Effects of preoperative play on post-hospital anxiety in school-age children and their parents
An experimental three group before/after design was used to examine the effects of structured preoperative play with the nurse or the parent on post-hospitalization anxiety in school age surgical clients and their parents. Fifty-four children, from ages 5-11 years, undergoing elective day surgery were randomly assigned to experimental and control groups. Twenty-four subjects completed the study.
The experimental treatment was a board game, General Hospital, designed for pre-operative teaching of school age children. Experimental group A played the game with the nurse. Experimental group B played with their parent with minimal assistance from the nurse. The control group did not play the game. All groups received routine nursing care of the institution.
Anxiety in the children was measured by scoring preoperative and posthospital drawings of "a person" obtained from each subject. In addition, the children's preadmission stress level was assessed and the Post-Hospital Behavior Questionnaire was completed by the parent. The State-Trait Anxiety Inventory was used to measure parents' preoperative and posthospital anxiety.
Repeated measures analysis of variance and analysis of covariance revealed that posthospital anxiety was not significantly reduced as a result of preoperative structured play in school age children and their parents. Children who played with their parents had significantly higher posthospital scores than preoperative scores. These children's posthospital anxiety scores were significantly higher than scores of the other children. Factors found to be related to the anxiety levels of the children and their parents were age, grade, no previous surgery, income level, and years of education of the father.