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Visual Education and Distraction for Reducing Preoperative Anxiety in Children and Parents: A Randomized Controlled
Ayla Kaya1, Fahriye Pazarcıkcı2, Emine Efe1
1Faculty of Nursing, Pediatric Nursing Department, Akdeniz University, Antalya, Türkiye.
Insights
Visual education and kaleidoscope distraction effectively reduced preoperative anxiety in children and parents undergoing surgery. Both methods proved beneficial, supporting better perioperative experiences for families.
Area of Science:
- Pediatric Surgery
- Nursing Research
- Psychological Interventions
Background:
- Preoperative anxiety is a common issue in pediatric surgery, affecting both children and their parents.
- Effective strategies are needed to manage anxiety and improve the surgical experience.
- This study investigates visual education and distraction techniques.
Purpose of the Study:
- To compare the effectiveness of visual education and kaleidoscope distraction in reducing preoperative anxiety.
- To assess anxiety levels in both children and their parents.
- To evaluate the impact of these interventions on the perioperative experience.
Main Methods:
- A three-arm, parallel-group randomized controlled trial was conducted.
- 105 children (5-12 years) and their parents were assigned to visual education, kaleidoscope distraction, or a control group.
- Anxiety was measured using the modified Yale Preoperative Anxiety Scale (mYPAS) and State-Trait Anxiety Inventory-State (STAI-S).
Main Results:
- Both visual education and kaleidoscope distraction significantly reduced preoperative anxiety in children and parents compared to the control group.
- Statistical analysis (repeated measures ANOVA, Bonferroni post hoc) confirmed the efficacy of both interventions.
- While visual education showed a numerically larger reduction in anxiety, the difference between the two interventions was not statistically significant.
Conclusions:
- Visual education and distraction strategies are effective in managing preoperative anxiety in pediatric surgical patients and their families.
- These interventions can be integrated into routine pediatric nursing practice.
- Implementing these strategies supports family-centered care and can improve overall perioperative outcomes and cooperation.
Aim:
To evaluate and compare the effectiveness of visual education and distraction methods in reducing preoperative anxiety among children and their parents.
Design:
Three-arm, parallel-group randomized controlled trial.
Methods:
The study was conducted between June 2023 and September 2024 in the paediatric outpatient surgery unit of a university hospital in Türkiye. A total of 105 children aged 5-12 years and their parents were randomly assigned to one of three groups: visual education, distraction using a kaleidoscope or control. Anxiety levels were assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) for children and the State-Trait Anxiety Inventory-State (STAI-S) for parents. Data were analysed using repeated measures ANOVA, independent samples t-tests, Bonferroni post hoc tests, effect size and observed power.
Results:
Both interventions significantly reduced preoperative anxiety compared with the control group. Repeated measures ANOVA revealed significant between-group differences for children (F = 11.937, p < 0.001, η2 = 0.190) and parents (F = 9.164, p < 0.001, η2 = 0.152). Bonferroni post hoc analyses confirmed that visual education and kaleidoscope distraction were effective in reducing anxiety in both children and parents. Although visual education produced a greater numerical reduction in anxiety, the difference between visual education and kaleidoscope distraction was not statistically significant.
Conclusion:
These results highlight the importance of integrating structured visual education and distraction strategies into routine paediatric nursing practice. Such interventions support family-centred care, enhance perioperative cooperation and may contribute to improved clinical experiences for children and parents.
Clinical Relevance:
Structured visual education programs and distraction strategies can be integrated into routine paediatric nursing practice to support children and parents in the surgical process, enhance cooperation and improve perioperative care outcomes.
Trial Registration:
ClinicalTrials.gov identifier: NCT05279976.