Preoperative Gamified Breathing Exercise on Anxiety and Delirium in Children.

This randomized controlled study investigates the impact of preoperative gamified breathing exercises on preoperative anxiety and postoperative emergence delirium in pediatric patients. Children in the intervention group and their parents receive specialized training on gamified breathing exercises starting 48-72 hours before surgery.

The intervention consists of various interactive breathing games selected based on the child's preference, including:

Ball Blowing: Blowing a cotton or ping-pong ball across a flat surface or into a 'goal' using a straw to encourage deep exhalation.

Bubble Blowing: Using soap bubbles to promote slow and controlled breathing patterns.

Tissue/Paper Blowing: Blowing on tissues to lift them or move paper windmills.

Candle Blowing: Simulating or practicing blowing out candles using different breath strengths.

Participants are asked to perform these exercises for 10 minutes every hour, approximately 10-15 times per day, until the time of surgery. The control group receives routine preoperative information and care.

Primary outcomes are measured using the Modified Yale Preoperative Anxiety Scale (mYPAS-SF) before the operation. Postoperative emergence delirium is assessed in the recovery room at 0, 15, and 30 minutes using the Pediatric Anesthesia Emergence Delirium (PAED) scale."

Bu Bölümden Sonraki Adım: Arms and Interventions Bu metni kaydedip ilerlediğinizde, sistem sizden grupları (Arms) ve müdahaleleri (Interventions) ayrı ayrı tanımlamanızı isteyecektir.

Arm 1 (Experimental): Gamified Breathing Exercise Group.

Arm 2 (No Intervention/Control): Routine Care Group.

Inclusion criteria

• Children aged 3 to 7 years (preschool age).

Scheduled for elective (planned) surgery at Bursa Uludag University Hospital.

Physical status classified as ASA I or ASA II.

Children and parents who volunteer to participate and provide written informed consent.

Exclusion criteria

Children with chronic neurological or psychiatric disorders.

Children with existing respiratory system diseases that prevent breathing exercises.

Children or parents with communication barriers (e.g., severe hearing or speech impairment).

Children undergoing emergency (non-elective) surgery.

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