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Play dough or balloon blowing? A clinical trial comparing creative interventions for reducing preoperative anxiety in
Razie Vakili1, Reza Feizi2, Yahya Salimi3
1Department of Operating Room, School of paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Insights
Play dough (PD) and balloon blowing (BB) effectively reduce preoperative anxiety in children. These engaging, non-pharmacological methods offer safe alternatives to medication, improving the surgical experience.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Child Psychology
Background:
- Preoperative anxiety is a significant concern in pediatric surgery, impacting patient outcomes.
- Pharmacological methods for anxiety reduction have side effects, necessitating non-pharmacological alternatives.
- Play-based interventions are age-appropriate for children undergoing surgery.
Purpose of the Study:
- To compare the effectiveness of play dough (PD) activities and balloon blowing (BB) in reducing preoperative anxiety in children.
- To evaluate non-pharmacological interventions as alternatives to traditional pharmacological approaches.
- To assess the impact of these interventions on children's emotional well-being before surgery.
Main Methods:
- A randomized controlled trial involving 90 children aged 4-8 years undergoing elective surgery.
- Participants were assigned to play dough, balloon blowing, or control (standard care with midazolam) groups.
- Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and Visual Analog Scale for Anxiety (VAS-A) at multiple time points.
Main Results:
- Both play dough and balloon blowing significantly reduced preoperative anxiety compared to the control group (P < 0.001).
- No significant difference in anxiety reduction was observed between the play dough and balloon blowing groups.
- VAS-A scores indicated a higher proportion of mild anxiety in the intervention groups versus the control group.
Conclusions:
- Play dough and balloon blowing are effective, safe, and cost-effective non-pharmacological interventions for pediatric preoperative anxiety.
- These creative, play-based strategies enhance the preoperative experience and can improve surgical outcomes.
- Integration of such interventions into pediatric care is recommended, with further research on long-term effects and broader applicability.
Background:
Preoperative anxiety is a significant concern for pediatric patients undergoing surgery, often leading to adverse physiological, emotional, and postoperative outcomes. Traditional pharmacological approaches, while effective, are associated with side effects, underscoring the need for age-appropriate non-pharmacological interventions. This study aimed to compare the effectiveness of play dough (PD) activities and balloon blowing (BB) in reducing preoperative anxiety in children.
Methods:
This randomized controlled trial included 90 children aged 4-8 years, a developmental stage characterized by responsiveness to play-based interventions, scheduled for elective surgeries at Besat Hospital, Hamedan, Iran, between November 2023 and January 2025. Participants were randomized into three groups: PD, BB, and Control (standard care with midazolam). Anxiety levels were assessed at baseline (T0), immediately before entering the operating room (T1), and during anesthesia induction (T2) using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Visual Analog Scale for Anxiety (VAS-A). Each intervention was administered for 15 min under direct supervision by a trained researcher. Statistical analysis included ANOVA for continuous variables and chi-square tests for categorical variables. Post hoc comparisons were performed using Tukey's method.
Results:
At T1 and T2, children in the PD and BB groups exhibited significantly lower anxiety levels compared to the Control group (P < 0.001). For m-YPAS scores at T1, the PD group mean 36.05 ± 4.28, and the BB group 35.15 ± 2.94, compared to 54.55 ± 4.05 in the Control group. Similar trends were noted at T2. VAS-A analysis further supported these findings, with the PD and BB groups showing higher proportions of mild anxiety compared to the Control group. No significant differences were detected between the PD and BB groups, indicating that both interventions were comparably effective.
Conclusions:
PD and BB are effective non-pharmacological interventions for reducing preoperative anxiety in children. These cost-effective, engaging techniques offer safe alternatives to pharmacological treatments and promote emotional well-being. The findings support integrating age-appropriate, creative, play-based strategies into pediatric surgical care, emphasizing their potential to enhance the preoperative experience and improve outcomes. Future research should investigate long-term impacts, applicability across diverse populations, and comparative efficacy in various clinical settings.
Trial Registration:
Registered in the Iranian registry of clinical trials ( https://irct.behdasht.gov.ir ) in 19/11/2023 with the following code: IRCT20230514058183N1.
