The Effect of Multisensory Stimulation Administered Before Clinical Encounters at the Pediatric Surgery Outpatient Clinic on Children's Anxiety and Fear Levels and Parental Anxiety

Overview

Encounters with healthcare services during childhood, particularly surgical evaluation processes, are a significant source of stress for both children and their parents. The initial evaluation, physical examination, and the prospect of a possible procedure conducted in pediatric surgery outpatient clinics can lead to increased levels of anxiety and fear in children. This situation not only affects the child's current psychological state but also reduces their cooperation during the examination, makes collaboration with healthcare professionals more difficult, and can negatively impact the overall healthcare experience. Increased levels of anxiety and fear in children are not limited to emotional reactions alone; they also affect physiological and behavioral responses, thereby shaping the entire healthcare process. Similarly, parents may also experience significant situational anxiety due to uncertainty about their child's health status, the possibility of surgical intervention, and the responsibility for care. Parental anxiety is a significant factor that can influence children's levels of anxiety and fear and can indirectly shape the child's healthcare experience through parent-child interaction.

In recent years, there has been an interest in non-pharmacological interventions to address anxiety and fear levels in pediatric healthcare. Methods such as distraction techniques, digital applications, game solutions, and multisensory stimulation have proven effective in children's health experiences. Multisensory stimulation, particularly with materials containing content targeting the senses of sight, hearing, smell, and touch, is a holistic, non-pharmacological approach that helps reduce developmental stage problems, behavioral issues, pain, fear, and anxiety in children. In its basic mechanism, multisensory stimulation activates tactile, thermal, and emotional systems, providing multiple stimuli and diverting children's attention away from the stressor through simultaneous auditory stimuli. The resulting sensory integration and attention redirection effect can contribute to the improvement of anxiety and fear levels. Among multisensory stimulation applications are: Mother-baby communication, skin-to-skin contact, breastfeeding which activates sensory receptors and taste in the skin, the use of amniotic fluid or aromatic scents are included. In addition, practices such as making eye contact with the baby, speaking in a soft tone of voice, massaging, coordinating and using parental credit are among the components of multisensory stimulation. However, it is noted that this is largely focused on childbirth and that the clinical limits are restricted. There is limited scientific evidence in the literature that multisensory stimulation may be effective in reducing pain and fear, especially after surgical procedures, in the days of birth. It is observed that the current centers, with multiple voice alerts, are quite limited in addressing the anxiety and fear at home before clinical encounters in pediatric surgery outpatient clinics, where most neonatal or pre-operative processes are evaluated, and the situational anxiety of individuals is addressed together with outbreaks. However, the outpatient setting has critical relationships as the first point of contact with the modern health system, and the anxiety, fear, and parental anxiety experienced at this stage significantly affect the child's subsequent health experiences and compliance with health services. Therefore, the emergence of effective, short-term, and non-pharmacological interventions in the pre-clinical encounter period will be of great importance. In line with this, these randomized controlled trials are planned to examine the effect of multiple sensory stimuli on the situational anxiety of individuals in pediatric surgery outpatient clinics, prior to clinical encounters, and in terms of anxiety and fear. The study results will contribute to supporting a low-level, effective, and effective intervention in pediatric surgery outpatient clinics. Furthermore, it will lay the groundwork for demonstrable practices that will strengthen this developmental, child and family-centered care approach and contribute to the widespread use of psychosocial support practices in pediatric health services.