• Ho Cheung William Li.
• Nurse Instructor, The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. williamli@cuhk.edu.hk
• J Clin Nurs. 2007 Oct 1;16(10):1919-26.

AimsThis study aimed to compare the effectiveness of two preoperative nursing interventions and examining the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative interventions.BackgroundThere is some evidence that the Children's Emotional Manifestation Scale can be used as an objective assessment tool in documenting children's emotional responses. However, it is uncertain from previous study that whether the scale can be used in evaluating the effectiveness of preoperative interventions.DesignA randomized controlled trial, between subjects design was carried out in a well-established day surgery unit.MethodChildren (7-12 years of age; n = 203) admitted for elective day surgery during a 13-month period, were recruited. By using a simple randomization method, 97 of children were assigned to the experimental group receiving therapeutic play intervention and 106 children were assigned to the control group receiving routine information preparation.ResultsChildren receiving therapeutic play preparation reported statistically significant lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures than children receiving information preparation. Children with high preoperative anxiety levels manifested more negative emotional behaviour during anaesthesia induction and were associated with faster heart rates and higher mean blood pressures.ConclusionThe study demonstrates the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative nursing interventions and presents clear evidence to support the effectiveness of therapeutic play intervention in preparing children for surgery when compared with the information preparation approach.Relevance To Clinical PracticeThis study contributes towards enriching the experience of using child-sensitive research tools in evaluating the effectiveness of preoperative nursing interventions. The findings heighten the awareness of the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.

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