This randomized controlled trial aimed to evaluate the effects of kaleidoscope and helicone distraction tools on pain and anxiety levels during venipuncture in school-age children. The study was conducted at Ankara Etlik City Hospital Pediatric Emergency Department between April and May 2025. A total of 210 children aged 6 to 12 years who were undergoing venous blood sampling for the first time were randomly assigned to one of three groups: Kaleidoscope, Helicone, or Control (standard care). The Kaleidoscope group used a passive distraction tool featuring dynamic visual patterns; the Helicone group used an active distraction tool that involves hand manipulation of a rotating toy. Pain levels were measured using the Wong-Baker FACES Pain Rating Scale, and anxiety levels were assessed using the Children's Anxiety Meter-State (CAM-S). Measurements were taken before, during, and after the procedure. This study seeks to determine the comparative effectiveness of active versus passive distraction techniques in pediatric procedural pain and anxiety management. All interventions were non-pharmacological, non-invasive, and conducted in a safe clinical setting with informed consent obtained from both children and their guardians.

Inclusion Criteria:

• Children aged between 6 and 12 years
• Requiring venipuncture for clinical purposes
• Able to verbally communicate pain and anxiety
• Accompanied by a parent or legal guardian who provides written informed consent
• Child provides verbal assent to participate

Exclusion Criteria:

• Children with cognitive or neurological disorders affecting pain or anxiety perception
• Use of any analgesics, anxiolytics, or sedatives within 6 hours prior to the procedure
• Visual or hearing impairments that interfere with the use of kaleidoscope or helicone
• Previous experience with similar distraction tools
• Presence of any skin condition preventing pain scale assessment