Preoperative Gamified Breathing Exercise on Anxiety and Delirium in Children.

Bozok University80 enrolled

Overview

This study aims to evaluate the effect of preoperative gamified breathing exercises on preoperative anxiety and postoperative emergence delirium in children. The intervention includes games like ball blowing and bubble blowing. Anxiety is measured using the mYPAS-SF scale, and delirium is assessed with the PAED scale.

This randomized controlled study investigates the impact of preoperative gamified breathing exercises on preoperative anxiety and postoperative emergence delirium in pediatric patients. Children in the intervention group and their parents receive specialized training on gamified breathing exercises starting 48-72 hours before surgery. The intervention consists of various interactive breathing games selected based on the child's preference, including: Ball Blowing: Blowing a cotton or ping-pong ball across a flat surface or into a 'goal' using a straw to encourage deep exhalation. Bubble Blowing: Using soap bubbles to promote slow and controlled breathing patterns. Tissue/Paper Blowing: Blowing on tissues to lift them or move paper windmills. Candle Blowing: Simulating or practicing blowing out candles using different breath strengths. Participants are asked to perform these exercises for 10 minutes every hour, approximately 10-15 times per day, until the time of surgery. The control group receives routine preoperative information and care. Primary outcomes are measured using the Modified Yale Preoperative Anxiety Scale (mYPAS-SF) before the operation. Postoperative emergence delirium is assessed in the recovery room at 0, 15, and 30 minutes using the Pediatric Anesthesia Emergence Delirium (PAED) scale." Bu Bölümden Sonraki Adım: Arms and Interventions Bu metni kaydedip ilerlediğinizde, sistem sizden grupları (Arms) ve müdahaleleri (Interventions) ayrı ayrı tanımlamanızı isteyecektir. Arm 1 (Experimental): Gamified Breathing Exercise Group. Arm 2 (No Intervention/Control): Routine Care Group.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Interventions

Gamified Breathing ExercisesBEHAVIORAL

The intervention involves providing preoperative training to children and their parents on gamified breathing exercises starting 48-72 hours before surgery. Children choose from various interactive breathing games, including: Ball Blowing: Blowing cotton or ping-pong balls across a surface using a straw. Bubble Blowing: Blowing soap bubbles to promote slow, deep exhalation. Candle Blowing: Practicing controlled breathing by blowing out candles. Tissue/Paper Blowing: Using breath to lift tissues or move paper windmills. Participants are instructed to practice these games for 10 minutes every hour, approximately 10-15 times per day, until the day of surgery. All necessary equipment (straws, bubbles, toys) is provided by the researchers.

Eligibility

Sex: ALLMin age: 3 YearsMax age: 7 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Children aged 3 to 7 years (preschool age). Scheduled for elective (planned) surgery at Bursa Uludag University Hospital. Physical status classified as ASA I or ASA II. Children and parents who volunteer to participate and provide written informed consent. Exclusion Criteria: Children with chronic neurological or psychiatric disorders. Children with existing respiratory system diseases that prevent breathing exercises. Children or parents with communication barriers (e.g., severe hearing or speech impairment). Children undergoing emergency (non-elective) surgery. \-

Outcomes

Primary Outcomes

Preoperative Anxiety Score

This will be assessed using the Modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF). The scale evaluates five categories of behavior: activity, vocalization, emotional expressivity, state of arousal, and use of parents. Scores range from 22.92 to 100, where higher scores indicate higher levels of anxiety.

Time frame: Immediately before the surgery (preoperative holding area).

Secondary Outcomes

Postoperative Emergence Delirium Level

This will be assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale. The scale consists of five items: eye contact, purposeful actions, awareness of surroundings, restlessness, and inconsolability. Scores range from 0 to 20, with a score of 10 or higher indicating the presence of emergence delirium.

Time frame: At 0, 15, and 30 minutes after arrival in the Post-Anesthesia Care Unit (PACU).