THE EFFECT OF SANDPLAY THERAPY ON THE ANXİETY AND PAİN LEVELS OF CHİLDREN DURİNG PREOPERATİVE PERİOD

NCT07433296 | Completed

• 2 other identifiers: OMU-2022-588BAP04-B-2024-5060
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to investigate the effects of preoperative sand play therapy on anxiety and pain levels in school-aged children (7-10 years old). The study was conducted with 68 children undergoing tonsillectomy, divided into an experimental group (sand play intervention) and a control group (routine care). Anxiety levels were measured using the Child Anxiety Scale-State (CAAS) and the Yale Modified Preoperative Anxiety Scale (mYPAS), while pain levels were assessed using the Wong-Baker Faces Pain Rating Scale. The study evaluates whether sand play before surgery is an effective non-pharmacological method for reducing preoperative anxiety and postoperative pain.

Conditions

Tonsillectomy; Postoperative Pain; Preoperative Anxiety

Keywords

pain; anxiety; child; surgery

Outcome Measures

Primary Outcomes (3)

• The Modified Yale Preoperative Anxiety Scale-Child Version (mYPAS-C)

  The Modified Yale Preoperative Anxiety Scale - Child Version (mYPAS-C) is an observational tool used to assess preoperative anxiety in children. The scale consists of 22 items and scores range from 23.33 to 100, with higher scores indicating higher levels of anxiety.

  Baseline (30 minutes before surgery) and immediately before anesthesia induction

• Children's Anxiety Meter-State (CAM-S)

  The Children's Anxiety Meter - State (CAM-S) is a self-report scale used to assess state anxiety in children. The scale ranges from 0 to 10, with higher scores indicating higher levels of anxiety.

  The evening before surgery, 30 minutes before surgery, and 1 hour after surgery

• Wong Baker Faces Pain Rating Scale

  The Wong-Baker Faces Pain Rating Scale is used to assess pain intensity in children. The scale consists of six faces representing increasing pain levels and scores range from 0 to 10, with higher scores indicating greater pain intensity.

  1 hour after surgery

Study Arms (2)

Experimental Group (Sand Play)

EXPERIMENTAL

Unlike the control group, a therapeutic play program was applied to the children one hour before surgery by the certified researcher in this group. The therapeutic play program was conducted in the child's room for 30 minutes. Materials used for the play included colored sand, a sand tray, a sand shaping set, a doll, a toy car, a mask, a cap, a toy doctor's set, colored pencils, drawing paper, and an ice cream cone. The child was given the opportunity to ask questions about things they were curious about to gain their trust. Then, the sand tray was filled with sand having the color chosen by the child, and the toys they selected were placed inside for them to play (the sand was given to each child in individual packets, and the materials were sterilized). Faces Pain Rating Scale (Wong Baker) was applied to assess pain following the surgery in both groups. The child and the parent were asked to complete Children's Anxiety Meter-State.

Behavioral: Sand Play Therapy

Control Group

NO INTERVENTION

The parents who agreed to participate in the study completed an "Informed Consent Form" and a "SocioDemographic Information Form" through face-to-face interviews in the evening before the surgery. An educational booklet was given to the families, and they were asked to read it to their child before the surgery. During the preoperative routine care, the child and family received necessary information about the pre- and post-operative procedures from the ward nurse and the researcher, including vital sign monitoring of the child and the medication prescribed by the physician.

Interventions

Sand Play Therapy BEHAVIORAL

This randomized controlled trial represents an advancement in considering sand play as an intervention applied in the pre-operative period, and it enhances its applicability and clinical success.

Experimental Group (Sand Play)

Eligibility Criteria

• Age: 7 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children aged between 7 and 10 years
• Scheduled for tonsillectomy surgery
• Able to communicate verbally

You may not qualify if:

• History of previous surgery
• Diagnosed neurological or developmental disorders
• Presence of chronic disease
• Postoperative physiological instability

Sponsors & Collaborators

• Ondokuz Mayıs University: lead

Study Sites (1)

Samsun Training and Research Hospital

Samsun, Samsun, 55090, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative; Pain; Anxiety Disorders

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Neurologic Manifestations; Signs and Symptoms; Mental Disorders

Study Officials

• Esra TURAL BÜYÜK, Assoc. Prof

  Ondokuz Mayıs University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor of Philosophy Registered Nurse

Model Details: Study sample was assigned to experimental and control groups with simple randomization method. Both groups are followed simultaneously from the preoperative period through the postoperative assessment.

Study Record Dates

• First Submitted: February 17, 2026
• First Posted: February 25, 2026
• Study Start: October 1, 2024
• Primary Completion: July 1, 2025
• Study Completion: July 1, 2025
• Last Updated: February 25, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)