Effect of Buzzy and Virtual Reality on Children Undergoing Venous Procedures

NCT07882602 — Not applicable, Recruiting, 105 participants, Bandırma Onyedi Eylül University

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The Effect of Buzzy and VR on Procedure Duration, Pain, Fear, and Parental Anxiety in Children Undergoing Venous Imaging

RegistryNCT07882602
StatusRecruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, supportive care
Enrollment105 (Estimated)
SponsorBandırma Onyedi Eylül University (Other)
ConditionsFever, Children
InterventionsVein-imaging device + virtual reality headset group, Vein-imaging device + Buzzy group (Behavioral)
Datesstart 2026-02-06, primary completion 2026-12-01 (estimated), completion 2027-01-01 (estimated), first posted 2026-10-20, last updated 2026-10-20
Locations1 site in Turkey (Türkiye)

Related Papers Related Patents Related Grants Related Experts
All trials for Fever All trials for Children All trials of Vein-imaging device + virtual reality headset group All trials of Vein-imaging device + Buzzy group

-Summary

Throughout the diagnostic and treatment process, pediatric patients are subjected to invasive procedures-such as peripheral intravenous catheterization (PIVC)-that cause pain, stress, fear, and anxiety. PIVC is one of the most commonly used procedures in modern medicine. This method is used for a variety of procedures, including intravenous fluid support, continued medication administration, monitoring of hemodynamic parameters, and the provision of total parenteral nutrition. However, the narrow diameter of veins in children and the fact that their vascular structure is not yet fully developed make the PIVC procedure more challenging compared to adults and often result in unsuccessful attempts. Particularly in time-critical units such as the emergency department, multiple failed attempts can lead to prolonged procedure times and various complications.

Inadequate vascular access can lead to negative emotional reactions in children-such as pain, fear, and anxiety-as well as disruptions in the treatment process, tissue damage, an increased need for diagnosis and treatment, an increased workload for healthcare providers, and higher healthcare costs. Furthermore, repeat procedures lead to increased parental anxiety and a decline in trust in healthcare services. Therefore, when approaching children within the framework of the principle of atraumatic care, the goal should not be the complete elimination of pain, but rather the reduction of the duration and intensity of exposure to it.

In this context, the proposed study aims to conduct a comparative analysis of the effects of distractions and technological interventions used during invasive procedures on children and their parents. By integrating these methods-which have been evaluated in only a limited number of studies in the literature-into nursing care, the study aims to develop evidence-based recommendations for improving patient comfort and reducing traumatic experiences.

Research Hypotheses

H0: There is no difference between the groups in terms of pain, fear, anxiety, procedure duration, and anxiety scores associated with central venous catheterization.

H1a: There is a difference between the groups in pain scores in children associated with the PIVC procedure.

H1b: There is a difference between the groups in fear scores in children associated with the PIVC procedure.

H1c: There is a difference between the groups in terms of anxiety scores in children associated with the PIVC procedure.

H1d: There is a difference between the groups in terms of worry scores in parents associated with the PIVC procedure.

H1e: There is a difference between the groups in terms of procedure durations associated with the PIVC procedure.

Working groups:

Vein imaging device + virtual reality headset group Ven imaging device + Buzzy group Vein imaging device

Data Collection Tools The study will use the Demographic Information Form, the Wong-Baker Facial Expression Rating Scale, the Children's Fear and Anxiety Scale, and the State-Trait Anxiety Inventory (STAI) to measure parental anxiety, and data will be collected while taking the duration of the procedure into account.

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+Arms and interventions

ArmTypeInterventionsDescription
Vein-imaging device + virtual reality headset groupExperimentalBehavioral: Vein-imaging device + virtual reality headset groupPatients and families will be informed that the Qualmedi MT-600 Vein-Finder is used to visualize veins; the device will identify the vein for PIVC insertion. Three minutes before and after the procedure, parents will complete the Descriptive Information Form and STAI, and children will complete the Wong-Baker FACES Pain Rating Scale and the Children's Fear and Anxiety Scales. The child will be introduced to a white smartphone-compatible "VR BOX 3.0" headset, which will be fitted 60 seconds before the procedure while an Amazon video is played. Disposable covers will be applied to facial-contact areas, and the outer surfaces and screen will be disinfected. Children who wish to remove the headset will be withdrawn. Immediately after the headset is fitted, the nurse will perform catheterization. Primary endpoint: voluntary headset removal; secondary: catheterization success and duration; tertiary: pain, fear, anxiety.
Vein-imaging device + Buzzy groupExperimentalBehavioral: Vein-imaging device + Buzzy groupPatients and families will be informed that the Qualmedi MT-600 Vein-Finder is used to visualize veins; the device will identify the vein for PIVC insertion. Buzzy® (MMJ Labs, Atlanta, USA), a reusable device combining cold and high-frequency vibration to reduce procedural pain and distract attention, will be used. Its frozen wing-shaped ice pack is inserted before use and wiped with 70% alcohol afterward. Three minutes before and after the procedure, parents will complete the Descriptive Information Form and STAI, and children the Wong-Baker FACES Pain Rating Scale and Children's Fear and Anxiety Scales. Sixty seconds before the procedure, Buzzy will be placed on the antecubital fossa; the nurse will then slide it about 3 cm proximally, apply the tourniquet, and perform catheterization. Primary endpoint: refusal of Buzzy; secondary: success and duration; tertiary: pain, fear, anxiety, and parental anxiety at 3 minutes.
Vein-imaging groupNo interventionIn the vein visualization group, a vein visualization device will be used during the PIVC procedure in addition to the standard procedure. Three minutes before and three minutes after the procedure, parents will be asked to complete the State-Trait Anxiety Inventory (STAI), and children will be asked to complete the Wong-Baker FACES Pain Rating Scale and the Children's Fear and Anxiety Scales. The researcher will start timing when the nurse applies the tourniquet to the child, and the procedure duration will be recorded on the form once the procedure is completed. In the vein visualization group, the primary endpoint is the success of vascular access and the duration of the intervention. The secondary endpoint is the pain, fear, and anxiety levels experienced by the child in relation to the procedure, which will be assessed three minutes after the vascular access attempt.
  • Vein-imaging device + virtual reality headset group (Behavioral): Patients and families will be informed that the Qualmedi MT-600 Vein-Finder is used to visualize veins; the device will identify the vein for peripheral intravenous catheter (PIVC) insertion. Three minutes before and after the procedure, parents will complete the Descriptive Information Form and State-Trait Anxiety Inventory (STAI), and children will complete the Wong-Baker FACES Pain Rating Scale and the Children's Fear and Anxiety Scales. The child will be introduced to a white smartphone-compatible "VR BOX 3.0" headset, which will be fitted 60 seconds before the procedure while an Amazon video is played. Disposable covers will be applied to facial-contact areas, and the outer surfaces and screen will be disinfected. Children who wish to remove the headset will be withdrawn. Immediately after the headset is fitted, the nurse will perform catheterization. Primary endpoint: voluntary headset removal; secondary: catheterization success and duration; tertiary: pain, fear, anxiety.
  • Vein-imaging device + Buzzy group (Behavioral): Patients and families will be informed that the Qualmedi MT-600 Vein-Finder is used to visualize veins; the device will identify the vein for peripheral intravenous catheter (PIVC) insertion. Buzzy® (MMJ Labs, Atlanta, USA), a reusable device combining cold and high-frequency vibration to reduce procedural pain and distract attention, will be used. Its frozen wing-shaped ice pack is inserted before use and wiped with 70% alcohol afterward. Three minutes before and after the procedure, parents will complete the Descriptive Information Form and STAI, and children the Wong-Baker FACES Pain Rating Scale and Children's Fear and Anxiety Scales. Sixty seconds before the procedure, Buzzy will be placed on the antecubital fossa; the nurse will then slide it about 3 cm proximally, apply the tourniquet, and perform catheterization. Primary endpoint: refusal of Buzzy; secondary: success and duration; tertiary: pain, fear, anxiety, and parental anxiety at 3 minutes.

+Outcome measures

Primary outcomes

  • Wong-Baker FACES Pain Rating Scale [3 minutes before the procedure and 3 minutes after the procedure]: The Wong-Baker FACES Pain Rating Scale, used to assess pain in this study, was first developed by Donna Wong and Connie Morain Baker in 1981 and revised in 1983. It is a visually based instrument, widely used worldwide, for assessing pain intensity in children aged three years and older, and it allows children to express themselves through facial expressions. The scale consists of six different facial expressions: the smiling face on the far left represents no pain (a score of 0), whereas the crying face on the far right represents severe pain (a score of 10). When administering the scale, the meaning of each face is explained to the child, and the child is asked to select the face that best represents how they feel. The scale has frequently been used in similar studies conducted in Türkiye (Erdoğan \& Aytekin Özdemir, 2021; Gerçeker et al., 2018). An email requesting permission was sent to the official website of the Wong-Baker FACES Foundation, and the Turkish version of the scale an
  • Children's Fear and Anxiety Scale (CFAS) [3 minutes before the procedure and 3 minutes after the procedure]: Developed by McMurtry and colleagues in 2011, this scale was designed to assess children's levels of fear and anxiety. Its validity and reliability in Turkish were established by Gerçeker et al. (2018). The scale is administered by presenting children with a visual display containing five different facial expressions that can be rated on a scale from 0 to 4. Each facial expression represents a specific emotional state. The assessment can be conducted by researchers or parents to determine levels of fear and anxiety both before and during a procedure. On the scale, a score of "0" indicates that the child experiences no fear or anxiety, while a score of "4" represents the highest level of fear and anxiety (Gerçeker et al., 2018; Akdemir, 2019; Akan, 2024). Since the Child Fear and Anxiety Scale is a sum-scored instrument, item-total correlations and the Cronbach's alpha coefficient could not be calculated.
  • STAI State-Trait Anxiety Inventory [3 minutes before the procedure and 3 minutes after the procedure]: The State-Trait Anxiety Inventory (STAI), developed by Spielberger et al. (1970) to assess anxiety as both a temporary state and an enduring trait, was adapted into Turkish, with validity and reliability established, by Öner and Le Compte (1998). It comprises two 20-item subscales, state and trait. Items are rated on a four-point Likert scale; total scores range from 20 to 80, with higher scores indicating greater anxiety (Fırat, 2016; Kaçmaz, 2024). Scores below 36 indicate no anxiety, 37-42 mild anxiety, and 42 or above high anxiety (Yurdaor et al., 2022). For the Turkish version, Kuder-Richardson alpha coefficients ranged from 0.83 to 0.87 (trait) and 0.94 to 0.96 (state); item-remainder correlations from 0.34 to 0.72 (trait) and 0.42 to 0.85 (state); test-retest coefficients from 0.71 to 0.86 (trait) and 0.26 to 0.68 (state). The state subscale, a validated measure, will be used to assess parental anxiety (Fırat, 2016; Kaçmaz, 2024; Yurdaor et al., 2022).

+Eligibility

Sex: All, ages: 7 Years to 12 Years

Inclusion Criteria:

* The child must be between the ages of 7 and 12.
* Written consent from the parents indicating their voluntary participation in the study.
* The child must have a fever (>37.5°C).

Exclusion Criteria:

* Parents wishing to withdraw from the study at any stage
* The patient having taken antipyretic or analgesic medications prior to the PIVC procedure
* The presence of severe dehydration

+Locations (1)

FacilityCityCountryStatus
Karacabey state hospitalBursaTurkey (Türkiye)Recruiting

+Publications

  • d. Kaynak Listesi (APA stiline uygun yazınız). Akan, Z. (2024). Çocuklarda venöz kan alma sırasında uygulanan aktif dikkat çekme yöntemlerinin ağrı ve korku üzerine etkisi: Düdük çalma ve baloncuk üfleme (Yayınlanmış Yüksek lisans tezi). Atatürk Üniversitesi, Erzurum. Akdemir, M. A. (2019). Çocuklarda venöz kan alma sırasında uygulanan üç farklı yöntemin ağrı ve anksiyete üzerine etkisi: EMLA krem, soğuk sprey ve Buzzy (Yayınlanmış Yüksek lisans tezi). Atatürk Üniversitesi, Erzurum. Can, M., ve Gerçeker, G. Ö. (2024). The effect of the Veinlite PEDI2 and passive virtual reality distraction on peripheral catheter insertion-related emotional behavior, pain, fear, and anxiety of children: A randomized controlled trial. Journal of Pediatric Nursing, 78, e227-e235. Demir, D., & Inal, S. (2019). Does the Use of a Vein Visualization Device for Peripheral Venous Catheter Placement Increase Success Rate in Pediatric Patients?. Pediatric emergency care, 35(7), 474-479. https://doi.org/10.1097/PEC.0000000000001007 Erdogan, B., ve Ozdemir, A. A. (2021). The effect of three different methods on venipuncture pain and anxiety in children: distraction cards, virtual reality, and Buzzy®(randomized controlled trial). Journal of Pediatric Nursing, 58, e54-e62. Eren, H., Topuz, A., & Türkmen, A. S. (2020). Hemşirelik Öğrencilerinin Periferal İntravenöz Kateter Yerleştirme İşlemi Hakkındaki Bilgi ve Beceri Düzeylerinin Belirlenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 7(2), 113-121. https://doi.org/10.31125/hunhemsire.763142 Gerçeker, G. Ö., Ayar, D., Özdemir, Z., & Bektaş, M. (2018). Çocuk Anksiyete Skalası-Durumluluk ve Çocuk Korku Ölçeğinin Türk diline kazandırılması. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 11(1), 9-13. http://cocuk-korku-olcegi-toad.pdf/ Gümüş, M. (2017). Periferal venöz kateter uygulamasında ven görüntüleme cihazı kullanımının ilk girişimde başarı oranına etkisi (Yayınlanmış Yüksek lisans tezi). Ege Üniversitesi

+Study documents

+Investigators