Effect of Distraction Interventions on Anxiety in Children Undergoing Surgery: A Meta-Analysis (original) (raw)
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The Effects of Distraction on Preoperative Anxiety Level in Children
Journal of PeriAnesthesia Nursing, 2016
The purpose of this study was to investigate the effects of distraction on the preoperative anxiety levels of pediatric patients. Design: A prospective, two-group experimental design was used. Methods: This study was conducted in the clinic of pediatric surgery of a university hospital in Turkey between November 20, 2013 and January 25, 2014. The population of the study was composed of a total of 83 children (40 in the study group and 43 in the control group) who met the inclusion. The data were collected using the ''Personal Information Form, '' ''Separation Scoring, '' and ''State-Trait Anxiety Inventory for Children-State Form. '' Distraction was performed on the children in the study group during the preoperative period. No intervention was applied to the children in the control group. Finding: The results of this study demonstrated that the separation scores and State-Trait Anxiety Inventory for Children-State scores of the children in the study group, on whom distraction was applied, were lower than those of the control group. Conclusions: Distraction applied to children in the preoperative period significantly reduced anxiety and separation anxiety.
Athens Journal of Health and Medical Sciences, 2022
Children experience high levels of anxiety before surgery. Preoperative anxiety interferes with anesthesia induction compliance and is associated with many short and long-term postoperative complications The aim of this integrative review was to evaluate the impact of distraction methods on preoperative anxiety in preschool and school-age children compared to standard of care or conventional methods. A systematic search of literature was conducted using PubMed and CINHAL databases. We found 15 full-text articles in English published, between the years 2015-2019 on preschool and school-age children on PubMed, CINHAL, and keyword search according to inclusion criteria. The tools used to measure the children’s anxiety included a personal information from, separation scoring, index of clinical stress score, modified Yale preoperative assessment scale, the state-trait anxiety inventory for children, post hospitalization behavior questionnaire, Hamilton anxiety rating scale, and vital sig...
Background Perioperative experience can be one of the most distressful experiences in a child's life if not managed properly by healthcare professionals. Its consequences can extend well beyond surgery and recovery into the child's future life. Healthcare professionals have a responsibility to decrease the anxiety associated with this experience, improve the child's and the parent's experience and prevent negative consequences. This has traditionally been performed through pharmacological treatment which might have negative side effects. More developmentally appropriate distraction methods are currently being trialled globally to augment the evidence that supports their use as a similarly efficient alternative. Objectives The aim of this study was to explore the efficiency of storytelling, pictures and colouring activities as an anxiolytic intervention in comparison to the traditional pharmacological premedication technique in a non-inferiority study. Study design A randomized non-inferiority controlled trial was carried out in 168 children scheduled for day surgery. Children's perioperative anxiety was assessed by a trained anaesthetist using the modified Yale Preoperative Assessment Scale and by parents using the State-Trait Anxiety Inventory for Children. Children's vital signs were also collected preoperatively during the induction period and during the recovery period. Results The primary endpoint, which is non-inferiority in terms of anxiety as per Yale Preoperative Assessment Scale survey between play distraction and preoperative medication, was met [average score 10.95 vs. 10.94, respectively, 95% confidence interval (À0.35; 0.37); P = 0.941]. Moreover, anxiety scores of both the intervention and the control group were quite comparable as per STAIC survey [20.90 vs. 20.73, respectively, 95% confidence interval (À0.52; 0.88); P = 0.708] and in terms of vital signs. Conclusion The results indicate that the distraction technique employed can be considered as an efficient alternative to traditional pharmacological premedication for children undergoing day surgery.
Open Journal of Nursing
Background: Children who undergo a day case surgery experience high levels of preoperative anxiety. Preoperative anxiety interferes with anesthesia induction compliance and is associated with many short and long term postoperative complications. Recently, video distraction intervention has been evaluated for its anxiolytic effects in preoperative children. Aim: The aim of this integrative review was to demonstrate the varying methodological approaches utilized to evaluate the effectiveness of a video distraction intervention in reducing preoperative anxiety in children undergoing day case surgery. Methods: A total of 8 articles, meeting the inclusion criteria, were evaluated and included. Findings: The eight studies investigating the effect of video distraction on children preoperative anxiety concluded that video distraction was significant in controlling children preoperative anxiety. Four of the eight studies (50%), investigated video distraction effectiveness against pharmacological comparisons and demonstrated superior or equal anxiolytic effect of video distraction on different points along the surgical continuum. Three of the eight studies compared video distraction against parental presences and video distraction showed superior anxiolytic effect. Three of the eight studies evaluated the effect of video distraction on anesthesia induction compliance and emergence delirium. A significant effect on anesthesia induction was demonstrated while non-significant effect on emergence delirium was documented. Conclusion: Video distraction is a safe, time and cost effective non pharmacological anxiolytic intervention. It can be provided by nurses to control children high level of anxiety before surgery and during anesthesia induction.
Background: High levels of anxiety during surgery are associated with poorer post-surgical outcomes. This prospective, non-blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction interventions for anxiety and pain management during minimally invasive venous surgery under local anaesthetic. Methods: 407 patients presenting with varicose veins at a private clinic, were randomized to one of four intraoperative distraction interventions or treatment as usual. All participants received endovenous thermoablation and/or phlebectomies of varicose veins. After losses to follow-up, 398 participants were entered into the analysis. Participants were randomly allocated to one of the following intraoperative distraction techniques: patient selected music (n = 85), patient selected DVD (n = 85), interaction with nurses (n = 81), touch (stress balls) (n = 80) or treatment as usual (TAU, n = 76). The state scale of the STAI, the Short-form McGill pain questionnaire and numeric rating scales were used to assess intraoperative pain and anxiety. Results: Intraoperative anxiety ratings were significantly lower when participants interacted with nurses, used stress balls or watched a DVD during surgery compared to treatment as usual. Intraoperative pain ratings were significantly lower than treatment as usual when participants interacted with nurses or used stress balls during surgery. Patients' satisfaction was not significantly impacted by intraoperative distractions. Conclusions: The use of simple intraoperative distraction techniques, particularly interacting with nurses, using stress balls or watching a DVD during surgery conducted under local anaesthetic can significantly improve patients' experiences.
Erciyes Medical Journal, 2023
Objective: Children can experience less pain and anxiety by being informed and distracted. Our goal was to assess the effectiveness of providing information and using an active distraction technique to treat pediatric venipuncture-related pain and anxiety in children. Materials and Methods: One hundred forty-two children between the ages of 3 and 8 years were randomized into three groups: the informed, the informed and distracted, and the control. In the informed group, information was provided to the parents and children in written and verbal forms; in the informed and distracted group, information was also provided to the parents and children while allowing the children to play a puzzle game on the tablet; and in the control group, the routine injection procedure was performed. Parents and an independent observer completed two separate forms to rate the pain and terror of the children. Results: According to the parents/caregivers, fear and pain experience were found to be significantly lower in the informed and distracted group (p=0.001 for pain; p=0.005 for fear) than in the control and the informed groups. Moreover, according to the independent observer, fear and pain experience were similarly found to be significantly lower in the informed and distracted group (p=0.002 for pain; p<0.001 for fear) than in the other two groups. According to the independent observer, the anxiety of the parents was significantly found to be lower in the informed and distracted group (p=0.007) than in the other two groups. Conclusion: Children and their families experience stress as a result of painful procedures. It may be possible to lessen the pain and anxiety that children experience during invasive operations by informing, preparing, and distracting them.
Prevention and Intervention Strategies to Alleviate Preoperative Anxiety in Children
Behavior Modification, 2007
Preoperative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgery experience (e.g., agitation, crying, spontaneous urination, and the need for physical restraint during anesthetic induction). Preoperative anxiety has also been associated with the display of a number of maladaptive behaviors postsurgery, including postoperative pain, sleeping disturbances, parent-child conflict, and separation anxiety. For these reasons, researchers have sought out interventions to treat or prevent childhood preoperative anxiety and possibly decrease the development of negative behaviors postsurgery. Such interventions include sedative premedication, parental presence during anesthetic induction, behavioral preparation programs, music therapy, and acupuncture. The present article reviews the existing research on the various modes of intervention for preoperative anxiety in children....
World Journal of Medical Sciences, 2018
Children's pain can be addressed as a fundamental human right. Pain and distress related to invasive technique can increase children's hospitalization, delay their recovery period which can be worse than the pain because the hospital itself is a very stressful place for families and their children. Distraction technique includes involving the children in intellectual activities to divert attention from painful stimuli and reduce pain and distress. This study aimed to evaluate the impact of distraction techniques on the level of pain, physiological indicators of pain and fears among hospitalized children undergoing selected invasive procedures in Port Said city. Quasi-experimental design was applied in the current study. A sample of 100 child was randomly selected to be included in the study. Children were selected from the pediatric medical ward in two governmental hospitals in Port Said. Four tools were used in the present study; demographic tool, Faces Pain Scale-Revised, Physiological Responses Tool (Vital signs) and The Child Medical Fear Scale tool. Study findings presented that, there were statistically significant differences between children's pain, physiological pain indicators and fear mean scores from before to after using the distracting techniques. It concluded that, distraction techniques had a significant effect on decreasing preschool children's pain and fear associated with invasive procedure. Based on the results of the study, the researchers recommended that, distraction techniques have to be incorporated with usual nursing intervention in combination of pharmacological methods when dealing with children.
Reduction of Preoperative Anxiety in Children Using Non- Pharmacological Measures
Several studies have shown that anxiety in children prior to surgical interventions has a negative effect on post-hospitalization recovery. The objective of the proposed project is to reduce anxiety in children prior to major outpatient surgery using non-pharmacological measures (costumes, games, magic tricks, jokes). These measures are to be used from the moment the children are admitted to hospital (the same morning of the surgery) until anaesthetic induction in the operating room. According to our results, the use of hospital clowns has been proven to reduce psychological discomfort in children in a hospital setting.
Effect of an Active Distraction Method for Pediatric Venipuncture Related Pain and Anxiety
2021
Needle-associated fear and pain in children can lead to poor health consequences and lower uptake rates of medical services. Information and distraction are significant methods in reducing pain and anxiety in children. We aimed to evaluate the effects of giving information and an active distraction method for pediatric venipuncture -related pain and anxiety in 3-8 years old children. Children were randomized into three groups as the control, the informed, the informed and distracted. Fear and pain experience were found to be significantly lower in the informed and distracted group rather than the control and the informed group according to the parents/caregivers. Fear and pain experience were similarly found to be significantly lower in the informed and distracted group than the other groups according to the independent observer. Informing, preparing, coping, distracting methods should be used before, during, and after the invasive procedures to reduce children's pain and anxiety.