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Original Article

Nonpharmacological interventions for managing postoperative pain and anxiety in children: A randomized controlled trial

Edlin Mathias¹  , Mamatha Pai¹  , Vijay Kumar², Dinesh Narayanakurup³, Malavika Kulkarni⁴, Vasudeva Guddattu⁵, Ann-Cathrine Bramhagen⁶, Baby Nayak¹, Anice George¹

¹Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
²Department of Pediatric Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
³Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
⁴Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
⁵Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
⁶Ann-Cathrine Bramhagen, Associate Professor, Faculty of Health and Society, Department of Care Science, Malmo University, Sweden

Correspondence Mamatha Pai ,Email: mamatha.spai@manipal.edu

Received: December 7, 2023; Revised: June 4, 2024   Accepted: June 9, 2024.

Abstract

Background
Hospitalizations and surgical procedures are unpleasant for both children and their parents. Therefore, postoperative pain assessments and management are less commonly performed in younger children than in adults.
Purpose
To evaluate the effects of nonpharmacological interventions on postoperative pain and anxiety in children.
Methods
In this randomized controlled trial, 160 children were randomly allocated to experimental (n=80) and control (n=80) groups. The children in the experimental group received age-appropriate distraction interventions for 3 postoperative days along with usual care. Children in the control group received standard care only. Each patient's pain was assessed using the EVENDOL pain scale, while their anxiety was measured using the modified Yale Preoperative Anxiety Scale. The data were analyzed using SPSS 23.0. Descriptive statistics (frequency, percentage, mean, and standard deviation) and repeated-measures analysis of variance were used to analyze the data.
Results
The children in the experimental group showed significantly decreased pain, anxiety, and physiological parameters (heart rate, respiratory rate, and oxygen saturation) compared to those in the control group. Significant intergroup differences were noted in the mean and standard deviation values of the pain, anxiety, and physiological parameters.
Conclusion
The distraction interventions provided by nurses reduced the pain and anxiety levels and improved the postoperative recovery of pediatric surgical patients.

Keywords :Anxiety, Child, Distraction, Pain, Surgical procedure