title: The effect of combined stimulation of external cold and vibration during immunization on pain and anxiety levels in children.
abstract: OBJECTIVE
  Procedures involving needles are the most common and major sources of pain in children. External cold and vibration via Buzzy (MMJ Labs, Atlanta, GA) is a method that combines cooling and vibration.
  
  
  METHODS
  This study investigated the effect of the combined stimulation of skin with external cold and vibration via Buzzy on the pain and anxiety levels in children during immunization.
  
  
  METHODS
  This study was a prospective, randomized controlled trial. Children were randomized into two groups: experimental (external cold and Buzzy) and control (no intervention). The pain and anxiety levels of the children were assessed using the Wong-Baker FACES scale and Children Fear Scale.
  
  
  RESULTS
  The experimental group showed significantly lower pain and anxiety levels than the control group during immunization.
  
  
  CONCLUSIONS
  The combined stimulation of skin with external cold and vibration can be used to reduce pain and anxiety during pediatric immunization.
authors.forename: Nejla
authors.initials: N
authors.lastname: Canbulat Şahiner
authors.forename: Sevil
authors.initials: S
authors.lastname: İnal
authors.forename: Ayşe
authors.initials: A
authors.lastname: Sevim Akbay
mesh_terms: D001007:Anxiety / Q000517:prevention & control*; D002648:Child; D003080:Cold Temperature; D005260:Female; D006801:Humans; D007114:Immunization; D008297:Male; D010146:Pain / Q000517:prevention & control*; D014732:Vibration
keywords: Buzzy; external cold and vibration; pediatric immunization; pediatric nursing; procedural pain and anxiety