1) The study aims to compare the effectiveness of cartoon videos versus bubble blowing in reducing pain perception during intravenous injection among children admitted to RajaRajeswari Medical College and Hospital, Bangalore. 2) A quasi-experimental study will be conducted with 30 children randomly assigned to either watch cartoon videos (experimental group 1) or blow bubbles (experimental group 2) during their intravenous injection. 3) The standardized FACES pain scale will be used to measure pain perception before and after the intervention. Statistical tests will then analyze differences in pain scores between and within the two groups.

1. Effectiveness Of Cartoon
Videos Versus Bubble Blowing
On Pain Perception During
Intravenous Injection among
Children admitted at
RajaRajeswari Medical college
and Hospital, Bangalore.

3. INTRODUCTION
• Medical procedures are procedures carried out in
health care setting today as the means of providing
diagnostic information, treatment or palliation
according to Childs condition. But , unfortunately
many of which produce pain.
• Pediatric patients are often subjected to unexpected
medical procedures that causes pain such as
intravenous insertions(IV), intramuscular or
subcutaneous injections and central venous port
access.
• Intravenous injection is one of the most commonly
experienced procedures by children and 50% of
children experience significant levels of pain and
distress during intravenous injection.

4. INTRODUCTION
• Distraction in Pediatrics is often defined as strategy
whether cognitive or behavioral that draws a child's
attention away from noxious pain stimuli.
• Distraction out of other non-pharmacological
interventions is the most commonly used and also an
effective method for procedural pain and distress.
Distraction technique can be broadly classified into two
types:
 active distraction ( Bubble Blowing, Controlled
Breathing, Relaxation, Playing Video games,
interactive toys or electronic games, guided imagery
etc)
 passive distraction (Watching Cartoon Videos,
Listening to stories, music).

5. NEED FOR STUDY
• Pain is described as the fifth vital sign and inadequate Pain
management is linked to numerous immediate and long-term
negative outcomes.
• Children’s being cared for in hospital undergo numerous painful
procedures . Healthy children also experience numerous painful
procedures as a part of routine medical care .
• L. Subhashini et.al conducted a research to compare the Two Pain
Scales in in Indian children at New Delhi. In that study it was stated
that mean pain score for Venipuncture 4.74 ± 2.43 and Intravenous
Injection 5.43 ± 2.47.(Indian Journal of Pediatrics)
• In Canada ,Recent research found that 78% of hospitalized children
had at least one painful procedure in last 24 hours. (World Journal
of Nursing Sciences)
• Nurses reported that pain signs were in 50 % of inpatients
hospitalized children which were detected during clinical procedures
. And also it was reported that pain was managed in 78%inpatients
by using pharmacological and non pharmacological interventions.

6. NEED FOR STUDY
• Painful Medical procedures can cause short term and long term effects .
These effects consists of a variety of physical, emotional, cognitive and
psychological manifestations including fear , anxiety, anger, aggressive
behavior, inability to concentrate , embarrassment etc.
• Researchers found there was high prevalence of pain in pediatric inpatients
at RRMCH
• To improve the treatment of pain in sick children, health care professionals
need to expand their knowledge, use appropriate assessment techniques,
intervene accordingly to manage pain.
• Distraction is also a non-pharmacological intervention and cost effective
means of reducing child pain and distress during intravenous injection.
• For improving this aspect of care, Researcher felt it is desirable to assess
the effectiveness of Cartoon Videos Vs. Bubble Blowing on Pain
Perception during Intravenous Injection .
• This will help in devising appropriate strategies to improve the practices
for pain management and also it is equally and effectively as a common
psychological interventions

7. STATEMENT OF THE PROBLEM
Effectiveness of Cartoon Videos Vs. Bubble
Blowing on Pain Perception during
Intravenous Injection among Children
admitted at RajaRajeswari Medical college and
Hospital, Bangalore.

8. OBJECTIVES OF THE STUDY
1. To asses the Perception of Pain during Intravenous Injection
in Experimental group 1(Cartoon Videos) and Experimental
group 2 (Bubble Blowing ) before Intervention.
2. To asses the Perception of Pain during Intravenous Injection
in Experimental group 1(Cartoon Videos) and Experimental
group 2 (Bubble Blowing ) after Intervention .
3. To Evaluate the effectiveness of cartoon videos and bubble
blowing in Experimental group 1and Experimental group 2.
4. To compare the effectiveness of cartoon videos and bubble
blowing between Experimental group 1and Experimental
group 2.
5. To find out association in Post test Perception of Pain scores
with their selected demographic variables in Experimental
group 1and Experimental group 2.

9. HYPOTHESES
H1: There will be a significant difference in the
Perception of Pain Scores between the Pre-test
and Post test in Experimental group 1 and
Experimental group 2.
H2: There will be a significant difference in the
Post test Perception of Pain scores between
Experimental group 1 and Experimental group 2.
H3: There will be significant association between
the Post test Perception of Pain scores with
selected variables in Experimental group 1 and
Experimental group 2.

10. ASSUMPTIONS
The study assumes that,
a) The child shows painful expressions during
Intravenous Injection.
b) Distraction shifting the Childs attention to
something engaging or attractive way ,in
order to hinder from the pain.
c) Cartoon videos & bubble blowing are the
distractive stimuli which helps to divert &
reduce the Pain level.

11. OPERATIONAL DEFINITIONS
1.EFFECTIVENESS: In this study it refers to degree in reducing the
level of pain in children who are undergoing IV cannulation.
2.Cartoon videos: In this study the process of showing video
animations to the school age children's by the use of laptop.
3. Bubble Blowing: In this study bubble blowing acts as a passive
distraction in which air will be blown to the soap water to make
the bubbles.
4.Pain: In this study, it refers to unpleasant sensory or emotional
experience during intravenous cannulation.
3. PERCEPTION: In this study it is the percentage in feeling of pain
during IV cannulation usually measured by FACES scale
reading.
4.INTRAVENOUS CANNULATION: In this study, it is the putting of
tube into the school age children's vein for administration of
fluids, medications etc.

12. DELIMITATION OF THE STUDY
1) The study will be conducted among the children in
Paediatric ward at RRMCH.
2) Study is limited to 30 children's who are admitted in
Paediatric ward.
3) There is no cause of pain except the painful medical
procedure(IntraVenous Injection).

14. RESEARCH APPROACH
• Evaluative approach

15. RESEARCH DESIGN
• Quasi Experimental Research Design
• Pre-test Post-test design
Experimental Group 1 Pre test intervention Post test
Experimental Group 2 Pre test intervention Post test

16. VARIABLES UNDER STUDY
Independent Variable:
• Cartoon videos
• Bubble blowing.
Dependent Variable:
Pain Perception.

17. RESEARCH SETTING
• The current study will be conducted in the Paediatric
ward at RajaRajeswari Medical college and Hospital,
Kambipura, Mysore Road, Bangalore.
• RajaRajeswari Medical college and Hospital is a 1100
bedded multispecialty Hospital.
• In Particularly Paediatric unit has 150 bedded.
• Department of Pediatric offers comprehensive critical
care facilities with 20 beds in NICU, 40 beds are
devoted to PICU,90 bedded to medical and surgical ward
which consists of three units 30 beds of each .
• Occupancy of bed especially in Medical and Surgical
ward for the past three months were 65% ,73% and 59%.
• Average bed occupancy is 66%

18. SAMPLE
POPULATION
Samples
Sample Size
Sampling
Technique:
The population of study include children’s
undergoing Intravenous Injection.
(Age: 8-12years)
Children’s undergoing IV Cannulation were
admitted in the pediatric ward of RRMCH ,
Bangalore are the sample for the study.
Sample size for present study is 30.
Exp.gp1: 15 Exp.gp2: 15
Purposive Sampling

19. SAMPLING CRITERIA
1. INCLUSIVE CRITERIA:
 Children of both the sexes.
 Children age for 8-12 years.
 Child should be conscious (i.e. able to
respond to painful stimuli).
 Child should be admitted in paediatric ward
RRMCH
 Child should not be under effect of any
sedative/anticonvulsant/analgesic drug.

20. 2.EXCLUSIVE CRITERIA
 School age children who are not available
during data collection.
 Who has history of chronic disease
condition.
 Who is taking oral supplements..
 Who have congenital malformations

21. TOOL FOR THE STUDY
• Standardized FACES pain scale will be used to depict pain
perception in children.
• The scale shows a series of faces ranging from a happy face at
0, "No hurt" to a crying face at 10 "Hurts worst" with
maximum score
• The researcher chose the face that best described how child
feels during intravenous injection.

22. • Structured Demographic Questionnaires:
which includes Socio Demographic variables
and health related variables like age , sex, level
of education , residence , diagnosis,name of
Medication (IV) ,Frequency of Medication,
Site of cannulation, Size of Cannula etc.

23. PROCEDURE
• An official permission will be obtained from the Hospital Authority
and HOD of paediatric unit.
• Oral and Written Consent and assents will be made after an
explanation of the aim, tools, benefits and duration of the study.
• First the socio-demographic data is to be collected using the
structured demographic questionnaire for 10-15 minutes for each
child.
• After that each child should be shown cartoon videos before the
time of administration of IV injection about 5-10 minutes and it will
be continued during and after the time of administration of IV
injection .
• During the time of administration of IV injection the researcher
should measure the intensity of pain by using Standardized FACES
pain scale. It takes about 2-3 minutes.
• For Experimental Group 2 Bubble blowing machine will be given to
the children and instruct to blow the bubbles. And the researcher
will be carried out the same steps to record the data.

24. PILOT STUDY
An initial pilot study will be done on 10% hospitalized
children to evaluate the content of tools , its objectivity
and its feasibility and to explain any discrepancies in the
tools.

25. DATA ANALYSIS
The data will be analyzed by means of
descriptive and inferential statistics.
1. DESCRIPTIVE STATISTICS
Frequency and percentage will be used to
describe the following in Experimental
group1& Experimental group 2
• Demographic variables
• Pre test and post test scores on pain
perception among children

26. CONT..
2)Inferential Statistics:
• ‘Paired t’ test will be used to compare pre and
post test scores of pain level among school
age children’s between experimental group(1)
& experimental group (2).
• “Student t” test will be used to compare pre
and post test scores between of pain level
among the school age children's between
experimental group (1) & experimental group
(2).
• Chi-square test was used to examine the
association between post test score of the
anxiety level with selected demographic
variables among school age children.