ORIGINAL MANUSCRIPT Effects of balloon inflation and cough trick methods on easing pain in children during the drawing of venous blood samples: A randomized controlled trial Birsen Mutlu and Serap Balcı Birsen Mutlu, PhD, is Assistant Professor; and Serap Balcı, PhD, is Assistant Professor, Istanbul University Florence Nightingale Nursing Faculty—Pediatric Nursing, Istanbul, Turkey Search terms Balloon inflation, child, cough trick, drawing blood, effect on method, Face Pain Scale-Revised, nonpharmacological method, pain, randomized control trial. Author contact bdonmez@istanbul.edu.tr, with a copy to the Editor: roxie.foster@ucdenver.edu Acknowledgement This research was supported by the Research Fund of Istanbul University, Turkey. Disclosure: The authors report no actual or potential conflicts of interest. First Received October 14, 2014; Revision received March 1, 2015; Accepted for publication March 2, 2015. doi: 10.1111/jspn.12112 Abstract Purpose. The purpose was to determine the effects of the balloon inflation and cough trick methods on easing pain in children during the drawing of venous blood samples. Design and Methods. In this prospective randomized controlled study, 9- to 12-year-old children in the intervention groups were asked to cough or inflate balloons during the venipuncture procedure. The Faces Pain Scale- Revised was used to assess pain intensity. Results. Pain intensity significantly differed between the control (n = 44) and intervention groups (balloon inflation [n = 44] and cough trick [n = 44], p < .001). Practice Implications. Coughing and inflating balloons during veni- puncture do not require preparation and are time saving, easy, accessible, and effective in reducing pain. Pain, generally a feeling that is first experienced in childhood, is one of the most momentous phenom- ena in a child’s life (O’Rourke, 2004; Young, 2005). Today, pain is considered the “fifth vital sign” to monitor in medical care, and health professionals should monitor and manage it when caring for pediatric patients (Cohen et al., 2008). Achieving intravenous access is a medical procedure that is fre- quently applied to children presenting at a hospital, and it is a significant source of pain and stress (Hughes, 2012; Kolk, van Hoof, & Fiedeldij Dop, 2000; Leahy et al., 2008; Stinson, Yamada, Dickson, Lamba, & Stevens, 2008; Uman, Chambers, McGrath, & Kisely, 2008). It has been reported that painful experiences suffered in childhood continue to have an effect in adulthood and may cause an increasing reaction to pain and avoidance of medical procedures in later life (Jones, DeMore, Cohen, O’Connell, & Jones, 2008; Kennedy, Luhmann, & Zempsky, 2008; Leahy et al., 2008; Mahoney, Ayers, & Seddon, 2010; Young, 2005). The American Academy of Pediatrics and the American Pain Society recommend that stress and pain should be reduced to a minimum or lessened, even in minor practices such as achieving intravenous access (American Academy of Pediatrics, Committee on Psychosocial Aspects of Child, Family Health, Task Force on Pain in Infants, Children, and Adolescents, 2001). Reducing or eliminating the pain that chil- dren experience in these interventions is, therefore, very important (DeMore & Cohen, 2005; Kennedy et al., 2008; Leahy et al., 2008). Distraction is a non-pharmacological intervention used often to reduce needle-related procedural pain in children (Uman, Chambers, McGrath, & Kisely, 2006). There are two main types of distraction tech- niques: active and passive (Wohlheiter & Dahlquist, 2013). The active distraction method involves Journal for Specialists in Pediatric Nursing 1 Journal for Specialists in Pediatric Nursing •• (2015) ••–•• © 2015, Wiley Periodicals, Inc.