Effect of a perioperative digital serious game (PeroPap) on pain and anxiety in children: A randomized controlled trial.

Abstract

This study aimed to evaluate the effectiveness of the Perioperative Pediatric Application (PeroPap) on perioperative adaptation and symptoms, including pain, anxiety, comfort, and nausea in children. This prospective randomized controlled trial was conducted in the pediatric surgery clinic of a tertiary education and research hospital in Türkiye. The study included 182 children aged 7-10 years undergoing surgery and their parents, who were randomly assigned to the experimental (n = 91) or control group (n = 91). Children in the experimental group received perioperative preparation through the PeroPap digital serious game one day before surgery, whereas the control group received standard preparation using an educational booklet. Perioperative anxiety and postoperative outcomes including pain, nausea, and comfort were assessed using validated instruments. Perioperative anxiety scores at post-intervention assessment time points were significantly higher in the control group (p < 0.001). Postoperative pain and nausea scores at 1 and 2 h after surgery were significantly higher in the control group (p < 0.001). Children in the experimental group demonstrated significantly higher comfort levels than those in the control group (p < 0.001). The PeroPap digital serious game effectively reduced perioperative anxiety, pain, and nausea while improving comfort in children undergoing surgery. Digital game-based education may be an effective strategy for improving perioperative symptom management in pediatric surgical patients. Integrating digital serious games such as PeroPap into routine preoperative education can enhance children's engagement and effectively reduce perioperative anxiety and pain. These scalable, child-centered interventions represent a practical strategy for improving perioperative outcomes and patient-centered care in pediatric settings.