The effect of sandplay therapy on anxiety and pain in children during the preoperative period

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Gündüz G., Tural Büyük E.

JOURNAL OF PEDIATRIC NURSING, cilt.89, ss.432-438, 2026 (SCI-Expanded, SSCI, Scopus)

Özet

Objective

This study was conducted to investigate the effect of sandplay therapy applied during the preoperative period on the anxiety and pain levels of 7–10-year-old children.

Methods

This study is a randomized controlled experimental study with a pre-test and post-test design. It was conducted with 7–10-year-old children who were scheduled for tonsillectomy surgery at a training and research hospital located in a city center between October 2024 and July 2025. The sample consisted of 68 children in total, including an experimental group (n = 34) and a control group (n = 34). Data were collected using Children's Anxiety Meter-State (CAM-S), the Modified Yale Preoperative Anxiety Scale-C (mYPAS-C), and the Wong-Baker Faces Pain Rating Scale.

Results

The experimental group demonstrated significantly lower CAM-S and mYPAS-C scores compared to the control group (p < 0.05). Similarly, pain scores were significantly lower in the experimental group (p < 0.05). A positive association was also observed between preoperative anxiety and postoperative pain levels in both groups (p < 0.05).

Conclusion

Sandplay therapy is an effective non-pharmacological intervention for reducing anxiety and pain in children undergoing surgery.

Practice implications

Tonsillectomy is one of the most frequently performed surgeries in the pediatric age group, and therapeutic play interventions should be incorporated into routine perioperative nursing care to reduce anxiety and improve pain management.