Elsevier

Journal of Pediatric Nursing

Volume 41, July–August 2018, Pages 80-83
Journal of Pediatric Nursing

Randomized Trial Evaluating the Effectiveness of Coloring on Decreasing Anxiety Among Parents in a Pediatric Surgical Waiting Area

https://doi.org/10.1016/j.pedn.2018.02.001Get rights and content

Highlights

  • •

    Anxiety is common among pediatric surgical patients and their parents.

  • •

    In other populations, producing art has been shown to significantly reduce anxiety.

  • •

    Parents who colored had a greater reduction in anxiety compared to parents who did not color.

  • •

    Coloring can decrease anxiety among parents in a pediatric surgical waiting area.

Abstract

Anxiety is common among pediatric surgical patients and their parents. Numerous studies have examined interventions to reduce pediatric patients' anxiety; however, less is known about reducing parental anxiety. In other populations, producing art has been shown to significantly reduce anxiety.

Purpose

This study aimed to determine whether parents' anxiety decreased after coloring while their child is in surgery.

Design and Methods

A block randomized controlled trial was conducted with a convenience sample of 106 parents of children who were having a scheduled surgery. Each day of data collection was randomized where all parents enrolled that day would either color a pre-drawn art template for 30 min or would simply wait in the waiting room for 30 min. The primary outcome measure was anxiety, measured by the 6-item short form of the Spielberger State Trait Anxiety Inventory (STAI).

Results

Parents' average anxiety score decreased from the initial measurement to the measurement 30 min later in both the control group and the intervention group. The reduction in anxiety was significantly greater for those parents who participated in coloring during their wait (p < 0.0001).

Conclusions

Coloring is a creative, simple, low cost, and effective activity to reduce anxiety among parents in a pediatric surgical waiting area.

Practice Implications

Providing coloring materials and information about the benefits of coloring in pediatric surgery waiting areas is an easy to implement intervention to reduce parental anxiety.

Section snippets

Design and Methods

A block randomized, controlled trial was conducted to examine the effect of coloring pre-drawn art templates on parental anxiety level while those parents' children were in surgery. The study took place in a surgical waiting area at a large, urban, mid-western pediatric hospital. Each day there are approximately 60–100 surgeries that are performed, resulting in a full surgical waiting area. Common surgeries performed include ear tube placement, tonsillectomy and adenoidectomy, eye muscle

Results

A total of 106 participants were enrolled in the study, with 52 in the control (no coloring) group and 54 in the intervention (coloring) group. Data were collected on 6 days. The 6 days were randomized to be either “no coloring” or “coloring” days. Participants were 18 years or older, and the majority of participants were female (78%). No statistically significant differences were found in participants' demographics between the control group and the intervention group (see Table 1). The mean

Discussion

Significant reductions in anxiety reported after participating in creative arts interventions among healthy volunteers (Curry & Kasser, 2005; Sandmire et al., 2012; Sandmire et al., 2016; Van der Vennet & Serice, 2012) and among parents of infants in a neonatal intensive care unit (Mouradian et al., 2013) were corroborated in this study, expanding the settings in which this intervention could be implemented to include parents in a pediatric surgical waiting area.

The current study is limited to

Conclusion

This study added to the current evidence that brief periods of art making is effective in decreasing anxiety by finding this same result in parents waiting in a surgical waiting. After 30 min of coloring a pre-drawn template, parents average anxiety score decreased significantly more than parents who did not color. Coloring is a creative, simple, low cost, and effective activity to reduce anxiety among parents in a pediatric surgical waiting area.

Acknowledgements

We would like to acknowledge the support of the staff and management of the Perioperative and Same Day Surgery Departments at Cincinnati Children's Hospital Medical Center. We gratefully acknowledge the parents and caregivers who participated in this study. In particular, we would like to thank Barb Tofani, Cindi Bedinghaus, Patti Mercurio, and Marc Kirsch for their leadership support. Thanks to Jane Gramke, RN who assisted with enrolling subjects and data gathering and Connie Cook who was so

References (15)

  • N.A. Curry et al.

    Can coloring mandalas reduce anxiety? A pilot study

    Art Therapy: Journal of the American Art Therapy Association

    (2005)
  • F. Cuzzocrea et al.

    A psychological preoperative program: Effects on anxiety and cooperative behaviors

    Pediatric Anesthesia

    (2013)
  • R. Esteve et al.

    Postoperative pain in children: Association between anxiety sensitivity, pain catastrophizing, and female caregivers' responses to children's pain

    The Journal of Pain

    (2014)
  • M.A. Fortier et al.

    Perioperative anxiety in children

    Pediatric Anesthesia

    (2010)
  • Z.N. Kain et al.

    Preoperative anxiety in children: Predictors and outcomes

    Archives of Pediatrics & Adolescent Medicine

    (1996)
  • B. Kerimoglu et al.

    Anesthesia induction using video glasses as a distraction tool for the management of preoperative anxiety in children

    Anesthesia & Analgesia

    (2013)
  • J. Lee et al.

    Cartoon distraction alleviates anxiety in children during induction of anesthesia

    Anesthesia & Analgesia

    (2012)
There are more references available in the full text version of this article.

Cited by (8)

View all citing articles on Scopus
View full text
© 2018 Elsevier Inc. All rights reserved.