Children's reactions and responses to pain differ from adults due to their immature body systems, developmental characteristics, and coping methods. Pain is used together with the concept of nociception in neurophysiology. Nociception is the totality of electrochemical events that begin with tissue damage and occur between pain perception. Nociceptors are free nerve endings located in the skin and subcutaneous tissue. Pain transmission from nociceptors occurs via A and C fibers. Knowing the physiology of pain and the child's responses plays an important role in nursing care. Among the short and long-term negative consequences of pain are; decreased comfort in the child, delayed healing, negatively affecting neurodevelopment, and causing hyperalgesia (Cardin et al., 2015; Çavuşoğlu, 2019; İnangil et al., 2020; Pillai Riddell et al., 2015).

One of the places where children experience the most intense pain and fear is emergency room. Some of the children who apply to the emergency department are followed up in the emergency department due to lacerations. Depending on the size and depth of the cut, the children are sutured. Different rates have been reported in the literature regarding the frequency of suturing. In the study conducted by Fidancı et al. (2021), it was determined that 36 (18.4 %) of 210 cases between the ages of 1–17 who applied to the emergency room had laceration-cut, and 30 (16 %) of the cases were sutured due to the cut (Fidancı et al., 2021). Similarly, in the study conducted by Albayati et al. (2021), it was determined that boys who applied to the emergency room with facial cuts were injured more than girls and that children aged 6–11 years old applied the most (Albayati et al., 2021).

Suturing is an invasive procedure and causes pain and fear in children. Children's high levels of pain and fear make it difficult to comply with the procedure. During invasive procedures, children cry, scream, express pain and fear, refuse procedures and treatment, and make it difficult for nurses to suture by moving the area to be sutured. As a result, children develop a fear of the hospital, the procedures to be performed, and health professionals. In this process, by using nonpharmacological distraction methods, the child's awareness of pain is reduced as a result of directing attention to the distractor rather than the pain (Ugucu et al., 2022). Distraction techniques are expected to affect at least one stimulus such as hearing, vision, or movement. Virtual reality glasses, one of the distraction techniques for children, give the feeling of being in a real environment in the minds of children with three-dimensional pictures and animations designed in a computer environment using technological tools (Kudubeş et al., 2021). With virtual reality glasses, children's attention is drawn to visual and auditory stimuli, distracting them from non-receptive pain, providing multi-sensory input, and reducing the child's pain (Walther-Larsen et al., 2019; Wong et al., 2019). Gold and Mahrer (2018) determined that the pain and anxiety scores of children using virtual reality glasses to prevent procedural pain during phlebotomy decreased significantly compared to the control group, and the satisfaction of the child and parent increased (Gold & Mahrer, 2018). In their study conducted by Walther-Larsen et al. (2019) with 64 children scheduled for venous intervention, the group using virtual reality glasses was made to watch an interactive virtual reality game in addition to standard care services. While there was no significant difference between the groups in terms of pain scores, patient satisfaction was reported to be higher in the group using virtual reality glasses (Walther-Larsen et al., 2019). Studies are showing that using virtual reality glasses during vascular access reduces the feeling of pain (Atzori et al., 2018; Özkan & Polat, 2020).

There are studies in the literature showing that playing digital games (Kavlakci et al., 2023), watching cartoons (Choi and Choi & Kim, 2021), and using a kaleidoscope (Taspinar & Turkmen, 2024) as a distraction method during the suture procedure reduce pain or fear. In addition, May et al. (2021) stated in their study with children aged 7–17 who underwent suture removal in orthopedic patients that the use of virtual reality glasses was effective in preventing pain and fear during medical procedures (May et al., 2021). However, no study has been found showing the effect of watching videos using virtual reality glasses on pain and fear in children during the suturing procedure. Suturing is an invasive procedure. When children see the suture needle, they experience fear, cry, and refuse the procedure. They also experience pain during the suturing process and their compliance with the procedure becomes more difficult. Virtual reality glasses used as a visual and auditory distraction method can be effective in reducing pain during painful procedures (May et al., 2021; Özkan & Polat, 2020). However, to our knowledge, this is the first study to determine the effect of watching a video with virtual reality glasses on pain and fear during the suturing procedure. Therefore, this study aimed to investigate the effect of watching videos using virtual reality glasses during suturing on procedural pain and fear in children.

H10: There is no difference in pain scores during and after suturing in children watching videos with virtual reality glasses compared to the control group.

H11: There is a difference in pain scores during and after the suturing procedure in children watching videos with virtual reality glasses compared to the control group.

H20: There is no difference in fear scores during and after the suturing procedure in children watching videos with virtual reality glasses compared to the control group.

H21: There is a difference in fear scores during and after the suturing procedure in children watching videos with virtual reality glasses compared to the control group.