The Effect of Health Riddles on Fear, Anxiety, and Pain in Circumcised Children

Primary outcomes

1. Introductory Information Form

   Time frame: Baseline

   The introductory information form prepared by the researchers consists of items related to the child's age, gender, height, weight, place of residence, number of siblings, previous hospitalization, previous surgery, mother's age, education status, father's age, education status and the family's economic status.

2. Child Fear Scale (CFS)

   Time frame: Baseline and up to 4 weeks

   This scale was developed by McMurtry and colleagues in 2011 and was adapted to Turkish by Gerçeker and his team in 2018 and validated. Designed for children between the ages of 5 and 10, this scale presents facial muscle changes in fearful expressions with a graphic artist's drawings based on photographs of frightened faces. The scale can be used by the family, child, or researcher to evaluate children. The scale shows the child a scale containing five facial expressions scored between 0 and 4. These expressions are interpreted as follows: 0: Neutral expression (no fear), 1: Very little fear, 2: Some fear, 3: More fear, 4: Highest level of fear. This scale can be used to measure the child's level of fear before and during the procedure.

3. Child Anxiety Scale-State (CAS-D)

   Time frame: Baseline and up to 4 weeks

   The "Child Anxiety Scale-State" (CAS-D) scale, developed by Ersig and his colleagues in 2013, is used to measure the situational anxiety of children between the ages of 4-10. Its validity was provided by Gerçeker and his team in 2018. CAS-D is designed in the shape of a thermometer and has a bulb chamber at the bottom and horizontal lines upwards. Each horizontal line represents one point, and there are 10 points in total. The bottom line represents a score of 0 and indicates a situation where there is no anxiety. The anxiety level increases as you go higher, and the top line represents the highest anxiety with a score of 10.

4. Wong Baker Pain Rating Scale

   Time frame: Baseline and up to 4 weeks

   The Wong-Baker Faces Pain Rating Scale is an adaptation of the Faces Rating Scale, a picture projection technique that uses 6 pictures of a child's facial expressions in pain to assess the child's level of pain. This scale is used to best describe the child's current level of pain.

   The child is asked to choose the face that best describes their pain. The descriptions of the faces are as follows:

   Face 0: Depicts a painless, happy face, meaning "I'm very happy, I'm in no pain." Face 5: Depicts a crying face, meaning "it hurts as much as you can imagine, but you don't have to cry to feel that bad." The responses on this 5-point scale range from 0 (very happy, no pain) to 5 (it hurts as much as you can imagine) and help determine the child's level of pain.