# Effectiveness of Play Therapy in Reducing Anxiety During the Preoperative Period in Pediatric Patients Undergoing Inguinal Hernioplasty

## TL;DR

This study compares play therapy and medication for reducing anxiety in children before surgery, finding play therapy to be effective.

## Contribution

The study demonstrates that play therapy is a viable alternative to pharmacological premedication for preoperative anxiety in children.

## Key findings

- Play therapy reduced anxiety scores in children more effectively than anxiolytic medication at post-intervention evaluation.
- Fewer children in the play therapy group were considered anxious at the final evaluation.
- Parent anxiety scores showed significant differences only at the final evaluation in the control group.

## Abstract

Introduction: The preoperative period is challenging in children due to increased anxiety. Preoperative anxiety results in increased postoperative pain, insomnia, nausea, fatigue, and reduced effectiveness of anesthesia and analgesia. Therefore, this study aimed to compare the efficacy of a play therapy intervention versus standard pharmacological premedication in reducing preoperative anxiety in pediatric patients undergoing inguinal hernioplasty.

Methods: A randomized controlled trial was conducted at Dr. Juan I. Menchaca Civil Hospital, Guadalajara, Mexico, involving 32 pediatric patients aged 3 to 6 years undergoing inguinal hernioplasty. Patients were randomized into two groups: (1) an intervention group, which received play therapy involving a transport cart and toys, and (2) a control group, which received anxiolytic medication and standard care. Patient anxiety was assessed using the modified Yale Preoperative Anxiety Scale-short form (mYPAS-SF), as a primary outcome, and the Visual Analogue Anxiety Scale for Parents (VAS-P), as a secondary outcome, at three different times prior to surgery: initial contact, post-intervention, and transfer to the preoperative area.

Results: VAS-P only showed significant differences at the final evaluation point, with lower anxiety scores observed in the control group. mYPAS showed significant differences in the score given at the post-intervention evaluation and in the number of patients considered anxious (>30 points), both of which were lower in the play therapy group. At the final evaluation, the number of patients considered anxious was lower in the play therapy group.

Conclusion: Play therapy proves to be an effective and safe intervention for reducing anxiety in children during the preoperative period. Its incorporation into standard clinical practices for pediatric surgery could enhance emotional management and improve surgical outcomes.