Give a child puppet, help ease surgery anxiety
Minor surgery, even if it doesn't involve anaesthesia or respiratory support, usually triggers anxiety in people, especially children. So how can they be helped? Hospitals often use puppet play as a method to prepare children for surgery, but a team of Greek researchers has conducted a controlled study to determine the impact of puppet play on children undergoing minor surgery. The results were recently published in the journal Psychotherapy and Psychosomatics. The objective of the study was to develop a structured preparation programme using puppet play for children who underwent elective surgery by determining whether the intervention positively impacted the child's pre- and post-operative distress and behaviour. The researchers assessed 91 children, aged 4 to 10, who were admitted for elective ear, nose and throat surgery at the Athens-based Aghia Sophia Children's Hospital. The children's mothers were also evaluated. The team split the sample into two age groups: ages 4-6 (preschool age) and ages 7-10 (school age). The participants were randomly assigned to either the intervention or the control group. The intervention was split in two parts: children participated in therapeutic puppet play and their mothers were given brief counselling sessions. The children were then informed of what would happen during their hospital stay including what medical procedures would be involved (e.g. anaesthesia induction and recovery). The researchers also encouraged the children to ask questions about the surgical procedures and hospital stay, as well as to talk about their feelings. The team reported considerably fewer behavioural disturbances in the children assigned to the intervention group following their surgeries. According to the researchers, these children were psychologically prepared for the procedures. Different measures were used, such as the Preschool Behaviour Questionnaire, which measures aggression, anxiety, hyperactivity, low concentration skills and fearfulness in preschoolers, and the Rutter scales for teachers and parents focusing on emotional and conduct disorders of children aged between 9 to 13 years. A drop in mean scores indicated an improvement in the behaviour of the child. The results also showed that the younger children (4-6 years old) assigned to the intervention group were less hyperactive and aggressive after surgery than those in the control group. The researchers noted that the key difference found between the two groups may suggest that the psychological preparation programme helped the children to process the surgical procedure in a constructive way and to 'be more resilient to emotional or behavioural disturbances' following their operations. The team said more research should be conducted to test the effectiveness of this programme with other age groups, and stressed the need for hospitals and medical staff to provide both medical and psychological care.
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Greece