The effectiveness of web‐based mobile health interventions in pediatric outpatient surgery:a systematic review and meta‐analysis of randomized controlled trials

Abstract Aims: To evaluate the effectiveness of web‐based mobile health interventions on pediatric patients and their parents in the day surgery context, where the primary outcome was children’s preoperative anxiety and secondary outcomes were postoperative pain and parents’ anxiety and satisfaction with entire course of the day surgery. Design: A systematic review and meta‐analysis of randomized controlled trials. Data Sources: CENTRAL, CINAHL, Scopus, Ovid MEDLINE and Web of Science were systematically searched without time limits (up to December 2018). Review Methods: Studies were appraised using the Cochrane risk of bias tool. A random effect meta‐analysis of children’s preoperative anxiety was performed. Results: Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web‐based mobile health interventions, including age‐appropriate videos, web‐based game apps and educational preparation games made for the hospital environment, was examined in preoperative settings. A meta‐analysis (N=560 children) based on six studies found a statistically significant reduction in preoperative anxiety measured by the Modified Yale Preoperative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction. Conclusions: Web‐based mobile health interventions can reduce children’s preoperative anxiety and increase parental satisfaction. Web‐based mobile health interventions could be considered as nonpharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children’s postoperative pain and parental anxiety using similar interventions. Impact: Web‐based mobile health interventions reduce children´s preoperative anxiety and could therefore be considered as non‐pharmacological distraction tools for children in nursing