Using a Stress Ball on Fear, Anxiety, Pain, and Satisfaction During Allergy Testing

NCT07750236 | Recruiting

• 1 other identifier: 2026/112
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to evaluate and compare the effects of watching cartoons and using a stress ball on levels of fear, anxiety, pain, and satisfaction among 90 children aged 4-10 undergoing skin prick testing at the Pediatric Allergy Outpatient Clinic of Çukurova University Balcalı Hospital. Participants will be randomly allocated via a computer algorithm into three equal groups ($n = 30$ each): a cartoon-watching intervention group, a stress ball intervention group, and a control group receiving routine pediatric care. Data will be gathered using a Demographic Information Form, the Children's Fear Scale, the Children's Anxiety Scale-State, the Wong-Baker FACES Pain Rating Scale, and a Child Satisfaction Form at three time points-2 minutes prior to the test, immediately after the procedure, and at the 15th-minute post-test evaluation-through child, parent, and observer nurse assessments.

Conditions

Child Allergy; Anxiety; Fear; Pain

Keywords

child; anxiety; fear; pain; satisfaction

Outcome Measures

Primary Outcomes (3)

• anxiety level

  Child Anxiety Scale-Dispositional Scale (CAS-D): It was developed by Ersig et al. (2013) to measure the anxiety levels of children aged 4-10 years. The CAS-D scale is shaped like a thermometer with a light bulb at the bottom and horizontal lines with intervals going upwards. In this scale for children aged 4-10 years, children are asked 'Imagine that all your anxious or nervous feelings are at the bulb or bottom of the thermometer' or 'If you are a little worried or nervous, the feelings may go up a little on the thermometer. If you are very, very anxious or nervous, emotions can go all the way to the top. Put a line on the thermometer showing how anxious or nervous you are'. In order to measure state anxiety (CAS-D), the child is asked to tick how he/she feels 'right now'. The score can range from 0-10.

  1 hour

• fear level

  Child Fear Scale: The scale was developed by Thurillet et al. It was developed to evaluate children\'s fears based on self-report of children aged 4-12 years. The scale consists of six facial expressions. The scale grades fear with a score ranging from 0 to 10 (gradually graded two by two) consistent with pain rating scales. The first facial expression shows that there is no fear, the fear increases as you go from right to left, and the sixth facial expression shows that the level of fear is the highest. A statistically significant positive and very high correlation was obtained between the Fear Scale and the Child Fear Scale (r=0.973; p;0.001). The high correlation value between the two forms shows that the child form is valid.

  1 hour

• pain level

  Wong Baker Pain Scale: It was developed by Donna Wong and Connie Morain Baker in 1980 and adapted again in 1983 to measure the pain levels of paediatric patients. There are 6 facial expressions scored between 0-5. In the Wong-Baker Scale, there are facial expressions indicating the degree of pain increasing from 0 to 5 from left to right.

  1 hour

Secondary Outcomes (1)

• satisfaction level

  1 hour

Study Arms (3)

cartoon-watching group

EXPERIMENTAL

Children in this group will engage in passive distraction by watching cartoons.

Other: cartoon-watching group

stress ball group

EXPERIMENTAL

Children in this group will engage in active physical distraction by using a stress ball.

Other: stress ball group

control group

NO INTERVENTION

Children in this group will receive the standard clinical care provided by the outpatient clinic without any specific non-pharmacological distraction interventions.

Interventions

cartoon-watching group OTHER

Children in this group will engage in passive distraction by watching cartoons.

cartoon-watching group

stress ball group OTHER

Children in this group will engage in active physical distraction by using a stress ball.

stress ball group

Eligibility Criteria

• Age: 4 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Aged 4-10 years
• Undergoing an allergy test for the first time
• Voluntary participation by both the child and the parent

You may not qualify if:

• The child must not have taken any medication prior to the skin test
• The child must have a visual, hearing, or intellectual disability
• The child must have a physical condition that would prevent them from using the stress ball

Sponsors & Collaborators

• Tarsus University: lead

Study Sites (1)

Tarsus University

Tarsus, Turkey (Türkiye)

RECRUITING

Related Publications (6)

• Aguero CA, Sarraquigne MP, Parisi CAS, Marino AI, Lopez K, Menendez Porfirio B, Sasia L, Lozano A, Bovina Martijena MDP, Gervasoni ME, Bozzola M, Colella M, Saranz R, Orellana J, Maspero JF, Seisdedos V, Behrends I, Blanco A, Dayan P, Matta Ruffolo M, Araoz I, Casaniti C, Garcia J, Skrie V, Garcia M, Suarez Garcia JM, Orellano F, Luconi N, Bandin G. [Allergic rhinitis in pediatrics: recommendations for diagnosis and treatment]. Arch Argent Pediatr. 2023 Apr 1;121(2):e202202894. doi: 10.5546/aap.2022-02894. Spanish.

  PMID: 36924507 BACKGROUND

• Ansotegui IJ, Melioli G, Canonica GW, Caraballo L, Villa E, Ebisawa M, Passalacqua G, Savi E, Ebo D, Gomez RM, Luengo Sanchez O, Oppenheimer JJ, Jensen-Jarolim E, Fischer DA, Haahtela T, Antila M, Bousquet JJ, Cardona V, Chiang WC, Demoly PM, DuBuske LM, Ferrer Puga M, Gerth van Wijk R, Gonzalez Diaz SN, Gonzalez-Estrada A, Jares E, Kalpaklioglu AF, Kase Tanno L, Kowalski ML, Ledford DK, Monge Ortega OP, Morais Almeida M, Pfaar O, Poulsen LK, Pawankar R, Renz HE, Romano AG, Rosario Filho NA, Rosenwasser L, Sanchez Borges MA, Scala E, Senna GE, Sisul JC, Tang MLK, Thong BY, Valenta R, Wood RA, Zuberbier T. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J. 2020 Feb 25;13(2):100080. doi: 10.1016/j.waojou.2019.100080. eCollection 2020 Feb.

  PMID: 32128023 BACKGROUND

• NIAID-Sponsored Expert Panel; Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010 Dec;126(6 Suppl):S1-58. doi: 10.1016/j.jaci.2010.10.007.

  PMID: 21134576 BACKGROUND

• Chamani, S., Mahmoudzadeh, S., Rezapour, H., & Fereidouni, M. (2021). Frequency of allergic sensitivity to local herbs pollen among medical students in east of Iran by use of skin prick test. Alergia Astma Immunologia, 26(1), 27-35.

  BACKGROUND

• Erdim L. The effect on pain and anxiety levels of using DistrACTION(R) Cards to distract children during a skin-prick test: a randomized controlled experimental study. Minerva Pediatr (Torino). 2022 Apr;74(2):167-175. doi: 10.23736/S2724-5276.21.06008-0. Epub 2021 Apr 2.

  PMID: 33820412 BACKGROUND

• Gurbuz F, Geckil E, Guner SN. The effect of virtual reality and buzzy(R) on pain, fear, and anxiety during skin prick testing in children: a randomized controlled trial. Eur J Pediatr. 2026 May 5;185(6):349. doi: 10.1007/s00431-026-07020-3.

  PMID: 42086773 BACKGROUND

MeSH Terms

Conditions

Anxiety Disorders; Pain; Personal Satisfaction

Condition Hierarchy (Ancestors)

Mental Disorders; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Central Study Contacts

Atiye KARAKUL

CONTACT

903246000033; atiyekarakul@tarsus.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc. Prof.

Study Record Dates

• First Submitted: August 1, 2026
• First Posted: August 6, 2026
• Study Start (Estimated): August 10, 2026
• Primary Completion (Estimated): April 10, 2027
• Study Completion (Estimated): May 10, 2027
• Last Updated: August 6, 2026

Record last verified: 2026-08

Locations

TU (1)