The Effectiveness of Bubble‐Blowing as a Distraction Technique During Pediatric Intravenous Cannulation: A Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Intravenous cannulation is a standard but potentially painful procedure. Distraction techniques can alleviate this discomfort by shifting attention from perceived pain. Bubble-blowing is an active distraction technique that combines breathing exercises and play therapy to alleviate pain and anxiety. AIMS: To assess the effectiveness of bubble-blowing versus video-watching in reducing pain during and anxiety before pediatric intravenous cannulation. METHODS: This ethically approved, randomized controlled trial assigned 2- to 5-year-old participants to bubble-blowing or video-watching groups during their intravenous cannulations in the medical imaging department. Patients who were non-verbal, did not have an awake intravenous cannulation, received premedication, or had topical anesthetic for < 30 min were excluded. The Face Legs Activity Cry Consolability scale rated pain before, during, and after intravenous cannulation. The modified Yale Preoperative Anxiety-Short Form rated anxiety immediately following parental consent (baseline) and before intravenous cannulation. RESULTS: Data from 120 participants (60 females, median [interquartile range] age 3.8 [2.9-4.4] years) were available. Of these, 105 participants underwent intravenous cannulation and were included in the analysis. Pain scores during intravenous cannulation were 2.0 [0.0-7.0] in the video-watching and 2.0 [0.0-5.0] in the bubble-blowing group; median difference 0.0 (95% confidence interval (CI) -1.0 to 1.0), p = 0.888. Anxiety scores before intravenous cannulation were 36.5 [22.9-63.4] in the video-watching and 27.1 [22.9-52.1] in the bubble-blowing group; median difference 0.0 (95% CI -10.4 to 0.0), p = 0.178. Pain during intravenous cannulation increased in 29/52 (56%) children in the video-watching and 30/53 (57%) in the bubble-blowing group; odds ratio 0.97 (95% CI 0.42-2.24), p > 0.999. Anxiety increased in 27/52 (52%) children in the video-watching and 16/53 (30%) in the bubble-blowing group; odds ratio 2.48 (95% CI 1.04-6.02), p = 0.030. CONCLUSION: The use of bubble-blowing as a distraction did not significantly reduce pain during or anxiety before IV cannulation compared to video-watching. However, further research is needed to explore whether active distraction techniques could be beneficial for young, neurodiverse, anxious, or fearful children. TRIALS REGISTRATION: This study was registered in ClinicalTrials.gov (NCT05899452; June 12, 2023).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".