The Palm Stimulator is grasped in the palm during painful interventions and provides stimulation. Blunt protrusions around the apparatus provide tactile stimulation in the palm. The blunt protrusions have been found to reduce the pain perceived during the intervention by closing the pain gate in the spinal cortex by creating stimuli according to the gate control pain theory without penetrating the skin. The researchers who developed the apparatus were contacted via e-mail and permission was obtained for using the palm stimulator.

In the study, the child held the palm stimulator in the palm during the PIK procedure, and the researcher evaluated pain and fear. After the PIK procedure was completed, the child was asked to release the apparatus from the palm.

Distraction by watching cartoons is a promising, cost-effective, and non-pharmacologic technique to reduce pain in children undergoing painful procedures. The cartoon was selected by expert researchers from the pediatric field in the research team following the age and consciousness level of the children. A projection device was placed in the intervention room for data collection. The cartoon was projected on a blank wall in the intervention room. The cartoon was played in preparation for the PIK procedure, and children were allowed to watch it until it was completed.

In the control group, the routine application phase was performed. Age-appropriate children were seated in the blood sampling chair, and those who could not sit were placed on a stretcher, and PIK was performed. The parent was also taken to the intervention room during the procedure.

The apparatus is 1.6 cm in diameter and 4 cm long. It has a cylindrical, non-slippery and easy-to-grasp structure for maximum contact with the palm

Before, during, and after the PIK procedure in intervention and control groups. Wong-Baker FACES Pain Scale: The scale used to diagnose pain in children was developed by Donna Lee Wong and Connie Morain Baker. The Wong-Baker Scale has been reported to be safe to use in children aged 3-18 who can verbally describe the level of pain. The scale includes facial expressions and numbers. The scale has a total of six facial expressions, and pain is graded between 0-10 (Wong & Baker, 1988).

Fear assessment before, during, and after the PIK procedure in intervention and control groups.

Child Fear Scale: The Turkish psychometric properties of the scale adapted to pediatric patients as "Children's Fear Scale" by McMurty et al. (2011) were evaluated by Özalp Gerçeker et al. The CSA is a scale consisting of five drawn facial expressions ranging from neutral expression (0=no anxiety) to frightened face (4=severe anxiety) and evaluated between 0 and 4 (Özalp Gerçeker et al., 2018). It can be used by families and researchers to assess pain and anxiety before and during the procedure and is intended for children aged 5-10 years. In the Turkish reliability and validity study, the content validity index of the scale was found to be 0.89 (Özalp Gerçeker et al., 2018).

Satisfaction assessment after the PIK procedure in intervention and control groups.

Individuals were asked to give a score between 0-10 to determine their satisfaction. A score of "0" means "not at all satisfied", while a score of "10" means "very satisfied".