Use of Audiobooks as an Environmental Distractor to Decrease State Anxiety in Children Waiting in the Pediatric
Leah I Stein Duker1, Anita R Schmidt2, Phung K Pham2
1Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States.
Insights
Audiobooks may help reduce fear and anxiety in children visiting the Pediatric Emergency Department (PED). This pilot study found listening to audiobooks feasible and effective for decreasing stress in pediatric patients during their wait times.
Area of Science:
- Pediatric Emergency Medicine
- Child Psychology
- Health Technology Interventions
Background:
- Children in Pediatric Emergency Departments (PEDs) frequently experience anxiety and stress from anticipatory stressors.
- Limited research exists on effective interventions to mitigate this stress in the PED setting.
Purpose of the Study:
- To assess the feasibility and effectiveness of using audiobooks to reduce fear and state anxiety in children within a PED.
- To gather preliminary data on audiobook intervention for pediatric patients experiencing stress.
Main Methods:
- A one-sample pretest-postest pilot study involving 131 children (kindergarten-8th grade) in a PED.
- Participants completed self-report measures for fear and state anxiety before and after listening to an audiobook.
- Paired samples t-test analyzed pre-post changes; patient experience data were also collected.
Main Results:
- Significant improvements were observed in children's fear and specific anxiety states (nervous, calm, happy, relaxed) after audiobook use (Cohen's d = 0.22-0.35).
- Older children showed greater improvements in fear and certain anxiety states, indicating potential age-related benefits.
- Over 60% of participants enjoyed the audiobook content and listening experience; 15% requested additional audiobooks.
Conclusions:
- Audiobook listening presents a feasible, low-cost, and portable method for potentially decreasing fear and state anxiety in children awaiting care in the PED.
- While results suggest modest effectiveness, further research with larger sample sizes and control groups is warranted to confirm the impact of audiobooks on pediatric patient stress.
Abstract:
Objectives: Anxiety and anticipatory stressors are commonly experienced by children visiting the Pediatric Emergency Department (PED), but little research exists that addresses the efficacy of interventions to decrease this stress. This one-sample pretest-postest pilot study gathered preliminary data on the feasibility and effectiveness of utilizing audiobooks to reduce fear and state anxiety in children in the PED. Methods: Participants were 131 children in kindergarten through 8th grade (M = 9.4 years, 54% female), triaged urgent or emergent, presenting to the PED. Participants self-reported fear (Children's Fear Scale) and state anxiety (modified State-Trait Anxiety Inventory for Children; mSTAIC) before and after listening to an age-appropriate audiobook (two options). Data regarding patient experience were also collected. Paired samples t-test was used to examine pre-post intervention changes in fear and state anxiety. Results: Significant, albeit small, improvements in fear and the mSTAIC states of nervous, calm, happy, and relaxed were found after use of the audiobook (Cohen's d = 0.22-0.35). Small, yet significant correlations were found between child age/grade level and improvements in fear and in the mSTAIC states of scared and relaxed, suggesting that the audiobook was more beneficial for older participants. Over 60% of participants liked the audiobook content "a lot" as well as enjoyed listening to the audiobook "a lot." Without prompting, 15% of participants requested to listen to an additional audiobook. Conclusions: Listening to an audiobook is feasible and could be effective in decreasing fear and state anxiety for children during a waiting period in the PED. The technology is low-cost, simple, and portable. The results of this study should be interpreted with prudence due to the lack of a control group and results that, although significant, were modest based on effect size conventions; future studies should explore the impact of audiobooks on patient stress with an expanded sample size and control group.
