title: A mixed-method study of effects of a therapeutic play intervention for children on parental anxiety and parents' perceptions of the intervention.
abstract: OBJECTIVE
  To examine the effects of a therapeutic play intervention for children on parents' perioperative anxiety, the relationship between parents' and their children's anxiety and to explore parents' perceptions of the intervention.
  
  
  BACKGROUND
  Therapeutic play intervention was found to reduce children's perioperative anxiety. Little is known about how such an intervention for children affects their parents' anxiety.
  
  
  METHODS
  A mixed method of randomized controlled trial with qualitative process evaluation was used.
  
  
  METHODS
  Ninety-five pairs of parents and children were recruited between November 2011-August 2013 and randomized into a control or an intervention group. The State Anxiety Scale for Children and the State Anxiety Scale for Adults were used to measure children's and parents' anxiety, respectively, at baseline, on surgery day and around 24 hours after surgery. Parents were interviewed about their perceptions of the intervention. Data were analysed using SPSS version 22·0 and thematic analysis.
  
  
  RESULTS
  There was no difference in parents' anxiety after participating with their child in the intervention compared with usual care. There were significantly positive relationships between parents' and their children's baseline anxiety and parents' postoperative anxiety and their children's pre-operative anxiety. Four themes were identified: reducing anxiety, increasing knowledge and understanding about anaesthetic procedure, the worthiness of attending the intervention and suggestions for improvement of the intervention.
  
  
  CONCLUSIONS
  Therapeutic play intervention had no significant effect on parents' perioperative anxiety. Parents' and their children's perioperative anxiety are correlated. Parents perceived the intervention as helpful preparation for themselves and for their children undergoing elective surgery.
authors: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors: Hong-Gu
authors: HG
authors: He
authors: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors: Li-Xia
authors: LX
authors: Zhu
authors: School of Nursing and Midwifery, The University of Newcastle, Australia.
authors: Wai-Chi Sally
authors: WC
authors: Chan
authors: Division of Nursing, KK Women's and Children's Hospital, Singapore.
authors: Joanne Li Wee
authors: JL
authors: Liam
authors: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors: Saw Sandar
authors: SS
authors: Ko
authors: School of Nursing, The University of Hong Kong, China.
authors: Ho Cheung William
authors: HC
authors: Li
authors: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors: Wenru
authors: W
authors: Wang
authors: Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
authors: Piyanee
authors: P
authors: Yobas
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D002648:Child; D006801:Humans; D010290:Parents / Q000523:psychology*; D010988:Play and Playthings
keywords: anxiety; parent; perception; perioperative; surgery; therapeutic play intervention