Effects of Pop-it Game and Stress Ball Use on Pain and Anxiety During Blood Collection in Children Aged 3-6 Years

Children were assessed according to the inclusion criteria and randomly assigned to the Pop-it, stress ball, or control groups. Children and parents were informed about the study, and informed consent was obtained.

Pain and anxiety were assessed using the Wong-Baker Faces Pain Rating Scale (WBFPRS) and the Children's Emotional Expression Assessment Scale (CEEAS).

Blood collection was performed by the same experienced nurse using a standardized procedure. The Pop-it group played with a Pop-it toy, while the stress ball group squeezed and released a stress ball with their free hand, starting 1 minute before blood collection and continuing throughout the procedure. The control group received routine phlebotomy without any non-pharmacological intervention.

Procedure duration and crying duration were recorded with stopwatches. Anxiety was assessed by both the researcher and the parent during the procedure. One minute after blood collection, pain and anxiety were reassessed using the WBFPRS and CEEAS.

Inclusion criteria

• Children aged 3 to 6 years.
• Accompanied by a parent.
• Absence of any auditory, mental, or neurological disability
• Being communicative and open to interaction.
• Not having received any analgesic, antipyretic, anti-inflammatory, sedative, or anxiolytic medication within the previous 6 hours.
• Absence of acute pain prior to the procedure.
• Phlebotomy performed by the same nurse.
• No history of regular invasive procedures (i.e., no chronic disease requiring routine blood monitoring, such as cancer or diabetes).
• Willingness of both the child and parent to participate in the study.

Exclusion criteria

• inability to perform the phlebotomy procedure on the first attempt.