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Publications

Journal Article Randomized Controlled Trial Epublish

PubMed: 42637802 DOI: 10.1038/s41598-026-66888-1

Effectiveness of an interactive music tablet intervention to reduce procedural anxiety in children: a randomized controlled trial.

Sci Rep 16(1)

Authors: Roland Imle, Ann-Sophie Wiemer, Katharina Hartwig, Christiane Hillebrenner, Stephan Vedder, Sven F Garbade, Christina Blume, Estelle Willuth, Thomas Mueller, Mira Boos, Julian Koenig, Dorothee von Moreau, Patrick Guenther, Philipp Romero

Affiliations

  • Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
  • Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany.
  • Hopp Children's Cancer Center Heidelberg (KiTZ), University Children's Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
  • National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany.
  • Soft-Tissue Sarcoma Research Group, Hopp Children's Cancer Center, Heidelberg (KiTZ), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
  • Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
  • Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany.
  • mbits Imaging, 69115, Heidelberg, Germany.
  • Department of Pediatrics I, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Medical Faculty of Heidelberg, 69120, Heidelberg, Germany.
  • Department of Neuropathology, German Cancer Research Center (DKFZ), University Hospital Heidelberg and CCU Neuropathology, German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.
  • Department of Anesthesiology, University Hospital Heidelberg, 69120, Heidelberg, Germany.
  • Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany.
  • Institute of Music Therapy, Hamburg University of Music and Drama, 20148, Hamburg, Germany.

Abstract

Procedural anxiety in children is common and associated with maladaptive behavior, reduced cooperation, and increased perioperative stress. Although music-based interventions show promise, few are designed for routine clinical care. We evaluated an interactive tablet-based music intervention ("MuMa") for reducing procedural anxiety in children aged 3-11 undergoing elective surgery. We conducted a single-center, parallel-group, randomized controlled trial including 80 children undergoing elective surgery and their caregivers. Participants were randomized to receive the MuMa intervention preoperatively or standard care. Primary outcomes were child (modified Yale Preoperative Anxiety Scale) and caregiver anxiety (State-Trait Anxiety Inventory), assessed before and after the intervention. Secondary outcomes included heart rate variability, compliance during anesthesia induction, postoperative agitation, and behavioral changes at 1, 4, and 12 weeks post-procedure. Trial registration: German Clinical Trials Registry (DRKS00027873), registered 13 May 2022. Here we show that the intervention reduces preoperative anxiety by 38% (standardized mean difference -0.8; 95% CI -1.2 to -0.3) and integrates readily into routine perioperative workflows. Effects are greatest in children with high baseline anxiety (SMD -1.7; 95% CI -2.8 to -0.5) and in those aged 3-6 years (SMD -0.9; 95% CI -1.5 to -0.3). No clinically relevant differences are observed for secondary outcomes. This interactive music intervention significantly reduces procedural anxiety in children, particularly among younger participants and those with high baseline anxiety. Its low resource requirements and ease of implementation support its potential as a scalable non-pharmacological strategy in pediatric perioperative care. Further research should evaluate its generalizability across diverse settings.

MeSH

Caregivers, Tablets, Aged, Child