Comparison the effects of active distraction and Shen Men point massage on pain and anxiety during venipuncture in children 4-7 year old hospitalized

Comparison the effects of active visual distraction and Shen Man point massage on pain and anxiety during venipuncture in 4-7 year old children hospitalized in Ekbatan Hospital, 1404

Clinical trial with intervention and control groups, single-blind, randomized

The study environment is the pediatric inpatient wards of Ekbatan Hospital in Hamadan. The test and control samples will be selected from among the children who meet the inclusion criteria for the study using a stratified random sampling method. The samples will be divided into three groups using a table of generated random numbers.In the massage group, acupressure point massage was performed five minutes before venipuncture, and then venipuncture was performed. In the distraction group, half-prepared emoticons were completed by the child five minutes before venipuncture. Anxiety scales were completed before, during, and after venipuncture using the Purey instrument, and pain intensity during venipuncture using the Wang Baker instrument by the evaluator.

Entry requirements: Hospitalized child 4 to 7 years old, having healthy organs and skin in the hand, not using painkillers 3 hours before venipuncture, the child is alert to time, place and person, not having mental retardation, the child is hospitalized for the first time, has experienced a second venipuncture during hospitalization, has no pain during venipuncture, has not experienced a painful procedure 24 hours before .Not have traumatized venipuncture and have only had one previous successful venipuncture. Exclusion criteria: unwillingness to continue participating in the study, failure in the first venipuncture, worsening of the child's medical condition

Intervention groups (Shen Man point massage, active distraction) Control group

Pain, anxiety

Sampling and Randomization Initially, all hospitalized children aged 4–7 years who met the inclusion criteria were stratified based on age (4–5 years and 6–7 years) and gender (female/male) in order to balance the distribution of these potential confounding variables across the study groups. Within each stratum, a list of eligible children was prepared, and a unique numerical code was assigned to each child. For randomization, a random allocation list for the three groups (active distraction group, Shen Men point massage group, and control group) was prepared in advance by an individual independent of the sampling process using a random numbers table (or computer‑generated random numbers). In this list, the allocation sequence of participants to the three groups was arranged using random blocks of equal size (e.g., blocks of six) to ensure that the number of participants in each group remained approximately equal. When each eligible child entered the study, the researcher responsible for data collection assigned the participant to one of the three groups according to the predetermined allocation sequence and the order of enrollment, without any personal judgment or interference. In this way, the likelihood of allocation bias was minimized and the principle of randomization was maintained in the study.

The study will be single-blind, meaning that the statistician will not know the type of intervention in the groups.