EFFECTIVENESS AND

APPROPRIATENESS OF THERAPEUTIC
PLAY INTERVENTION IN PREPARING
CHILDREN FOR SURGERY: A
RANDOMIZED CONTROLLED TRIAL
STUDY
By :
Thetiya Cica Yudo (462011047)
Novitasari Mariyanto (462011048)
Marlinda M Raange (462011052)
Grace D M Rudjubik (462011053)
BACKGROUND
Many anxieties faced by
parents and children
performed surgery, and
in HONG KONG this
approach is mostly
focused on providing
procedural information;
the psychological needs
of children and their
parents have seldom
been taken into
consideration
to examine the
effectiveness and
appropriateness of using
therapeutic play in
preparing children for
surgery.
PURPOSE
METHODS
Design
Participants
By using a simple complete
randomization method,
participants were
randomly assigned to the
experimental group,
receiving therapeutic play
intervention, and the
control group, receiving
routine information
preparation. The study was
carried out in a well-
established day surgery
unit
criteria were as follows:
children should be
between 7 and 12 years of
age, able to speak well,
and accompanied by their
parents (either mother or
father) on the preoper-
ative assessment day and
on the day of surgery
Interventions
In the control group,
children and their
parents received routine
information intervention
on the preoperative
assessment day.
In the experimental
group, children and their
parents were invited to
receive therapeutic play
intervention at around 1
week before each childs
operation
The state anxiety level of
the children was
measured by using the
CSAS-C.
The state anxiety level of
the parents was
measured by using the
Chinese version of the
State Anxiety Scale for
Adults.

MEASURES
Figure 3. A Child Explores
Equipment in the Operating
Theater.

Figure 4. With Supervision, a
Child Return Demonstrates the
Procedures on the Doll.
DATA
COLLECTION
The PPSQ is a scale
measuring the parents
perceptions and opinions
of the interventions
received preoperatively,
which covered the
appro- priateness,
adequacy, relevancy,
understanding, and use
of preoperative
information and skills to
help their children cope
with the stress of surgery
The data collection
lasted for 13 months. A
total of 203 children
along with their parents
were recruited. The
response and attrition
rates were 88% and 18%,
respectively. Of the 203
children and parents, 106
were randomly assigned
to the control group and
97 were assigned to the
experimental group.
RESULTS

Demographic
Characteristic
Experimental (n=97)
Frequency (%)
Control (n=106)
Frequency (100%)
Age of Children (Years)
7 8 (8,2) 11 (10,4)
8 14 (14,4) 16 (15,1)
9 27 (27,8) 30 (28,3)
10 24 (24.7) 27 (25,5)
11 13 (13,4) 12 (11,3)
12 11 (11,3) 10 (9,4)
Gender of Children
Male 67 (69,1) 73 (68,9)
Female 30 (30,9) 33 (31,1)
Table 1. Demographic Data of Participants in the
Experimental and Control Groups
Cont
Parents educational
attainment
Primary 10 (10,3) 9 (8,5)
Lower secondary 46 (47,4) 46 (43,3)
Upper secondary 35 (36,1) 46 (43,3)
Tertiary 6 (6,2) 5 (4,7)
Type of surgery performed
Circumcision 45 (46,4) 42 (39,6)
Herniorrhaphy 18 (18,6) 21 (19,8)
Minor eye operation 11 (11,3) 13 (12,3)
Minor ENT operation 8 (8,2) 9 (8,5)
Dental operation 9 (9,3) 13 (12,3)
Minor orthopedic operation 6 (6,2) 8 (7,5)
Table 2. The Results of Independent t-Test on State Anxiety Scores in
Children and Parents in the Pre- and Postoperative Periods, and Parents
Satisfaction Scores Between the Experimental and Control Groups

Experimental
(Mean, SD)
Control
(Mean, SD)
t - value p - value
Childrens
preoperative
A-state
34,36 , 8,08 38,60 , 8,52 3.6 ,001
Childrens
postoperative
A-state
33,58 , 5,89 36,16 , 5,60 3,2 ,002
Parents
preoperative
A-state
39,90 , 9,36 44,04 , 9,56 3,11 ,002
Parents
postoperative
A-state
36,57 , 7,65 39,13 , 8,71 2,02 ,030
Parents
satisfacation
scores
27,28 , 2,35 25,90 , 2,13 4,04 ,001
CONCLUSION
Children who received therapeutic play
intervention reported lower state anxiety
scores in the pre- and postoperative periods
than children who received information
intervention.
The information from this study will promote
awareness in nurses and parents that play is a
very important part of childrens lives and
they need play even when they are ill.