The effect of virtual reality and local cold application-vibration methods on reducing anxiety, fear and pain developed by intramuscular injection in children

Aim: This study was carried out to evaluate the effects of virtual reality (SG) and local cold application-vibration (Buzzy®) applications in reducing anxiety, fear and pain due to intramuscular (IM) injection applied to the vastus lateralis in children aged 5- 10 years. Method: It is a randomized controlled trial. The research was carried out with 117 children aged 5-10 years, who underwent IM application to the vastus lateralis area in the Pediatric Emergency Unit of the Selcuk University Medical Faculty Hospital between November 2020 and January 2022.Three groups were; SG (n:40), Buzzy (n:39) and control group (n:38), took part in the study. Data were collected using the Child and Parent Information Form, Children's State Anxiety (CAS-S), Child Fear Scale (CFS), and Wong Baker FACES (WB-FACES) Pain Assessment Scale. The scales were filled in separately by the nurse who performed the IM injection, the parent, and the child before the procedure and within the first 5 minutes after the procedure. Descriptive statistics, Kruskall-Wallis H test and chi-square test were used in the analysis of research data. Concordance between Nurse, Parent and child measurements was assessed by Intra Class Correlation (ICC) analysis (p<0,05) was considered significant. Results: According to the evaluations of the nurses, parents and children after the IM procedure, the mean scores of CAS-S, CFS and WB-FACES of the children in the control group were; it was higher than Buzzy® and SG groups (p<0.05). According to all three evaluators, There was no significant difference between the post intervention CAS-S, CFS and WB-FACES measurements of the SG and Buzzy groups (p>0.05). Conclusion: It was determined that virtual reality and Buzzy® applications were effective in reducing anxiety, fear and pain caused by IM injection applied to the vastus lateralis in children aged 5-10 years, but they were not superior to each other. Key words: intramuscular, pain, anxiety, fear, child, pediatric nurse, virtual reality, Buzzy®, local cold application-vibration