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

Background: Hospital environments can be distressing for pediatric patients, particularly before surgery. Preoperative anxiety is a common issue among children, potentially leading to adverse psychological and physiological effects. Child-friendly environmental modifications, such as incorporating cartoon characters and natural scenery in hospital design, may help reduce anxiety and improve patient experience. Objective: This study aimed to evaluate the effect of child-friendly environmental design interventions-specifically, painting pediatric surgery ward walls with universal cartoon images and natural scenes-on preoperative anxiety levels in children.

A mixed-methods design (comparative and descriptive) was employed. The study included 80 children aged 4 to 10 years, divided into two groups (n = 42 in the first group, n = 38 in the second group). Preoperative anxiety levels were assessed using The Children's Anxiety Meter-State and Trait scales. Additionally, children in the second group were asked, "What is your opinion about painting the walls?" to collect qualitative feedback.

The mean preoperative state anxiety score was 5.40 ± 3.46 in the first group and 3.52 ± 3.50 in the second group (p < .05), indicating a significant reduction in anxiety after the environmental intervention. In group 2 (after painting), 78.5% (n = 30) of children responded to the open-ended question, with 90% expressing satisfaction with the newly designed environment.

Painting pediatric surgery ward walls with child-friendly imagery and natural scenes was found to be an effective nonpharmacological intervention in reducing preoperative anxiety in children. These findings support the integration of child-friendly environmental designs in pediatric healthcare settings to enhance patient wellbeing.