The Effectiveness of Therapeutic Play Intervention in Reducing Perioperative Anxiety, Negative Behaviors, and Postoperative Pain in Children Undergoing Elective Surgery: A Systematic Review

He, Hong; Zhu, Lixia; Chan, Sally Wai‐Chi; Klainin‐Yobas, Piyanee; Wang, Wenru

doi:10.1016/j.pmn.2014.08.011

Cited by 52 publications

(43 citation statements)

References 31 publications

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“…He, Zhu, Chan, Klainin‐Yobas, et al. () explored the effectiveness of therapeutic play in their narrative systematic review and found out the impact of this intervention on children's perioperative anxiety, maladaptive behaviours and postoperative pain is controversial and suggesting more rigorous studies to be conducted in future, which is consistent with the findings of this review. And this review takes one step further to question which element is truly effective — therapeutic play or theatre orientation.…”

Section: Discussionsupporting

confidence: 76%

“…Several systematic reviews (Chieng et al, 2014;Chow et al, 2016;He, Zhu, Chan, Klainin-Yobas, & Wang, 2015) explore the effectiveness of different PPP programmes to alleviate PPA, yet none of them consider qualitative evidence. It is increasingly accepted that effectiveness alone is not sufficient to inform policy change or decision-making.…”

Section: Introductionmentioning

confidence: 99%

“…Yet the effectiveness of some strategies remains uncertain. Moreover, not every child could benefit from the same programme (He, Zhu, Chan, Klainin-Yobas, et al, 2015;Wakimizu, Kamagata, Kuwabara, & Kamibeppu, 2009). One possible reason is that the majority of current PPP fails to take different influencing factors such as the cultural, contextual and individual interpretation of the intervention, into consideration (Capurso & Ragni, 2016).…”

Section: Introductionmentioning

confidence: 99%

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A mixed‐method systematic review of the effectiveness and acceptability of preoperative psychological preparation programmes to reduce paediatric preoperative anxiety in elective surgery

Dai

Livesley

2018

Journal of Advanced Nursing

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Aim To explore the effectiveness of preoperative psychological preparation programmes aimed to reduce paediatric preoperative anxiety and the potential factors that could have an impact on parent and children's acceptance of such interventions. Background Various preoperative psychological preparation programmes are available to address paediatric preoperative anxiety. No mixed‐method review has been conducted to explore the effectiveness and acceptability of these programmes. Design A mixed‐method systematic review. Data sources Seven bibliographic databases were searched from inception to September 2016, complemented by hand searching of key journals, the reference lists of relevant reviews, search for grey literature and the contacting of associated experts. Review methods The review process was conducted based on the framework developed by the Evidence for Policy and Practice Information and Co‐ordinating Centre. A narrative summary and a thematic synthesis were developed to synthesize the quantitative and qualitative data respectively, followed by a third synthesis to combine the previous syntheses. Results Nineteen controlled trials and eleven qualitative studies were included for data synthesis. The controlled trials reveal that educational multimedia applications and web‐based programmes may reduce paediatric preoperative anxiety, while the effectiveness of therapeutic play and books remains uncertain. Qualitative studies showed parent–child dyads seek different levels of information. Conclusions Providing matched information provision to each parent and child, actively involving children and their parents and teaching them coping skills, may be the essential hallmarks of a successful preoperative psychological preparation. Further research is necessary to confirm the effectiveness of therapeutic play and books.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A mixed‐method systematic review of the effectiveness and acceptability of preoperative psychological preparation programmes to reduce paediatric preoperative anxiety in elective surgery

Dai

Livesley

2018

Journal of Advanced Nursing

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“…Of the 45 included SRs, only two SRs analyzed nonpharmacological interventions-therapeutic play 20 and music intervention. 21 One SR analyzed different regimens of providing analgesics, with comparisons of "as required" with "fixed schedule" analgesic administration.…”

Section: Systematic Review Characteristicsmentioning

confidence: 99%

Interventions for postoperative pain in children: An overview of systematic reviews

Borić

Došenović

Kadić

et al. 2017

Pediatric Anesthesia

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The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children. Out of 45 systematic reviews that investigated various interventions for postoperative pain in children, 19 systematic reviews (42%) presented conclusive evidence of efficacy. Positive conclusive evidence was reported in 18 systematic reviews (40%) for the efficacy of diclofenac, ketamine, caudal analgesia, dexmedetomidine, music therapy, corticosteroid, epidural analgesia, paracetamol, and/or nonsteroidal anti-inflammatory drugs and transversus abdominis plane block. Only one systematic review reported conclusive evidence of equal efficacy that involved a comparison of dexmedetomidine vs morphine and fentanyl. Safety of interventions was reported as conclusive in 14 systematic reviews (31%), with positive conclusive evidence for dexmedetomidine, corticosteroid, epidural analgesia, transversus abdominis plane block, and clonidine. Seven systematic reviews reported equal conclusive safety for epidural infusion, diclofenac intravenous vs ketamine added to opioid analgesia, bupivacaine, ketamine, paracetamol, and dexmedetomidine vs intravenous infusions of various opioid analgesics, oral suspension and suppository of diclofenac, only opioid, normal saline, no treatment, placebo, and midazolam. Negative conclusive statement for safety was reported in one systematic review for caudal analgesia vs noncaudal regional analgesia. More than half of systematic reviews included in this overview were rated as having medium methodological quality. Of 45 included systematic reviews, 10 were Cochrane reviews and they had higher methodological quality than non-Cochrane reviews. As evidence concerning efficacy and safety is inconclusive for most of the analyzed interventions, our review points out the need for more rigorous trials concerning pain management in children.

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“…Also, this anxiety may cause them experience the nightmares, separation anxiety, eating disorders, and bedwetting and negatively affects children's behavior after discharge. Researches have shown that the risk of postoperative negative behavior in children with higher level of preoperative anxiety, is 3.5 times higher and these problems may continue until 6 to 12 months after discharge (1,3,6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). On the other hand, this anxiety affects parents of these children (17).…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Dramatic Puppet and Therapeutic Play in Anxiety Reduction in Children Undergoing Surgery: A Randomized Clinical Trial

Dehghan

Reyhani

Mohammadpour

et al. 2016

Iran Red Crescent Med J

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Background: Surgery as a stressful experience can affect the child and quality of care plan. Nurses can use non-pharmacological intervention to reduce anxiety and help children cope with this stress. Objectives: This study was designed to compare the effects of dramatic puppet and therapeutic play on anxiety of children undergoing surgery. Methods: In this randomized clinical trial, 75 children were divided into three groups (dramatic puppet, therapeutic play, and control) using a simple random allocation method. The study was conducted in Iran in 2013-2014. The revised children's manifest anxiety scale (RCMAS) was used to determine the anxiety of children. The data were analyzed using paired t-test, one-way analysis of variance (ANOVA), and Tukey test. Results: The findings revealed that the changes of anxiety scores after the intervention were significantly different among the three groups (P < 0.001), so that the anxiety scores decreased in both the intervention groups (puppet and play) and increased in the control group. Conclusions: Therapeutic play and dramatic puppet can be used by nurses as a care strategy and effective preoperative preparation intervention to reduce anxiety in children undergoing surgery.

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The Effectiveness of Therapeutic Play Intervention in Reducing Perioperative Anxiety, Negative Behaviors, and Postoperative Pain in Children Undergoing Elective Surgery: A Systematic Review

Cited by 52 publications

References 31 publications

A mixed‐method systematic review of the effectiveness and acceptability of preoperative psychological preparation programmes to reduce paediatric preoperative anxiety in elective surgery

A mixed‐method systematic review of the effectiveness and acceptability of preoperative psychological preparation programmes to reduce paediatric preoperative anxiety in elective surgery

Interventions for postoperative pain in children: An overview of systematic reviews

The Effectiveness of Dramatic Puppet and Therapeutic Play in Anxiety Reduction in Children Undergoing Surgery: A Randomized Clinical Trial

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