Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6–8 years: A randomized experimental study

Published:April 08, 2022DOI:


      • Venipuncture is one of the procedures that cause pain, anxiety, and fear in children.
      • Active and passive distraction methods are frequently used in the nursing management of procedural pain in children.
      • Cartoon watching and bubble-blowing are effective methods in reducing venipuncture pain in children.
      • Cartoon watching is more effective than bubble-blowing in reducing venipuncture-induced pain, anxiety, and fear.



      This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6–8 years.

      Design and methods

      This experimental study randomly assigned 56 children aged 6–8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests.


      The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008).


      This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6–8 years compared to bubble-blowing as an active distraction method.

      Practice implications

      The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6–8 years.


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