The Effect of Audio-Visual Methods on Preoperative Anxiety in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Children presenting to hospitals during the preoperative period are often exposed to procedures that cause significant stress. Through preoperative interventions, nurses play an important role in relieving the anxiety of children and their parents. Objective: This study was conducted to determine the effect of audio-visual methods on preoperative anxiety levels in children. Methods: PubMed (including MEDLINE), Cochrane, EBSCOHost, Web of Science, YÖK National Thesis Center, and Google Scholar databases of randomized controlled studies published in the last 10 years were searched for this meta-analysis. 32 studies were included in the meta-analysis, and the total sample size was 2795. Results: Q According to the results of the meta-analysis using the random-effects model, audio-visual methods had a positive effect on reducing anxiety (SMD: -1.312, %95 CI -1,666-(0,958), Z=-7,260, p < 0,001, Q-value = 556,572 I2 = 94.519). The moderator analysis demonstrated that cartoons (SMD:-1.645, p < 0.001), games (SMD:-1.931, p = 0.001), music (SMD:-0.534, p < 0.001), video showings (SMD:-1.363, p = 0.001), and virtual reality (SMD:-1.782, p < 0.001) reduced preoperative anxiety in children. Conclusions: Audio-visual methods are effective in reducing preoperative anxiety in children. The results of this study may provide pediatric perioperative nurses with additional information to help them decrease anxiety for patients and their families.