Buzzy®, a cognitive–Behavioral intervention package, and a kaleidoscope for reducing pain, fear, and anxiety during subcutaneous injections in children with Cancer: A three-arm randomized controlled trial
Journal of Pediatric Nursing, cilt.91, ss.16-26, 2026 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 91
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.pedn.2026.07.064
- Dergi Adı: Journal of Pediatric Nursing
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.16-26
- Anahtar Kelimeler: Anxiety, Cancer, Fear, Injections, Pain, Subcutaneus
- Kocaeli Üniversitesi Adresli: Evet
Özet
Purpose To compare the effects of Buzzy®, a cognitive–behavioral intervention package (CBIP), and a kaleidoscope on pain (primary outcome), fear, and anxiety during subcutaneous injections in children with cancer. Design and methods This three-arm randomized parallel trial was conducted at a university pediatric oncology clinic in Türkiye from December 2024 to September 2025. Forty-five children aged 6–12 years were randomized 1:1:1 to Buzzy®, CBIP, or kaleidoscope groups. Post-injection pain was assessed using the Wong–Baker Faces Pain Rating Scale. Fear and state anxiety were assessed before and immediately after injection using the Children's Fear Scale and Children's Anxiety Scale–State, respectively, through child self-report and researcher ratings. Results Fear decreased significantly in all groups in child self-reports and researcher ratings, without between-group differences. Researcher-rated anxiety decreased significantly with Buzzy® and CBIP but not kaleidoscope; child-reported anxiety decreased significantly in all groups. Between-group anxiety differences were nonsignificant. Child-reported post-procedural pain was significantly lower with Buzzy® than with CBIP, whereas researcher-rated pain was significantly lower with Buzzy® than with both CBIP and kaleidoscope. Conclusions Fear decreased in all three groups, without clear superiority for fear or anxiety. Buzzy® was associated with lower pain ratings in specific comparisons. Findings warrant caution because this small, single-center trial compared three active interventions without a standard-care control group. Practice implications Intervention selection may reflect children's needs and preferences. Buzzy® may be useful when injection pain is the primary concern; CBIP and kaleidoscope are reasonable alternatives when nonpharmacological procedural support is desired.