Non-pharmacological interventions to reduce anxiety among children undergoing surgery: A systematic review

Abstract

A hospitalized child experiences anxiety more frequently as compared to non-hospitalized children. Surgery can be emotionally distressing for children, and subsequently their parents and caregivers, this distress can cause profound adverse impacts on children. We aimed to identify the effect of non-pharmacological interventions on children’s (1–18 years) anxiety undergoing surgery. The following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Proquest, Web" of Science, and Cochrane Central Register of Controlled Trials were systematically searched for full-text articles. The review included 15 randomized controlled trials. The risk of bias was assessed using Cochrane Risk of Bias tool. The interventions included in the study were preoperative education, puppet play, therapeutic play, distraction activities, parental presence, and clown therapy. The review presents a narrative reporting of the findings. This review identifies that non-pharmacological interventions are effective in reducing anxiety among children undergoing surgery. There are a limited number of studies from developing countries. Further research is required to underpin the use of these interventions with children before surgery.

Nursing interventions for the management of preoperative anxiety in the pediatric patient

“…Los estudios de Mathias et al 34 y Dai et al 35 comparan diferentes intervenciones para mejorar el estado ansioso preoperatorio del paciente pediátrico. Se incluyeron intervenciones como la distracción mediante la utilización de plastilina o intervenciones que se centraban en la presencia de los padres 34 que no están incluidas en nuestra revisión y dónde se obtienen buenos resultados en cuanto a la reducción de la ansiedad en los participantes.…”

“…Los estudios de Mathias et al 34 y Dai et al 35 comparan diferentes intervenciones para mejorar el estado ansioso preoperatorio del paciente pediátrico. Se incluyeron intervenciones como la distracción mediante la utilización de plastilina o intervenciones que se centraban en la presencia de los padres 34 que no están incluidas en nuestra revisión y dónde se obtienen buenos resultados en cuanto a la reducción de la ansiedad en los participantes. Si se revisan otras actividades que incluimos en nuestro trabajo como el juego basado en incentivos, educación preoperatoria mediante folletos informativos y vídeos, imágenes guiadas, narración de cuentos, el uso de payasos y la preparación psicológica.…”

“…Si se revisan otras actividades que incluimos en nuestro trabajo como el juego basado en incentivos, educación preoperatoria mediante folletos informativos y vídeos, imágenes guiadas, narración de cuentos, el uso de payasos y la preparación psicológica. En el estudio de Mathias et al 34 se concluye que las intervenciones estudiadas (juego terapéutico, imágenes guiadas, payasos, educación preoperatoria) son altamente eficaces para reducir la ansiedad preoperatoria en los más pequeños; mientras que Dai et al 35 afirma que la utilización de folletos informativos y juegos terapéuticos no son tan eficaces si no se combinan con contenido audiovisual.…”

Systematic review of the development and effectiveness of digital health information interventions, compared with usual care, in supporting patient preparation for paediatric hospital care, and the impact on their health outcomes

“…This study's strength is that it evaluates the design and development of DHIs used in preparing children for hospital procedures, correlating this against effectiveness in improving outcomes. Previous systematic reviews ( 6 , 19 , 20 , 22 , 23 , 98 – 100 ) have predominately focused on the type of health interventions used and their effectiveness in improving health outcomes and/or reducing pre-operative anxiety, stress, and pain. In addition, some of these reviews included non-digital health interventions ( 98 – 100 ) and those used for distraction ( 6 , 100 ).…”

“…Previous systematic reviews ( 6 , 19 , 20 , 22 , 23 , 98 – 100 ) have predominately focused on the type of health interventions used and their effectiveness in improving health outcomes and/or reducing pre-operative anxiety, stress, and pain. In addition, some of these reviews included non-digital health interventions ( 98 – 100 ) and those used for distraction ( 6 , 100 ). This study has specifically evaluated DHIs used for preparation.…”