title: Therapeutic play intervention on children's perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial.
abstract: OBJECTIVE
  To examine if therapeutic play intervention could reduce perioperative anxiety, negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery.
  
  
  BACKGROUND
  Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations. Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children's perioperative anxiety, negative emotional manifestation and postoperative pain.
  
  
  METHODS
  A randomized controlled trial was used.
  
  
  METHODS
  Suitable children were recruited from November 2011-August 2013. They were randomized to receive either routine care (control group, n = 47) or a 1-hour therapeutic play intervention (experimental group, n = 48). Children's state anxiety, negative emotional manifestations and postoperative pain were measured at baseline, on the day of surgery and around 24 hours after surgery. Repeated measures analysis of covariance (ancova) and univariate ancova adjusting for all possible confounding factors were used in the data analysis.
  
  
  RESULTS
  The time effect of state anxiety was significant, but no group and interaction (group x time) effects between the control and experimental groups were found. Compared with the control group, children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain.
  
  
  CONCLUSIONS
  Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery. These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery.
authors.affiliation: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors.forename: Hong-Gu
authors.initials: HG
authors.lastname: He
authors.forename: Lixia
authors.initials: L
authors.lastname: Zhu
authors.forename: Sally Wai-Chi
authors.initials: SW
authors.lastname: Chan
authors.forename: Joanne Li Wee
authors.initials: JL
authors.lastname: Liam
authors.forename: Ho Cheung William
authors.initials: HC
authors.lastname: Li
authors.forename: Saw Sandar
authors.initials: SS
authors.lastname: Ko
authors.forename: Piyanee
authors.initials: P
authors.lastname: Klainin-Yobas
authors.forename: Wenru
authors.initials: W
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control*; D002648:Child; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D010988:Play and Playthings
keywords: anxiety; children; negative emotional manifestation; nursing; postoperative pain; therapeutic play