Discussion
venipuncture-induced pain, anxiety, pain
This study is one of few comparing the topical anesthetic (i.e. EMLA emulsion), the distraction techniques (i.e. toy whistle, books, cartoon animation, video games, and breathing exercises), and the combination of the two interventions above in mitigating pain during venipuncture in the pediatric ward. Due to ethical considerations, we did not set a control group with no pain control. Instead, results from previous studies were used as a comparison to show that children undergo severe pain when there is no pain relief during venipuncture [Psychological interventions like distractions aim to help children to develop and use their coping skills to manage pain and distress and can be used by non-psychologist [Focusing on something other than pain can keep patients from fear and anxiety [In the EMLA group, we used EMLA emulsion to inhibit the transmission of nerve impulses to reduce venipuncture-induced pain. While this method is proven effective in previous studies [Contrary to expectations, although the results showed the effectiveness of the integration of EMLA emulsion and distraction techniques in the combined group for reducing pain consistent with Heiden’s research, it did not show the statistical differences between the EMLA group and distraction group [The salivary collection allows for non-invasive, timed measurement of free cortisol. It is associated with the hypothalamus–pituitary–adrenal axis (HPAA) adaptation to stress. A systematic review shows salivary cortisol is a clear indicator of stress in children and adults [