Audiovisual distraction techniques for reducing preoperative anxiety in children undergoing elective surgery

Abstract

Background: This review investigates the effectiveness of audiovisual (AV) distraction techniques in alleviating preoperative anxiety in children under 12 undergoing elective surgery. Preoperative anxiety is linked to various adverse events such as heightened emergence delirium (ED). The Research Question: Do audiovisual distraction interventions reduce preoperative anxiety in children undergoing elective surgery? The PICO Elements: The Population (P) is children under 12 years old undergoing elective surgery. The Intervention (I) is audiovisual distraction techniques. Comparison (C) is usual care. The Outcome (O) is reduced preoperative anxiety. Inclusion and Exclusion Criteria: Patients under 12 who were admitted to hospital for elective surgery were included. Patients were excluded if they were adolescents or adults or underwent emergency surgeries. AV distractions considered were televisions, VR, video games, tablet-computers or music while other forms of distraction were excluded. Non-surgical-related anxiety was excluded. Furthermore, the eligible studies had to be peer-reviewed journals and written in English. Method: A comprehensive search on databases including HyDi, Scopus, and Stella Search along with reference list screening identified 6 eligible articles all of which were Randomised Controlled Trials (RCTs). The CASP tool for RCTs was employed for critical appraisal. Results: Out of the 6 RCTs, statistical significance was only found in four studies, namely those by Wang et al. (2022), Buyuk et al. (2021), Jung et al. (2021) and Stewart et al. (2019). Kim et al. (2015) and Clausen et al. (2020) showed no statistically significant results. Conclusion: This literature review suggests that the use of AV distraction techniques may have potential benefits in reducing preoperative. Implications and Recommendations: Further research is required, especially locally, with a particular emphasis on using a homogenous approach regarding AV interventions. The necessity for educating nurses on adverse effects of preoperative anxiety in children was identified. The introduction of a standardised assessment tool used for routine evaluation of preoperative anxiety in children is highly recommended. Implementation of the use of AV devices in paediatric surgical wards and holding areas at the local hospital requires substantial financial resources, staff awareness and training.