Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not therapeutic play is effective at reducing preoperative anxiety in children age 4 through 12.

STUDY DESIGN: Three single blind, randomized controlled trials that were published between 2008 and 2010 and published in the English language.

DATA SOURCES: Each of the three studies that evaluate the effectiveness of therapeutic play in pediatric populations were found using the PubMed database based on their relevance to the clinical question and their inclusion of patient oriented outcomes.

OUTCOMES MEASURED: These three articles compared anxiety and stress levels in preoperative therapeutic play and standard preoperative procedures with the Modified Yale Preoperative Anxiety Scale (m-YPAS), Chinese version of the State Anxiety Scale for Children (CSAS-C) and Preschool Behavior (Behar) Questionnaire.

RESULTS: All three studies found a significant decrease in the anxiety levels of children who were involved in preoperative therapeutic play when compared to those who underwent standard preoperative procedures. In the Athanassiadou et al. study, a p-value was not reported; however, the results were concluded to be statistically significant in showing that preoperative play led to lower anxiety levels in children.1 In the Hosseinpour et al. study, it was demonstrated that preoperative play was successful at reducing anxiety levels in children with a statistically significant p-value of 0.001generalizable to gender and age for the targeted population.2 In the Li et al. study, the experimental had a mean anxiety level of 34.36 and a control mean anxiety level of 36.16 with a reported test statistic p-value of 0.002 indicating statistical significance.3

CONCLUSION: The results of these three studies comparing anxiety levels in children who received preoperative play with children who received standard preoperative procedure demonstrated that it is possible to reduce anxiety levels in children age 4 through 12 with intended intervention.

Included in

Surgery Commons