PAIN-RELATED FEAR IN CHILDREN DURING PHLEBOTOMY VIA VENIPUNCTURE

J. Raudenska¹, I. Kloubkova¹, A. Javurkova^1|2 | ¹Department of Nursing, 2^nd Faculty of Medicine, Charles University, Prague, Czech Republic; ²Department of Clinical Psychology, University Hospital Kralovske Vinohrady, Prague, Czech Republic

Abstract

Background and Aims. Phlebotomy via venipuncture is the most common painful procedure in children, and children's pain-related fear can negatively affect their experiences with other medically painful procedures.
Methods. Data collection took place from 5/2025 to 1/2026 at the Central Collection Department of the Motol University Hospital in Prague after approval by the ethics committee. Inclusion criteria for data collection were the child's age of 6–15 years, signed informed parental consent, and knowledge of the Czech language. The following methods were used: anamnestic data, the Wong-Baker Faces Pain Rating Scale (WBFPRS, Wong and Baker, 1988), and the Children's Fear Scale (CHFS, McMurtry et al., 2011).
Results. N = 189 children were examined (mean age M = 11.2, SD = 2.5 years, 53% boys). According to the intensity of pain, we divided the children into 3 groups: G1, no pain, WBF 0 (n = 22); G2, mild pain, WBF 2 (n = 133); and G3, moderate to severe pain, WBF 4-10 (n = 34). All groups differed significantly in the level of fear (CHFS) before and after phlebotomy via venipuncture (all post hoc <0.001). The intensity of procedural pain was slightly related to age (rs = -0.222, p = 0.002). Fear before procedure increases significantly the likelihood of moderate to severe procedural pain in our sample (OR = 10.86, 95% CI: 4.60–25.63).
Conclusions. It is important to prevent fear associated with procedural pain during phlebotomy via venipuncture in children and to be able to manage it using non-pharmacological approaches, most often cognitive behavioral therapy.