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Does Child-Friendly Design Reduce Preoperative Anxiety in Pediatric Surgery Patients?

Zeynem Yildirim Balkan1, Ebru Yesildag2, Ezgi Taylan3

  • 1Faculty of Health Science, Department of Nursing, Tekirdag Namik Kemal University, Tekirdag, Türkiye.

HERD
|July 31, 2025
PubMed

Insights

Child-friendly hospital environments featuring cartoon characters and nature scenes significantly reduce preoperative anxiety in pediatric patients. This non-pharmacological approach enhances patient well-being and satisfaction in healthcare settings.

Area of Science:

  • Pediatric healthcare
  • Environmental psychology
  • Child psychology

Background:

  • Hospital environments can induce distress in pediatric patients, particularly before surgery.
  • Preoperative anxiety is common in children, potentially causing adverse psychological and physiological effects.
  • Child-friendly design elements like cartoons and nature scenes may alleviate anxiety and improve patient experience.

Purpose of the Study:

  • To evaluate the impact of child-friendly environmental design interventions on preoperative anxiety levels in children undergoing surgery.
  • Specifically, to assess the effect of painting pediatric surgery ward walls with cartoon images and natural scenes.

Main Methods:

  • A mixed-methods approach was used, including comparative and descriptive designs.
  • Eighty children (aged 4-10) were divided into two groups.
  • Preoperative anxiety was measured using The Children's Anxiety Meter-State and Trait scales, with qualitative feedback collected from the intervention group.

Main Results:

  • The group exposed to the child-friendly environment showed a significant reduction in mean preoperative state anxiety scores (3.52 ± 3.50) compared to the control group (5.40 ± 3.46).
  • In the intervention group, 78.5% of children provided feedback on the wall paintings.
  • Ninety percent of children expressed satisfaction with the redesigned, child-friendly environment.

Conclusions:

  • Painting pediatric surgery ward walls with child-friendly imagery and natural scenes is an effective non-pharmacological intervention for reducing preoperative anxiety in children.
  • Integrating child-friendly environmental designs into pediatric healthcare settings can enhance patient well-being and improve the overall healthcare experience.

Keywords:
child-friendly designchildren preoperative anxietychildrens hospitalsenvironmental designnurses in design

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