ORIGINAL RESEARCH: CLINICAL TRIAL Therapeutic play intervention on children’s perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial Hong-Gu He, Lixia Zhu, Sally Wai-Chi Chan, Joanne Li Wee Liam, Ho Cheung William Li, Saw Sandar Ko, Piyanee Klainin-Yobas & Wenru Wang Accepted for publication 3 November 2014 Correspondence to H.-G. He: e-mail: nurhhg@nus.edu.sg Trial registration: This study has been registered with BioMed Central Ltd. (Registration No.: ISRCTN11421435). Hong-Gu He MD PhD RN Assistant Professor Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore Lixia Zhu PhD RN Research Assistant and Project Manager Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore Sally Wai-Chi Chan PhD RN Professor School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia Joanne Li Wee Liam BSc (Nursing) RN Nurse Clinician Division of Nursing, KK Women’s and Children’s Hospital, Singapore Ho Cheung William Li PhD RN Assistant Professor School of Nursing, The University of Hong Kong, China Saw Sandar Ko MM BSc MD Research Assistant Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore HE H.-G., ZHU L., CHAN W.-C.S., LIAM J.L.W., LI H.C.W., KO S.S., KLAININ-YOBAS P. & WANG W. (2015) Therapeutic play intervention on chil- dren’s perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial. Journal of Advanced Nursing 00(0), 000– 000. doi: 10.1111/jan.12608 Abstract Aim. To examine if therapeutic play intervention could reduce perioperative anxiety, negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery. Background. Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations. Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children’s perioperative anxiety, negative emotional manifestation and postoperative pain. Design. A randomized controlled trial was used. Methods. Suitable children were recruited from November 2011–August 2013. They were randomized to receive either routine care (control group, n = 47) or a 1-hour therapeutic play intervention (experimental group, n = 48). Children’s state anxiety, negative emotional manifestations and postoperative pain were measured at baseline, on the day of surgery and around 24 hours after surgery. Repeated measures analysis of covariance (ANCOVA) and univariate ANCOVA adjusting for all possible confounding factors were used in the data analysis. Results. The time effect of state anxiety was significant, but no group and interaction (group x time) effects between the control and experimental groups were found. Compared with the control group, children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain. Conclusions. Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery. These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery. © 2015 John Wiley & Sons Ltd 1 continued on page 2