The goal of this clinical trial is to learn which distraction method works better to reduce needle pain in children aged 4-12 years during blood draws.

The main questions it aims to answer are:

• Does watching cartoon videos lower children's pain more than squeezing a stress ball?

• Which method do parents prefer for their children?

  120 children will be randomly assigned to watch cartoons or squeeze a ball while nurses draw blood. Pain will be measured using a 0-10 pain scale right after the needle.

This study will help nurses choose the best way to make blood draws less painful for children.

This study compares two distraction methods (cartoon projection vs. ball squeezing) to reduce venipuncture pain in children aged 4-12 years.

120 children will be randomized 1:1 to receive either immersive cartoon videos or tactile stress ball distraction during routine blood draws at Karbala Pediatric Hospital.

Pain intensity (primary outcome) will be assessed using Visual Analogue Scale (VAS, 0-10; higher=worse) immediately post-procedure.

The study protocol received ethical approval from University of Baghdad College of Nursing (No. 77, Jan 29, 2026).

Inclusion Criteria:

• Children aged 4-12 years
• Requiring venipuncture for routine blood testing
• Able to watch cartoon video during procedure
• Parental consent obtained

Exclusion Criteria:

• Developmental delay preventing cooperation
• Severe anxiety disorder
• Visual impairment
• Non-English/Arabic speaking parents