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Effect of Buzzy®, Cognitive Behavioral Intervention, and Kaleidoscope During SC Injection in Children With Cancer
Sponsor: Kocaeli University
Summary
Subcutaneous injections are commonly used in pediatric oncology care and may cause pain, fear, and anxiety in children. Repeated exposure to needle-related procedures may increase procedural distress and affect children's cooperation and coping during treatment. Therefore, simple, safe, and feasible non-pharmacological interventions are needed to improve children's comfort during routine procedures. This randomized parallel trial was designed to compare three clinically feasible non-pharmacological approaches with different mechanisms during subcutaneous injections in children with cancer. Buzzy® provides cold and vibration as a sensory-based method, the cognitive behavioral intervention package supports preparation and coping, and the kaleidoscope provides visual distraction. By comparing these approaches within the same procedural context, the study aimed to provide practical evidence for pediatric oncology nurses when selecting interventions to reduce procedural distress. All procedures were conducted in the routine clinical procedure area of a pediatric oncology clinic. The same subcutaneous injection procedure was used for all participants, and standardized assessment time points were applied before and immediately after the procedure.
Official title: 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
Key Details
Gender
All
Age Range
6 Years - 12 Years
Study Type
INTERVENTIONAL
Enrollment
45
Start Date
2024-12-01
Completion Date
2025-09-24
Last Updated
2026-06-25
Healthy Volunteers
No
Interventions
Cognitive Behavioral Intervention Package Group
The Cognitive Behavioral Intervention Package was delivered by the researcher before, during, and after the subcutaneous injection. Before the procedure, the child received brief age-appropriate preparation, selected a preferred distraction or coping strategy, and the parent was guided on how to support the child. During the injection, the researcher provided standardized verbal coaching, encouragement, and coping support, while the parent provided physical and verbal comfort. The child used the selected coping strategy throughout the injection. After completion of the outcome assessments, brief positive reinforcement was provided. The intervention was implemented using a structured checklist to support standardization.
Buzzy® Group
The Buzzy® device was used as a cold and vibration intervention during subcutaneous injection. The device was placed at the injection site 60 seconds before needle insertion, and cold and vibration were initiated. Immediately before needle insertion, the device was repositioned approximately 3 cm proximal to the injection site. It remained in place throughout the injection and was removed immediately after the procedure was completed. No additional distraction or cognitive behavioral coaching was provided beyond standard procedural explanations.
Kaleidoscope Group
The kaleidoscope was used as a visual distraction intervention during subcutaneous injection. The child was shown the kaleidoscope shortly before the procedure and was allowed a brief familiarization period. The kaleidoscope was introduced approximately 1 minute before needle insertion, and the child continued to look through it throughout the injection. The intervention ended when the injection was completed. No additional cognitive behavioral coaching or cold/vibration intervention was provided beyond standard procedural explanations.
Locations (1)
Kocaeli University
Kocaeli, İzmit, Turkey (Türkiye)