Use of a Preoperative Playroom to Prepare Children for Surgery

Abstract

Objective: The aim of this study was to evaluate the efficacy of a playroom next to the operating room to reduce preoperative anxiety in children.

Methods and Materials: In 2009, we designed a playroom in a preoperative waiting room in our hospital. The playroom had colored toys and cars appropriate for different ages and a TV and video to show cartoons. Patients were randomly assigned into a case or a control group. Control group patients were admitted to the preoperative waiting room 30 min prior to operation. Case group patients were admitted to the playroom for the same period of time. The anxiety levels of the children were compared using the modified Yale Preoperative Anxiety Scale (m-YPAS).

Results: In this study 200 children were evaluated (100 patients in the case group, 100 patients in the control group). There were 20 female and 80 male patients in the case group with a mean age of 4.33±1.5 years and 26 female and 74 male patients in the control group with a mean age of 3.87±1.2 years (p=NS). Inguinal herniorraphy was the most common procedure in both groups. Preoperative anxiety was significantly decreased for all categories of the anxiety score as assessed by m-YPAS questionnaire.

Conclusion: A preoperative playroom is a very effective method to reduce preoperative anxiety in children.

Key words

preoperative anxiety - anxiety questionnaire - playing - m-YPAS

References

• 1 Bringuier S, Dadure C, Raux O. et al . The perioperative validity of the visual analog anxiety scale in children: a discriminate and useful instrument in routine clinical practice to optimize postoperative pain management.  Anesth Analg. 2009;  109 (3) 737-744
• 2 Wollin SR, Plummer JL, Owen H. et al . Anxiety in children having elective surgery.  J Pediatr Nurs. 2004;  19 (2) 128-132
• 3 Doverty N. Therapeutic use of play in hospitals.  Br J Nurs. 1992;  1 77-81
• 4 LeVieux-Anglin L, Sawyer EH. Incorporating play interventions into nursing care.  Pediatr Nurs. 1993;  19 459-463
• 5 Vessey JA, Mahon MM. Therapeutic play and the hospitalized child.  J Pediatr Nurs. 1990;  5 328-333
• 6 Li HC, Lopez V, Lee TL. Psycho educational preparation of children for surgery: the importance of parental involvement.  Patient Educ Couns. 2007;  65 (1) 34-41
• 7 Cohen J. A power primer.  Psychol Bull. 1992;  112 155
• 8 Polit DF, Beck CT. Nursing Research: Principles and Methods. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2004
• 9 Kain ZN, Mayes LC, Cicchetti DV. et al . The Yale Preoperative Anxiety Scale: how does it compare with a “gold standard’.  Anesth Analg. 1997;  85 (4) 783-788
• 10 Spielberger CD. Manual for the State-Trait Anxiety Inventory for Children. Palo Alto, CA: Consulting Psychologists Press; 1973
• 11 Vangoli L, Caprilli S, Robiglio A. et al . Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study.  Pediatrics. 2005;  116 e563-e567
• 12 Gorayeb RP, Petean EB, de Oliveira Pileggi F. et al . Importance of psychological intervention for the recovery of children submitted to elective surgery.  J Pediatr Surg. 2009;  44 (7) 1390-1395
• 13 Lumley MA, Melamed BG, Abeles LA. Predicting children's presurgical anxiety and subsequent behaviour changes.  Journal of Pediatric Psychology. 1993;  184 481-497
• 14 Yip P, Middleton P, Cyna AM. et al . Non-pharmacological interventions for assisting the induction of anaesthesia in children.  Cochrane Database of Systematic Reviews. 2009;  Issue 3. Art. No.: CD006447. DOI: 10.1002/14651858.CD006447.pub2
• 15 Li HC, Lopez V. Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: a randomized controlled trial study.  J Spec Pediatr Nurs. 2008;  13 (2) 63-73
• 16 Li HC. Evaluating the effectiveness of preoperative interventions: the appropriateness of using the Children's Emotional Manifestation Scale.  J Clin Nurs. 2007;  16 (10) 1919-1926
• 17 Oppenheim D, Simonds C, Hartmann O. Clowning on children's wards.  Lancet. 1997;  350 1838-1840
• 18 Bornstein Y. Medical clowns at hospitals and their effect on hospitalized children.  Harefuah. 2008;  147 (1) 30-32
• 19 Golang G, Tighe P, Dobija N. et al . Clowns for the prevention of preoperative anxiety in children: a randomized controlled trial.  Pediatr Anesth. 2009;  19 (3) 262-266
• 20 Larosa-Nash PA, Murphy JM. Behavioural disorders in children.  AORN J. 2005;  61 (3) 526-531
• 21 Stewart EJ, Algren C. Reducing anxiety in children and adolescents.  Todays OR Nurse. 2005;  16 (2) 9-14

Correspondence