undergoing blood draw in a pediatric phlebotomy unit. The study aims to compare three nonpharmacological methods involving different mechanisms: active distraction through pinwheel blowing, passive visual distraction through 3D hologram viewing, and rhythmic oral and gustatory stimulation through flavored gum chewing.

Eligible children will be assigned to the study groups in a 1:1:1:1 ratio using block randomization stratified by sex (female or male) and age group (5-7 or 8-10 years). A block size of four will be used within each stratum.

In the pinwheel blowing group, children will begin blowing a colorful handheld pinwheel one minute before the blood draw and continue until the procedure is completed. In the 3D hologram viewing group, children will watch an age-appropriate holographic video featuring colorful flying butterflies, beginning one minute before the blood draw and continuing until the procedure is completed. In the gum chewing group, children will select a flavored sugar-free gum, begin chewing it one minute before the blood draw, and continue throughout the procedure. Children in the control group will receive the routine blood draw procedure without any additional pharmacological or nonpharmacological pain-relieving intervention. The accompanying parent will remain with the child throughout the procedure.

All blood draws will be performed by the same nurse, who has at least five years of pediatric phlebotomy experience, using a standardized procedure. Pain experienced during the blood draw will be assessed using the Wong-Baker FACES Pain Rating Scale, which ranges from 0 to 10. Fear will be assessed using the Children's Fear Scale, which ranges from 0 to 4. Immediately after the procedure, pain and fear will be rated independently by the child, the accompanying parent, and an independent observer nurse. Parental satisfaction will be evaluated using a single-item numerical rating scale ranging from 1 to 10.

Because of the visible nature of the interventions, the children, parents, researcher delivering the interventions, phlebotomy nurse, and observer nurse cannot be blinded to group allocation.

Study Type

Interventional

Enrollment (Estimated)

164

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 Contact

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:

  • Children aged 5 to 10 years
  • Scheduled to undergo a blood draw
  • No analgesic medication use within 6 hours before the procedure
  • No visual, hearing, or speech impairment
  • No neurological disorder
  • No oral or jaw condition that may prevent gum chewing
  • No chronic illness requiring frequent invasive procedures
  • Written informed consent provided by the parent or legal guardian
  • Verbal assent provided by the children

Exclusion Criteria:

  • Previous history of syncope during blood draw procedures
  • Blood draw not completed on the first attempt
  • Development of syncope during the procedure
  • Inability or unwillingness to complete the assigned intervention
  • Withdrawal of consent or assent by the parent or child at any stage of 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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 3D Hologram Viewing Group
Children will watch an age-appropriate 3D holographic video featuring colorful flying butterflies. The intervention will begin one minute before the blood draw and continue until the procedure is completed.
Behavioral: 3D Hologram Viewing
Children will watch an age-appropriate 3D holographic video featuring colorful flying butterflies. The holographic display will be positioned approximately 50 cm from the child. The intervention will begin one minute before the blood draw and continue until the procedure is completed.
Experimental: Pinwheel Blowing Group
Children will begin blowing a colorful handheld pinwheel one minute before the blood draw and continue until the procedure is completed.
Behavioral: Pinwheel Blowing
Children blow a colorful handheld pinwheel with a diameter of 16 cm. The intervention begins one minute before the blood draw and continues until the procedure is completed. Children hold the pinwheel with the hand not used for blood collection; the researcher holds it when necessary.
Experimental: Gum Chewing Group
Children will select a flavored sugar-free gum, begin chewing it one minute before the blood draw, and continue until the procedure is completed.
Behavioral: Gum Chewing
Children will select a 14.5-g piece of sugar-free flavored gum and begin chewing it one minute before the blood draw. The available flavors will include watermelon, strawberry, orange, and mixed fruit. Children will continue chewing the gum until the procedure is completed.
No Intervention: Control Group
Children will receive the routine blood draw procedure used in the pediatric phlebotomy unit. No additional pharmacological or nonpharmacological pain-relieving intervention will be provided. The accompanying parent will remain with the child and may talk to and maintain eye contact with the child during the procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Child-Reported Pain Intensity During Blood Draw Assessed Using the Wong-Baker FACES Pain Rating Scale
Time Frame: Immediately after the blood draw, within approximately 5 minutes
Pain experienced during the blood draw will be assessed by the child using the Wong-Baker FACES Pain Rating Scale. The scale consists of six faces scored as 0, 2, 4, 6, 8, and 10, where 0 indicates no pain and 10 indicates the worst possible pain. Higher scores indicate greater pain intensity.
Immediately after the blood draw, within approximately 5 minutes
Child-Reported Fear During Blood Draw Assessed Using the Children's Fear Scale
Time Frame: Immediately after the blood draw, within approximately 5 minutes
Fear experienced during the blood draw will be assessed by the child using the Children's Fear Scale. The scale consists of five facial expressions scored from 0 to 4, where 0 indicates no fear and 4 indicates extreme fear. Higher scores indicate greater fear.
Immediately after the blood draw, within approximately 5 minutes

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Parent-Reported Satisfaction With the Blood Draw Procedure
Time Frame: Immediately after the blood draw, within approximately 5 minutes
Parental satisfaction with the care provided during the blood draw procedure will be assessed using a single-item numerical rating scale ranging from 1 to 10, where 1 indicates the lowest level of satisfaction and 10 indicates the highest level of satisfaction. Higher scores indicate greater parental satisfaction.
Immediately after the blood draw, within approximately 5 minutes

Collaborators and Investigators

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

Sponsor

Gülsev Kutman

Collaborators

Tekirdağ City Hospital

Investigators

  • Principal Investigator: Gülsev Kutman, Tekirdağ City Hospital

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)

June 15, 2026

Primary Completion (Estimated)

September 15, 2026

Study Completion (Estimated)

September 15, 2026

Study Registration Dates

First Submitted

August 8, 2026

First Submitted That Met QC Criteria

August 14, 2026

First Posted (Actual)

August 18, 2026

Study Record Updates

Last Update Posted (Actual)

August 18, 2026

Last Update Submitted That Met QC Criteria

August 14, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KUTMAN-PED-2026-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the informed consent process and ethics committee approval did not include the sharing of participant-level data with other researchers. As the study involves children, participant privacy and confidentiality will be strictly protected. Only aggregate study findings will be reported in scientific publications.

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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