The Effect of Reading Story Books on Fear and Anxiety Levels
Condition: Operative Incision
MeSH terms: Surgical Wound
Study type: Interventional

Summary: 
      The aim of this project is to determine the effect of reading the story book, which is
      considered within the scope of the pedagogically approved research that introduces the
      surgical environment before the surgical intervention in children, on the pain and anxiety of
      the child. The project is a randomized controlled trial. The population of the research will
      be children between the ages of 4 and 6 who come to Atatürk University Health Research and
      Application Center Pediatric Surgery Clinic between March and September 2022 for treatment.
      The research sample; children and parents who are hospitalized in the clinic on the dates
      specified by the probabilistic sampling method and meet the research criteria, willing to
      participate in the research. "Survey Form", "Modified Yale Preoperative Anxiety Scale
      (mYPAS)" and "Child Fear Scale" will be used in data collection.
    

Detailed description: 
      Type of Study: The study is of the randomized controlled experimental type. Place and Time of
      the Research: The research will be carried out between March-September 2022 at Atatürk
      University Health Research and Application Center Pediatric Surgery Clinic. Surgical
      procedures performed in the clinic are frequently prepuce, hernias, undescended testis, acute
      abdominal traumas and dilatation.

      Population and Sample of the Study: The population of the research will be children aged 4-6
      years who come to Atatürk University Health Research and Application Hospital Pediatric
      Surgery Clinic between March-September 2022 for treatment.

      The research sample; hernia and undescended testis will be operated on the dates specified by
      the probabilistic sampling method and children who meet the research criteria and volunteer
      to participate in the research will be formed.

      In order to prevent interaction between the groups of children in the clinic, data collection
      will not be carried out simultaneously in the story group and control groups. In order to
      ensure randomization, children who met the criteria will be included in the control group in
      the first week, and children who come in the second week will be included in the story group,
      and this cycle will be continued until the end of the study and randomization will be
      ensured.

      Data Collection Tools: Questionnaire Form, Modified Yale Preoperative Anxiety Scale and Child
      Fear Scale will be used to collect research data. The book titled "Elif Is Surgery", which is
      licensed by Çamlıca Children's Publishing, which owns the copyrights, will be used as an
      intervention tool in the research.

      Questionnaire Form: In this form, which was prepared by the researcher by examining the
      literature; There will be questions about the introductory features of the child and the
      parent.

      Modified Yale Preoperative Anxiety Scale (mYPAS): The Yale Preoperative Anxiety Scale (YPAS),
      which was developed in 1995 to measure the preoperative anxiety of children, was modified in
      1997 (mYPAS) and used in many studies covering various health fields such as dentistry,
      anesthesia, surgery, and pediatrics. The scale evaluates five basic parameters. These;
      Activity includes speech, emotional state, marked arousal, and relationship with family. In
      the scale, the parameters of activity, emotional state, marked arousal state and relationship
      with family are evaluated between (1-4) and speech (1-6).

      Child Fear Scale (CFS): Child Fear Scale was developed in 2011 to measure fear in children
      undergoing painful medical procedures. The Child Fear Scale is a scale from 0-4 showing five
      faces ranging from a neutral expression (0 = no worry) to the feared face (4 = serious
      anxiety).

      Intervention Tool to be Used in Research Storybook: As an intervention tool in the research,
      the book titled "Elif Is Surgery" will be read by her parents.

      In the selection of the story book, attention was paid to the fact that it was pedagogically
      appropriate and at the same time the author of the book was a child developmentalist and
      pedagogue. In this storybook, the operating environment is introduced in a way that children
      can understand and is suitable for the age group of the study. Words such as cut and blood,
      which are specific to this age, are not used in the storybook. While the story book will be
      read, the child's opinion will be taken and the book will be read with a character name that
      he wants. For example, ask the children, "What name would you like to give your character
      before the book is read?" Asking the child's opinion will increase his self-confidence, and
      at the same time, it will be ensured that he listens carefully to the story with the
      curiosity of "What will happen to my character?" Data Collection The researcher will be in
      the pediatric surgery service for 2 days to examine the pediatric surgery service and will
      make a preliminary application before collecting the data of the children in the storybook
      group and the control group children. The children and their parents were given preliminary
      information about the research (the purpose of the research, why the research was conducted,
      the story book would be used to relieve the child's fear and anxiety, it was thought that it
      would be effective in preventing fear, etc.) will be obtained through face-to-face
      interviews.

      Control Group: Questionnaires and scales will be filled by the researcher 30 minutes before
      the surgery. Only routine applications will be done within 5 minutes. The scales will be
      refilled 10 minutes before the surgery and when the child moves to the premedication room.
      The families of the children will be with the children until the premedication room. Filling
      out the forms will take 5-10 minutes on average.

      Story Group: Questionnaires and scales will be filled in 30 minutes before the surgery by the
      researcher. The child's parent will read the storybook. In reading the story book; It will
      reduce fear and anxiety by attracting the patient's attention (sound, image…) and enabling
      him to get away from the negative emotions he is in. Routine applications will be done within
      5 minutes. The scales will be refilled 10 minutes before the surgery and when the child moves
      to the premedication room. The families of the children will be with the children until the
      premedication room. Filling out the forms will take 5-10 minutes on average.

      Evaluation of Data The processing and statistical analysis of the collected data will be done
      with the analysis software called SPSS (Statistical Package for the Social Sciences) for
      Windows 20.0.

      Ethical Principles of Research In order to carry out the research, official permission from
      the relevant institution will be obtained from the Ethics Committee with ethical approval.
      Children who meet the criteria of the research group will be informed about the purpose of
      the study, their questions will be answered, and their verbal and written consent will be
      obtained. Parents and children will be informed that the data collected during the research
      will be processed anonymously, confidentially, and will not be used outside of the study in
      question, and that they can leave the study whenever they wish. Since the research is based
      on the use of data obtained from humans, and therefore, due to the necessity of observing
      personal rights, the relevant ethical principles "Informed Consent", "Volunteerism" and
      "Protection of Confidentiality" will be followed.
    

Intervention name(s): storybook
Intervention type(s): Behavioral
Intervention description(s): anxiety and fear during operative
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Supportive Care