Non-pharmacological interventions to reduce anxiety among children undergoing surgery: A systematic review

Edlin Glane Mathias, Mamatha Shivananda Pai, Vasudeva Guddattu, Ann Cathrine Bramhagen

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


A hospitalized child experiences anxiety more frequently as compared to non-hospitalized children. Surgery can be emotionally distressing for children, and subsequently their parents and caregivers, this distress can cause profound adverse impacts on children. We aimed to identify the effect of non-pharmacological interventions on children’s (1–18 years) anxiety undergoing surgery. The following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Proquest, Web" of Science, and Cochrane Central Register of Controlled Trials were systematically searched for full-text articles. The review included 15 randomized controlled trials. The risk of bias was assessed using Cochrane Risk of Bias tool. The interventions included in the study were preoperative education, puppet play, therapeutic play, distraction activities, parental presence, and clown therapy. The review presents a narrative reporting of the findings. This review identifies that non-pharmacological interventions are effective in reducing anxiety among children undergoing surgery. There are a limited number of studies from developing countries. Further research is required to underpin the use of these interventions with children before surgery.

Original languageEnglish
Pages (from-to)13674935211062336
JournalJournal of Child Health Care
Publication statusAccepted/In press - 2022

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics


Dive into the research topics of 'Non-pharmacological interventions to reduce anxiety among children undergoing surgery: A systematic review'. Together they form a unique fingerprint.

Cite this