Clinical Scorecard: Effects of Nursing Care Based on Comfort Theory on Anxiety Levels and Recovery Results in Pediatric Patients Undergoing Strabismus Surgery

At a Glance

Key Highlights

• Comfort Theory–based nursing significantly reduces perioperative anxiety measured by m-YPAS scores before induction and postoperative day 1.
• Physiological stress responses such as heart rate and mean arterial pressure are lower with comfort-guided care.
• Postoperative pain scores decrease and behavioral recovery improves, with faster consciousness recovery, earlier oral intake, and shorter hospital stays.

Guideline-Based Recommendations

Diagnosis

• Assess perioperative anxiety using validated scales such as the Modified Yale Preoperative Anxiety Scale (m-YPAS).
• Evaluate postoperative pain with tools like the FLACC scale.
• Monitor behavioral recovery using instruments such as the Post-Hospitalization Behavior Questionnaire (PHBQ).

Management

• Implement Comfort Theory–guided nursing interventions including individualized psychological preparation, environmental optimization, parental involvement, and continuous emotional support.
• Incorporate holistic care addressing physical, psychospiritual, sociocultural, and environmental comfort needs.
• Engage parents actively during perioperative phases to provide emotional reassurance.

Monitoring & Follow-up

• Continuously monitor physiological stress indicators such as heart rate and mean arterial pressure preoperatively.
• Track postoperative pain levels at multiple time points using standardized scales.
• Observe behavioral recovery patterns post-hospitalization to identify maladaptive changes.

Risks

• Recognize that perioperative anxiety can provoke tachycardia, elevated cortisol, increased anesthetic requirements, prolonged recovery, greater postoperative pain, and behavioral disturbances.
• Be aware of communication barriers in children that may mask anxiety or pain, necessitating comprehensive assessment.

Patient & Prescribing Data

Pediatric patients undergoing elective strabismus surgery

Comfort Theory–guided nursing care reduces anxiety and physiological stress, decreases postoperative pain, and accelerates functional recovery compared to routine nursing care.

Clinical Best Practices

• Use a structured Comfort Theory framework to assess and meet multifaceted comfort needs in pediatric surgical patients.
• Provide individualized psychological preparation tailored to each child's emotional and cognitive level.
• Optimize the perioperative environment to be child-friendly and reduce sensory stressors.
• Encourage parental presence and active involvement during induction and recovery phases.
• Deliver continuous emotional support to foster trust and cooperation throughout the perioperative period.

References

• Kolcaba K. Comfort Theory in Nursing
• Modified Yale Preoperative Anxiety Scale (m-YPAS)
• Face–Legs–Activity–Cry–Consolability (FLACC) Pain Scale
• Post-Hospitalization Behavior Questionnaire (PHBQ)