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NCT Number: NCT07031271

The Effect of the Strategic Game Tangram on Postoperative Patient Outcomes

The aim of this study was to investigate the effects of playing tangram game after surgery on pain, fatigue and comfort levels in patients undergoing abdominal surgery.

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Pain Management Agnosia Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Nursing Care Pathological Conditions, Signs and Symptoms Perceptual Disorders Postoperative Care Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Aydın Adnan Menderes University

Aydin, Aydın, 09010, Turkey (Türkiye)

About this study

Tangram game is a skill and strategy game based on creating 100 different forms, made of 4 or 7 pieces, made of wood. 100 different shapes are obtained by using all the given pieces. These patterns should be arranged from easy to difficult by following a given guide. Tangram game is a strong stimulant as it appeals to both visual and mental skills. Strong stimulants prevent the ongoing pain stimulus at that moment. Pain transmission is interrupted and the individual is prevented from feeling pain. During and after the game, the pain level begins to decrease thanks to different stimulants. Applications that give the individual pleasure, such as Tangram, provide the secretion of substances such as enkephalin and endorphin. With these secreted substances, the body's own analgesia system is supported and the severity of pain is reduced. There are studies in the literature testing non-pharmacological interventions in the management of post-operative pain and fatigue. Some of these studies include studies evaluating the effects of massage, listening to music, cold application, distraction strategies such as playing a tangram game or giving auditory stimulation, mobilization, reflexology, chewing gum, and acupuncture. There are limited studies in the literature on the use of tangram games in the management of postoperative pain, and no studies have been found examining the effects of this intervention on pain, fatigue, and patient comfort.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Having had abdominal surgery
  • Being on the first day after surgery
  • Having a first pain measurement score of at least 2
  • Having at least 3 hours since the last analgesic application

Exclusion criteria

  • Having hearing/vision/mental problems
  • Having limited movement in the hand/wrist/arm
  • Having undergone surgery due to cancer
  • Being diagnosed with a psychological illness (schizophrenia, depression)

Treatment and study plan

Tangram game

Behavioral

Tangram game; It is a very old intelligence and attention game of Chinese origin. This game stands out with its both entertaining and educational aspects. Tangram consists of seven geometric pieces formed from a square shape. These 7 pieces; 2 large right triangles, 1 medium right triangle, 2 small right triangles, 1 square and 1 parallelogram. The aim is to create various shapes (animals, people, objects, letters, etc.) with these pieces. The aim of the Tangram game is to recreate the same appearance with a given shape (silhouette) using the pieces. All 7 pieces must be used in the game, the pieces must not be overlapped, the pieces must not be cut or divided, the pieces can be rotated or turned according to the selected shape. For example, the person is asked to create a cat figure with these 7 pieces in accordance with the rules. This game is one of the non-pharmacological pain management techniques by diverting the attention of the patients. It is easy to apply and cheap.

Primary outcomes

  1. Pain level

    Time frame: Postoperative 1st day

    The numerical rating scale to be used in the assessment of pain is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "no pain", corresponding to 0 points, and the upper end is "unbearable pain", corresponding to 10 points. As the pain intensity expressed by the patient increases on the scale, it will be interpreted that the patient's pain increases. This is first measurement.

  2. Pain level

    Time frame: 20 minutes later after first measurement

    The numerical rating scale to be used in the assessment of pain is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "no pain", corresponding to 0 points, and the upper end is "unbearable pain", corresponding to 10 points. As the pain intensity expressed by the patient increases on the scale, it will be interpreted that the patient's pain increases. This is second measurement.

  3. Pain level

    Time frame: 30 minutes later after second measurement

    The numerical rating scale to be used in the assessment of pain is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "no pain", corresponding to 0 points, and the upper end is "unbearable pain", corresponding to 10 points. As the pain intensity expressed by the patient increases on the scale, it will be interpreted that the patient's pain increases. This is third measurement.

  4. Fatigue level

    Time frame: Postoperative 1st day

    The numerical rating scale to be used in the assessment of fatigue is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "not tired" corresponding to 0 points, and the upper end is "unbearably tired" corresponding to 10 points. As the fatigue intensity expressed by the patient increases on the scale, it will be interpreted as the patient's fatigue increasing. This is first mesurement.

  5. Fatigue level

    Time frame: 20 minutes later after fist measurement

    The numerical rating scale to be used in the assessment of fatigue is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "not tired" corresponding to 0 points, and the upper end is "unbearably tired" corresponding to 10 points. As the fatigue intensity expressed by the patient increases on the scale, it will be interpreted as the patient's fatigue increasing. This is second mesurement.

  6. Fatigue level

    Time frame: 30 minutes later after second measurement

    The numerical rating scale to be used in the assessment of fatigue is a one-dimensional 10 cm scale based on the patient's self-report. The lower end is "not tired" corresponding to 0 points, and the upper end is "unbearably tired" corresponding to 10 points. As the fatigue intensity expressed by the patient increases on the scale, it will be interpreted as the patient's fatigue increasing. This is third mesurement.

Secondary outcomes

  1. Comfort level

    Time frame: 30 minutes after second measurement

    General Comfort Scale-Short Form will be used to evaluate the comfort level. The scale consists of 28 items and the items of the scale are scored between 28-168. General Comfort Scale Short Form consists of three sub-dimensions: relief, relaxation, and superiority. GKÖ-SF was developed by Kolcaba in 2006 and its Turkish validity and reliability study was conducted by Çıtlık et al. in 2018. It includes the sub-dimensions of comfort, relief (9 items), relaxation (9 items), and overcoming problems (10 items). In the evaluation of the scale consisting of positive and negative items, the negative items are reverse coded and summed. The mean value is found by dividing the total score by the number of scale items. The lowest possible value, 1, indicates low comfort, and the highest value, 6, indicates high comfort.

Sponsors and collaborators

Lead sponsor

Aydin Adnan Menderes University

Other

Registry information

Official study title

Investigation of the Effect of Tangram Game on Patient Outcomes in Patients Undergoing Abdominal Surgery: A Randomised Controlled Study

Important dates

Study start
2025
Primary completion
2025
Study completion
2026
First posted
Jun 22, 2025
Registry last updated
Jun 29, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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