Effect of Distracting Methods on Procedure-Related Fear, Anxiety, and Pain During Intramuscular Injection: A Randomized Controlled Trial.

Introduction: Distraction methods such as virtual reality and cold vibration devices (Buzzy) are recommended during vascular access. Few studies focused on distraction during intramuscular injection.

Methods: This study evaluated the effect of distraction methods on procedure-related pain, fear, and anxiety during the intramuscular injection in children aged 5 to 12 years in the pediatric emergency department. In the study, children (n = 126) were assigned to 4 groups: virtual reality, manual pressure vibration, Buzzy, and control groups. Heart rate, respiration, blood pressure, and partial oxygen saturation were measured before, during, and after the procedure. Emotional behavior was evaluated using the Children's Emotional Manifestation Scale before the procedure. After the procedure, pain, fear, and anxiety were evaluated using the Child Fear Scale, Child Anxiety Scale-State, Wong-Baker FACES Pain Scale, and Color Analog Scale. The mean scores obtained from the scales were compared using the Kruskal-Wallis analysis (Clinical Trials number: NCT04847934).

Results: The diastolic and median blood pressure values were higher, and the partial oxygen value was lower in the control group after the procedure. There was no statistical difference among the groups in terms of emotional behavior before the procedure. There was a statistical difference among the groups in terms of pain scores, but no difference was found in terms of fear and anxiety.

Discussion: Virtual reality, manual pressure vibration, and Buzzy distractions were effective on intramuscular injection-related pain. Future studies should also focus on intramuscular injection-related fear and anxiety.