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Title: A study to access the effectiveness of the provision of written material in the form of a storybook in lessening anxiety in children aged 5-11 years undergoing tonsillectomy and adenoidectomy
Author: Tunney, Anne Marie
ISNI:       0000 0004 5346 4108
Awarding Body: University of Ulster
Current Institution: Ulster University
Date of Award: 2014
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Aims This study aimed to assess the effectiveness of a storybook, entitled, The Tale of Woody's Tonsils, written by the researcher, in reducing the level of anxiety of children, aged 5 - 11 years who were undergoing tonsillectomy and adenoidectomy. The study also aimed to explore a number of variables which may have had an impact on anxiety and which may be influenced by the administration of the storybook. Background There is evidence, in both adult and paediatric studies, that effective psychological preparation for a surgical procedure has an impact on the individuals' coping ability with reduced levels of anxiety leading to better post operative outcome, faster recovery and a reduction in long term sequelae associated with admission to hospital. A storybook, as a method of preparation, has been recommended by a number of researchers but the effectiveness of a specific storybook has not yet been investigated in the UK. Previous studies have mainly used only one research instrument for anxiety measurement and chi Id self report is not a common feature of such research. Design A quasi-experimental study, using convenience sampling was conducted using a repeated measures design at two points in time. XI Method Eighty children on a waiting list for tonsillectomy and adenoidectomy were alternately allocated to either an experimental group, receiving a copy of the storybook or to a comparative group, receiving a colouring book. Pre intervention testing consisted of the subjects completing a self report Hospital Fears Rating Scale and the Child Drawing: Hospital, a projective technique based on child drawing. This was repeated post intervention and scores obtained from both instruments were used to determine anxiety levels. Results Results indicated that the use of the storybook reduced anxiety levels of children aged 5 - 11 years awaiting admission for tonsillectomy and adenoidectomy. No relationship was found between age, gender, experience of previous hospitalisation or experience of sibling hospitalisation on the level of anxiety experienced. There was evidence from the results to suggest that the storybook was particularly effective in reducing anxiety levels of females, children with no experience of previous hospitalisation, children with experience of sibling hospitalisation and children in the seven year old age group. Conclusion This study demonstrates that, as a method of psychological preparation of children aged 5 - 11 years awaiting tonsillectomy and adenoidectomy, a storybook about a fictional human child undergoing the same procedure was effective in alleviating anxiety pertaining to the admission. It also supports the appropriateness and benefits of a combined approach, using quantitative scoring and impressionistic interpretation, to the measurement of anxiety. Relevance to practice This study fills a gap in the knowledge base regarding psychological preparation of children for ENT surgery. It reinforces the need for assessment to be inclusive of exploration of anxiety triggers and their intensity so that preparation and nursing care can be individualised for each child. The study also provides evidence that there is a need for child focused anxiety measurement tools to be chosen carefully for use within the field of paediatrics. The two anxiety measurement tools used within this study could be effectively used in a number of health care settings, both long and short term care and with a variety of age groups. Finally, this study has demonstrated that the use of a storybook is a particularly effective method for preparing children for an ENT surgical procedure and the principles of its development and use could be extended to other specialties.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available