The effect of using a kaleidoscope on pain levels during invasive procedures in children aged 4 to 12 years: A systematic review

Abstract

Background

Invasive procedures are a major source of procedural pain in pediatric patients. Although pharmacological methods are routinely used, non-pharmacological approaches such as visual distraction techniques are gaining prominence in childcentered care.

Purpose

This systematic review aimed to evaluate the effectiveness of kaleidoscope use in reducing procedural pain among children aged 4 to 12 years undergoing invasive interventions.

Materials and methods

A systematic literature search was conducted in six electronic databases (PubMed, Web of Science, Scopus, WILEY Online Library, Medline, and ScienceDirect) from inception to November 2024. Randomized controlled trials (RCTs) published in English that investigated kaleidoscope use during invasive procedures in children were included. Methodological quality was assessed using standardized tools, and data were independently extracted by two reviewers. The review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025630649).

Results

From 153 identified articles, nine RCTs met the inclusion criteria, comprising a total of 1460 children. All studies reported a statistically significant reduction in procedural pain among children who used a kaleidoscope during the invasive interventions.

Conclusion

Kaleidoscopes represent an effective, non-invasive, and low-cost tool for pediatric pain management during invasive procedures.

Practical implications

Incorporating kaleidoscopes into routine pediatric care may improve children's experiences during medical procedures and support holistic, evidence-based nursing practice.