Structured game and parental education on postoperative pain and anxiety in children with appendicitis

doi:10.4240/wjgs.119824

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Publication Name

World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 119824
Published online Aug 27, 2026. doi: 10.4240/wjgs.119824

Structured game and parental education on postoperative pain and anxiety in children with appendicitis

Si Chen, Xiao-Qian Dun

Si Chen, Xiao-Qian Dun, Department of Pediatric Rehabilitation, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China

Author contributions: Chen S contributed to conceptualization, methodology, investigation, data curation, formal analysis, writing-original draft preparation, writing-review and editing, visualization, project administration; Dun XQ contributed to conceptualization, methodology, validation, resources, supervision, funding acquisition, writing-review and editing.

AI contribution statement: AI was used only for language translation during the preparation of this manuscript. No AI was used for content generation, data analysis, study design, result interpretation, or image creation.

Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki. The research protocol was reviewed and approved by the Institutional Review Board (or Ethics Committee) of Shijiazhuang Maternal and Child Health Hospital, date of approval: Date, 15 March 2024. Informed consent was obtained from the parents or legal guardians of all participating children.

Informed consent statement: Written informed consent was obtained from the parents or legal guardians of all children enrolled in this study.

Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The data supporting the findings of this study are not publicly available due to ethical restrictions and the need to protect the privacy of the pediatric participants. De-identified data may be available from the corresponding author upon reasonable request and with the approval of the institutional ethics committee.

Corresponding author: Xiao-Qian Dun, Department of Pediatric Rehabilitation, Shijiazhuang Maternal and Child Health Care Hospital, No. 396 Youyi South Street, Qiaoxi District, Shijiazhuang 050000, Hebei Province, China. guoxiaoqian206@163.com

Received: March 27, 2026
Revised: April 22, 2026
Accepted: June 3, 2026
Published online: August 27, 2026
Processing time: 141 Days and 21.5 Hours

Abstract

BACKGROUND

Acute appendicitis is a common surgical emergency in children. Postoperative pain and anxiety are prevalent among pediatric patients, and parents often experience significant negative emotions during the perioperative period.

AIM

To explore the effect of structured game intervention combined with parental empowerment education model on postoperative pain control and anxiety levels in children undergoing appendicitis surgery.

METHODS

Sixty children with appendicitis who underwent surgical treatment in Shijiazhuang Maternal and Child Health Hospital Department of Pediatric Surgery from February 2022 to February 2025 were prospectively selected for the study. According to the lottery method, the children were randomly divided into the control group (30 people, with standardized care) and the observation group (30 people, with structured game intervention combined with parent empowerment education). The clinical indicators, anxiety, depression, pain within 72 hours after the intervention, postoperative psychological trauma and the occurrence of complications of the two groups of children were compared. The psychological state and nursing satisfaction of the parents of the two groups of children after the intervention were also compared.

RESULTS

After the intervention, the intestinal peristalsis time, feeding time, getting out of bed time, frequency of pain-relieving drug use and hospital stay, modified Yale Perioperative Anxiety Scale score (27.63 ± 1.17) points, Children’s Depression Inventory score (6.42 ± 2.40) points, Face, Legs, Activity, Cry, Consolability scores at 12 hours, 24 hours, 48 hours and 72 hours after surgery, postoperative crying (3.33%), and irritability (6.6) of the children in the observation group. The incidences of 7%, night terrors and insomnia (3.33%), and complications (3.33%) were all significantly lower than those in the control group, P < 0.05; the Hamilton Anxiety Scale score (16.29 ± 4.17) points and Hamilton Depression Rating Scale score (9.13 ± 1.74) points of the parents of the children in the observation group were significantly lower than those in the control group, and the total satisfaction with nursing (96.67%) was significantly higher than that in the control group, P < 0.05.

CONCLUSION

The structured game intervention combined with parent empowerment education model can enhance the postoperative rehabilitation effect of children patients, alleviate their anxiety and pain conditions, reduce the incidence of postoperative psychological trauma and complications, and simultaneously improve the negative emotions of parents and increase their satisfaction.

Keywords: Structured games; Parental empowerment education; Children; Appendicitis; Postoperative pain; Anxiety

Core Tip: This study pioneers a dual-strategy model that combines structured, theme-based games with practical parental coaching for children after appendectomy. This approach actively engages both child and parent in recovery, going beyond routine nursing. Results show it shortens hospital stays, reduces painkiller use, eases children’s emotional distress, and lowers caregiver anxiety. The model provides a practical, family-centered blueprint to improve pediatric surgical outcomes and overall care satisfaction.