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A combined intervention of art therapy and clown visits to reduce preoperative anxiety in children
Author(s) -
Dionigi Alberto,
Gremigni Paola
Publication year - 2017
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13578
Subject(s) - anxiety , medicine , psychological intervention , intervention (counseling) , observational study , repeated measures design , midazolam , general anaesthesia , analysis of variance , physical therapy , anesthesia , psychiatry , sedation , statistics , mathematics
Aims and objectives To test whether a combined intervention of art therapy and clown visits could enhance the efficacy of oral medication in reducing children's anxiety at parental separation prior to induction of anaesthesia. Background Approximately 50% of children undergoing surgery report high anxiety at anaesthesia induction. Complementary therapies have been used to decrease children's anxiety, but no study has evaluated the efficacy of a combination of such therapies. Design This is an observational study, which involved allocating different interventions to two groups and measuring their anxiety at two time points. Methods This study assigned 78 children (aged 3–11 years) undergoing general anaesthesia for surgery to two conditions. The control group underwent general anaesthesia following standard practice, and the intervention group received an intervention of integrated art therapy and clown visits upon their arrival at the hospital and throughout their time in the preoperating room. Each child in both groups received 0·5 mg/kg oral midazolam 30 minutes before surgery and had a parent present throughout their time in the preoperating room. Each child's anxiety was evaluated twice using the Modified Yale Preoperative Anxiety Scale: at baseline and at separation from parents. Repeated measures anova was used to test for differences between the time points and the two groups. Results Children in the intervention group showed a significant ( p < 0·001) reduction in Modified Yale Preoperative Anxiety Scale scores at parental separation compared to those in the control group. Additionally, the majority of parents and nurses evaluated the intervention to be effective for reducing children's anxiety. Conclusions This study found that an intervention based on art therapy and clown visits enhanced the effect of midazolam in reducing children's anxiety at preoperative separation from parents. Relevance to clinical practice Paediatric staffs may consider using such a combination of strategies in preparing children for anaesthesia induction.