Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6-8 years: A randomized experimental study.

PURPOSE: This study aimed to compare the effects of bubble-blowing (active distraction) and cartoon watching (passive distraction) techniques on pain, anxiety, and fear during venipuncture in children aged 6-8 years. DESIGN AND METHODS: This experimental study randomly assigned 56 children aged 6-8 years to cartoon watching or bubble-blowing groups. The child, parent, and researcher assessed pain using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children's State Anxiety Scale, and fear using the Children's Fear Scale. The study data were analyzed using the Chi-square tests and independent Sample t-tests. RESULTS: The groups were similar in clinical and demographic characteristics. The scores on pain, anxiety, and fear during the procedure were lower in the cartoon watching group than in the bubble-blowing group (pain t(47) = 2.638, p = .013; anxiety t(47) = 2.358, p = .023; and fear t(47) = 2.784, p = .008). CONCLUSION: This study revealed that cartoon watching as a passive distraction method was more effective in reducing pain, anxiety, and fear during venipuncture in children aged 6-8 years compared to bubble-blowing as an active distraction method. PRACTICE IMPLICATIONS: The cartoon watching technique, which is affordable, easy to access, and effective (in reducing pain, anxiety, and fear), can be safely used during venipuncture in children aged 6-8 years.

Effect of quadrant switch on intraocular pressure change in intravitreal aflibercept or ranibizumab injection applications.

OBJECTIVE: To evaluate the effect of injection quadrant switch on the intraocular pressure (IOP) change in intravitreal aflibercept or ranibizumab applications. METHODS: 123 eyes of 123 patients who received intravitreal injection (IVE) into the superotemporal quadrant at least 10 times for age-related macular degeneration or diabetic macular edema have been recruited. The demographic data, lens status, IOP values (preoperative, postoperative 0th min, and postoperative 30th min), and amount of vitreous reflux (VR) following IVE have been recorded. Next IVE application was performed into the inferotemporal quadrant of the patient, which had never been injected before. RESULTS: The mean IOP value at postoperative 0th min was 50.24 ± 7.66 mmHg after injections into the superotemporal quadrant and was 34.85 ± 4.96 mmHg after injections into the inferotemporal quadrant. No significant difference was observed between the preoperative and postoperative 30th min-IOP values (p > 0.05), while a significant difference was found between the postoperative 0th min-IOP values among quadrants (p < 0.001). VR was significantly higher in applications into the inferotemporal quadrant than those into the superotemporal quadrant (p < 0.001). CONCLUSION: One of the most principal factors affecting the postoperative short-term IOP increase is the amount of VR, and this amount decreases the IOP following an IVE. The high amount of VR produced in the quadrant where the injection was applied for the first time caused a low-level IOP, while the low amount of VR formed in the quadrant where the repeated injections were applied caused a higher IOP.