the effect of combined external cold and vibration during immunization on pain and anxiety levels in children

Context: pain associated with needle procedures is very common among children and causes discomfortamong them.aim: the purpose of this study is to evaluate the effectiveness of combined external cold and vibrationduring immunization on pain and anxiety levels in children.setting and design: this study was a randomized clinical trial in the abdullahi comprehensive healthservices center in qom, iran, in 2019.materials and methods: one hundred and five eligible children were allocated into experimental(external cold and buzzy), placebo (off buzzy device without cold), and control groups (no intervention).simultaneous external cold and vibration (with buzzy device) and appalling off buzzy device were used inthe experimental and placebo groups, respectively. children in the control group had received routine careduring immunization. the pain and anxiety levels of the children were measured using the wong–bakerfaces scale and children’s emotional manifestation scale.statistical analysis used: data were analyzed using chi‑square, one‑way anova, ancova, and scheffepost hoc analysis.results: pain during immunization in the experimental group (3.71 ± 1.61) was significantly lower than theplacebo (5.25 ± 1.37) and control groups (4.45 ± 4.45). the difference between before and after anxietylevel was not significant in the three study groups (p < 0.001).conclusion: the simultaneous external cold and vibration (with buzzy device) can be used as an effectiveintervention in pain reduction during intramuscular vaccine injection in children.