Educational Comic Book Has Little Effect on Preoperative Anxiety Among Children

Educational Comic Book Has Little Effect on Preoperative Anxiety Among Children

An educational comic book was not an powerful intervention for decreasing anxiousness amongst pediatric patients undergoing surgery. These findings had been published in the Journal of Pediatric Nursing.

Children and adolescents (N=60) undergoing surgery in 2020 at the Botucatu State Hospital in Brazil had been recruited for this randomized parallel, 2-group controlled clinical trial. Patients had been randomly assigned to get verbal preoperative guidance alone (n=30) or accompanied by a comic book depicting the surgical practical experience (n=30). The parents and kids had been evaluated by the Hamilton Anxiety Rating Scale (HAM-A), Children’s Anxiety Questionnaire (CAQ), modified Yale Preoperative Anxiety Scale (mYPAS), and they rated their anxiousness utilizing the Visual Analog Scale (VAS).

The patients had been a median age of 8. (variety, 6. to 14.) years, 63.3% to 73.3% had been boys, and the median length of surgery was 60 (variety, 20 to 120) minutes. The parents had been a median age of 33.5 to 35. (variety, 23. to 59.) years, 57% to 63% had undergone a earlier surgery, 33% to 53% had been a surgical companion ahead of, and they had a median of 11. to 12. (variety, 1. to 16.) years of education.

No substantial alterations to the CAQ score or any of the subscores had been reported following the handle and comic book interventions (all P ≥.222). Among the experimental cohort, VAS scores tended to be decrease postintervention (median, 3.00 vs 4.00 P =.070).

Among the comic book recipients, HAM-A scores (P =.024), sensory symptoms (P =.009), anxious mood (P =.012), psychic anxiousness (P =.015), tension (P =.018), and somatic anxiousness (P =.021) had been considerably decreased following the intervention. There had been substantial alterations to HAM-A scores (P =.049), interview behavior (P =.011), sensory symptoms (P =.018), nervous technique symptoms (P =.026), cardiovascular symptoms (P =.026), depressive mood (P =.042), and somatic anxiousness (P =.047) postintervention amongst the handle group.

Compared in between groups, no substantial variations in mYPAS general score (P =.751) or the activity (P =.871), vocalization (P =.759), expression (P =.520), status (P =.514), or interaction (P =1.00) elements had been observed.

This study may perhaps have been restricted by utilizing the CAQ instrument which was made to assess anxiousness amongst kids aged 5 to 8 years and this study recruited kids aged 6 to 14 years.

Study authors concluded, “Preoperative guidance provided by nurses, irrespective of the type of intervention, proved beneficial in reducing parental anxiety after separation from their children outside the operating room. However, both types of interventions, performed on the day of surgery, failed to reduce self-reported preoperative anxiety in children and adolescents upon admission to the operating room. The use of educational materials to minimize children’s anxiety remains controversial, and requires future multicenter studies in high-, middle-, and low-income countries.”


De Avila MAG, Prata RA, Jacob FLDS, De Oliveira Nóbrega FM, De Barros GR, Sugiura BMG. Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: a randomized clinical trial. J Pediatr Nurs. 2022S0882-5963(22)00171-3. doi:10.1016/j.pedn.2022.07.010

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