Anxiety Levels In Children Research Articles

The effect of anxiety and depression levels of children with celiac disease on quality of life

PurposeThis study was conducted to examine the effect of anxiety and depression levels on quality of life in children with celiac disease. Design and methodThis descriptive and correlational study was conducted with 98 children diagnosed with celiac disease who applied to the pediatric outpatient clinic of a university hospital in Eastern Anatolia between September 2021 and August 2022. Data were collected using the State-Trait Anxiety Scale, Depression Scale, and Quality of Life Scale through face-to-face interviews conducted by the researchers. Percentage distribution, mean, independent samples t-test, Pearson correlation analysis and regression analysis were used to analyze the data. ResultsIt was found that 62% of the participant children were female and their mean age was 11.69 ± 4.15 years. The mean scores of state anxiety, trait anxiety, depression and quality of life of children with celiac disease were 42.46 ± 5.42 (high), 43.83 ± 7.08 (high), 23.37 ± 4.79 (high) and 43.67 ± 19.67 (low), respectively. Regression analysis revealed that anxiety had a statistically significant relationship with quality of life. ConclusionsIt was found that children with celiac disease experienced high levels of depression and anxiety along with physical functionality and psychosocial health problems and this negatively affected their quality of life. It is recommended that children with celiac disease should be followed up and supported psychosocially. Practice implicationsThat healthcare professionals can contribute to reducing the depression and axienty and improving the quality of life by strengthening the social support systems of childrens with celiac disease.

A narrative review on the effectiveness of therapeutic communication in reducing anxiety in children during dental treatment procedures

Background: Dental anxiety is anxiety about dental treatment carried out before or immediately after a dental treatment procedure, which will have an impact on the difficulty of the dental team in carrying out dental treatment. One of the interventions that the dental team can carry out with pediatric patients is therapeutic communication. Objective: This study aims to further discuss regarding the effectiveness of therapeutic communication in reducing anxiety in children during dental treatment procedures. Methods: A systematic search of the Google Scholar database, then a narrative review of the identified articles was conducted with a focus on articles published in the last 10 years. Discussion: Therapeutic communication, a non-pharmacological intervention, plays an important role in managing anxiety in children when undergoing dental treatment procedures, because it has the benefit of reducing psychological problems in children such as anxiety, fear and changes in behavior, especially during dental treatment procedures. Some scientific evidence shows a significant value of p <0.05 and an OR value >1 which indicates a correlation between therapeutic communication and the level of dental anxiety. Conclusion: Based on the results of the narrative review conducted, we conclude that the better the therapeutic communication carried out by the dental team, the lower the level of anxiety in children during dental treatment procedures.

Effects of Cooperative, Competitive, and Solitary Exergames on Cognition and Anxiety Levels in Children with Developmental Disabilities.

Objective: Exergames are playing an important role in person-centered therapy, health care services, and in the rehabilitation field. This study aimed to compare the effects of cooperative, competitive, and solitary exergames on cognition and anxiety levels in children with developmental disabilities (DD). Materials and Methods: This study was a randomized controlled trial pretest-posttest including 36 children with DD who were allocated to the cooperative exergame group (CGG), competitive exergame group (CmGG), and solitary exergame group (SGG). The exergame program was performed two times a week for 8 weeks and the outcome measurements were conducted before and after the program. A paired sample t-test and one-way analysis of variance (ANOVA) were used to analyze the changes within and between the groups. Results: The result indicated a significant improvement in memory, attention, and visual perception in all groups; the CGG and CmGG showed a high increase in attention compared with the SGG. However, only the CGG presented a significant improvement in the language subscale. In terms of anxiety, only the CGG presented substantial improvements in all anxiety subscales. The CmGG showed improvement in social phobia and the SGG in physical injury fears, social phobia, and general anxiety fears. Conclusion: The findings suggest that cooperative and competitive exergames may be used to effectively improve cognitive functions; cooperative exergames can be applied as the most effective method to reduce anxiety compared with the other game types for children with DD.

A Comparison of the Resilience, Anxiety, and Life Satisfaction of Chinese Left-Behind Children and International Students

The present study compared the resilience level, anxiety level, and life satisfaction level of Chinese left-behind children (LBC) and international students (IS) between 11 and 15 years old and investigated the relationships between these three variables and physical activity (PA). Chinese LBC (n = 86) from Guiyang City, Guizhou Province, China and Chinese IS (n = 60) in Vancouver, Canada filled out a survey that measured their resilience level, anxiety level, life satisfaction level, the duration and frequency of PA of different types and intensities in various domains, PA Enjoyment, and participants’ attitudes toward PA. In addition, 10 participants were randomly chosen to participate in an interview after completing the survey. The survey results showed that IS possessed higher resilience level and life satisfaction level than LBC, and both groups had no significant difference in anxiety level; LBC engaged in more PA than IS. Besides, resilience level was positively related to the amount of light PA in household or yard work domain as well as PA enjoyment; anxiety level was negatively related to PA enjoyment as well as annual household income; life satisfaction was positively related to the total amount of PA across all domains as well as PA enjoyment. Participants also mentioned in the interviews the effectiveness of PA in distracting them from worries and other negative emotions, which in turn helped reduce their anxiety and improve their resilience and life satisfaction. Therefore, participating in more PA could be a promising way to improve resilience level and life satisfaction level or reduce anxiety level for the two groups.

The Role of the Educational Program in Reducing the Child's Anxiety at the Dentist

The objective of the study was to create and implement an educational program with the aim of reducing children's anxiety at the dentist. The study began with the hypothesis that the implementation of an educational program can lead to a decrease in the level of dental anxiety among children. The sample included 196 children (experimental group of 95 children and control group of 101 children), primary school pupils. The educational program was structured in the form of twelve PowerPoint presentations, focusing on three essential themes. These were: the importance of oral hygiene, methods and techniques used for good oral hygiene and the role of nutrition in maintaining healthy teeth. The methods used were the questionnaire, PowerPoint presentations, semi-structured interviews, demonstrations and exercises. A questionnaire was applied and saliva was taken to determine immunoglobulin A, both at the beginning and at the end of the study. In the experimental group, there were statistically significant differences between the initial and final results of both the questionnaire and immunoglobulin A testing (p<0.05). There were no statistically significant differences in the control group (p>0.05). Following the interpretation of the results, the hypothesis was confirmed according to which the implementation of an educational program can lead to a decrease in the level of dental anxiety in children.

Clinical determinants for State-Trait Anxiety Inventory of the parents of children with respiratory problems.

Understanding factors associated with anxiety of parents/carers of children with respiratory problems is clinically important yet there is relative paucity of data. In 106 children seen in the respiratory clinic of a pediatric hospital, we evaluated (a) the determinants for parental anxiety and (b) whether the anxiety scores correlate with quality-of-life (QoL) scores in the subset with chronic cough. We opportunistically re-analyzed data of our main study that examined the benefits of using spirometry for pediatric respiratory consultation where parents completed an anxiety questionnaire (State-Trait Anxiety Inventory, STAI) pre- and postconsultation. A subset (children with chronic cough) also completed the parent-proxy quality-of-life (PC-QoL) tool. We computed the association between clinical characteristics and anxiety scores using multivariable regression and between the two patient-reported outcome measures using Spearman's correlation. The majority of parents/carers were women (n = 89, 84%). Most children (mean age = 10.9 years, SD = 3.7 years) were previously seen at the clinic (n = 67, 63.2%). In multivariate regression, parental anxiety score was significantly associated with reported presence of cough [coefficient β = 17.31 (95%confidence interval 9.62, 25.1)] and lower forced expiratory volume in first second(FEV1 )/forced vital capacity(FVC) [-3.88 (-7.05, -0.71)] at preconsultation, but associated with cough only [coefficient β = 12.04 (5.24, 18.84)] at postconsultation, all p < .05. STAI strongly correlated with PC-QoL scores at pre- but only modestly at postconsultation (rs = -.63 and -.39, respectively, p < .05). Parental anxiety levels of children attending respiratory clinics are influenced by the presence of cough and low FEV1 /FVC of their child and are associated with poorer QoL. These highlight the need for on-going research to reduce parental anxiety focusing on cough and lung function indices.

Anxiety level in overweight and obese children

Purpose - to evaluate personal and situational anxiety levels in overweight and obese children. Materials and methods. 153 children (72 girls and 81 boys) aged 12-17 were involved in the study at the Odesa Regional Children’s Clinical Hospital. Anthropometric indicators (weight, height, body mass index (BMI)) were assessed taking into account the sex and age of children. Based on BMI values, 3 groups were selected: 1 - children with a body weight corresponding to age and gender - 47 persons (Control); 2 - children with excessive body weight - 50 persons (Overweight); 3 - children with obesity - 56 persons (Obesity). The state of personal and situational anxiety was determined using the Spielberger-Khanin questionnaire. Statistical data analysis was carried out using packages STATISTICA 12.0, MedCalc 20.0, Microsoft EXCEL 2003. Results. In children with obesity, the most common comorbidities were biliary dyskinesia (14.28%), arterial hypertension (10.52%), skin infections 4% and obstructive sleep apnea syndrome 2%. In the studied groups of children, the level of anxiety increased in proportion to the degree of increase in body weight. Personal anxiety in children with obesity compared to control was noted at a higher level - 50.1±1.04 and 30.27±0.98, respectively (χ2=49.9, p=0.0001). Situational anxiety also increased in children with obesity, but the differences were expressed to a lesser extent - 38.94±0.74 and 33.91±0.93 (χ2=5.49, p=0.019). Conclusions. The obtained results indicate the feasibility of further study and monitoring of the psycho-emotional state and quality of life of overweight and obese children and adolescents for individual psychological support and correction of psycho-emotional disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Impact of COVID-19 on Lifestyle Habits and Emotional State of Childhood Cancer Survivors and Their Parents.

The COVID-19 pandemic and associated social distancing measures affected the physical and emotional state of children and parents worldwide. Survivors of childhood cancer may be particularly vulnerable to these effects. We aimed to evaluate the lifestyle habits and emotional states of childhood cancer survivors and their parents during the COVID-19 outbreak. Lifestyle habits and emotional distress were assessed in 43 childhood cancer survivors (aged 8-21 years) and their parents before and during the COVID-19 lockdown, using the PROMIS anxiety and depression modules and the "Mabat Youth" questionnaire. Most parents (80.5%) reported eating more family meals during home confinement compared to their usual routine. Patients' physical activity levels did not change significantly during confinement, leisure-related screen time nearly doubled (p < 0.001), and sleep duration increased (p = 0.006). Anxiety levels of children (p = 0.045) and parents (p = 0.02) increased during confinement compared to pre-pandemic levels, with no significant changes in depression levels. Contrary to concerns regarding lifestyle habits during the COVID-19 lockdown, eating behaviors of childhood cancer survivors improved, sleep duration increased, and physical activity remained unchanged. Still, screen time increased significantly. Parents of childhood cancer survivors reported higher anxiety levels for themselves and their children during home confinement. Our findings may assist medical and psycho-social teams in guiding parents of cancer survivors during similar circumstances in the future.

Meningkatkan Kemampuan Sosial Emosional Anak Usia Dini melalui Permainan Petak Umpet di TK Karya Bunda Mandiri

This study aims to investigate the potential of hide-and-seek games as a tool in improving social-emotional abilities in early childhood. Improving social-emotional abilities is an important goal in Early Childhood education interventions because children's social-emotional development is often hampered. In this study researchers used an approach based a hide-and-seek game that attracts children's interest and utilizes the social-emotional concepts involved in this game, such as developing interaction skills, the ability to work together in groups and the ability to manage emotions. The research method used involved participants in the apple group at Karya Kindergarten Mandiri mothers with an age range of 4-5 years arranged in an intervention group. Researchers provide a scaled structured hide-and-seek game session in which children will be given the opportunity to participate in games and apply previously learned emotional social skills. Researchers also use various supporting strategies such as role models, positive reinforcers and tailored feedback in shaping children to understand and use desired social emotional skills. The results of the study showed a significant increase in children's social emotional abilities after participating in a game-based intervention of hide and seek .Children show improvement in the ability to interact with peers, understand and express their emotions better and work effectively in groups.In addition, hide-and-seek games also show effectiveness in increasing children's involvement in group activities, which can increase children's motivation and reduce the level of social anxiety in children.

Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study.

To assess and compare children's anxiety level and pain perception during cavity preparation using an erbium-doped yttrium aluminum garnet (Er:YAG) laser vs traditional rotational treatment. A randomized, controlled, split-mouth clinical trial was carried out in 35 healthy children with 70 carious primary molars. Teeth were divided equally into two groups according to the method of treatment. A bur was used to prepare the cavity in one quadrant, while an Er:YAG laser was used to prepare the cavity in the other quadrant. Anxiety was assessed using Venham's dental anxiety scale and a fingertip pulse oximeter. The pain was assessed using the Wong-Baker Face Pain Rating Scale, and the number of local anesthesia (LA) needed during both procedures was also considered. The mean age was 9.4 ± 1.29. Males accounted for 51.4% of the participants. There were no statistically significant variations in pulse rate at the baseline between Er:YAG laser and the conventional treatments. The mean pulse rate was higher during the conventional intervention than during the laser intervention; this difference was statistically significant vs the baseline pulse rate. The mean pulse rate with the conventional method was significantly higher during and after cavity formation than with the laser method. The Er:YAG laser and the conventional groups showed statistically significant differences in the Venham's and Wong-Baker scores. The scores of both scales were much higher in the conventional group. The number of participants who requested LA during the conventional technique was significantly higher than during the laser procedure. Using Er:YAG lasers to remove caries produces minimal pain and anxiety and reduces the requirement for LA. During cavity preparation, the Er:YAG laser helps children stay calm. Abdrabuh RE, El Meligy OAES, Felemban OM, et al. Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study. Int J Clin Pediatr Dent 2023;16(S-1):S39-S44.

Association between Salivary Cortisol Levels, Dental Anxiety, and Dental Caries in Children: A Cross-Sectional Study.

This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. The study group showed significantly higher salivary cortisol levels compared to the control group (p < 0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p < 0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p = 0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p < 0.001). The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.

Penerapan Terapi Bermain Boneka Tangan Terhadap Kecemasan Anak Usia Prasekolah di RSUD dr. Soeratno Gemolong

Hospitalization is a condition in which a person experiences compulsion to be hospitalized and can make a child feel uncomfortable, threatened, which causes anxiety. Efforts to reduce anxiety can use hand puppet play therapy. Hand puppets are games that are played using hand puppets and make children imagine using storytelling techniques. Knowing the results of the implementation of hand puppet therapy on the level of anxiety due to hospitalization. Using a case study design, the subject is 2 preschool-age children who are treated in the Children's Room of RSUD dr. Soeratno Gemolong. The measurement tool for anxiety uses the FIS and SCAS anxiety scales. The application was carried out 2 times in 2 days. The anxiety level of FIS and SCAS before the hand puppet therapy was carried out, the two subjects were different. Subject 1 had a higher level of anxiety (FIS: severe anxiety and SCAS: severe anxiety) than subject 2 (FIS: moderate anxiety and SCAS: moderate anxiety). Hand puppet play therapy in preschool age children (3-6 years) can reduce children's anxiety levels.

The Benefits of Dog-Assisted Therapy for Children With Anxiety

Background Anxiety disorders are one of the most common mental health disorders experienced by children, and they have a negative effect on social, academic, and health functioning. While traditional psychotherapy has focused on methods such as cognitive behavioural therapy and parental anxiety management to treat these children, interest is growing in animal-assisted therapy (AAT) as a therapeutic modality, and recent research suggests the benefits of AAT within the realms of psychotherapy for children with anxiety. Aim This review aimed to perform a critical appraisal of the available literature relating to dog-assisted psychotherapy for children with anxiety and investigate the effectiveness of this therapy method in reducing anxiety. Method This structured literature review was guided by the 12 steps recommended by Kable et al. (2012). The search was conducted in August and September 2021 through the databases ScienceDirect, PsycInfo, and PubMed to locate published peer-reviewed literature on the therapeutic benefits of including a dog in psychotherapy sessions for children with anxiety. After critical appraisal, 10 articles were included in the review. Results General agreement exists that dog-assisted therapy can boost positive emotions and reduce anxiety levels in children, and that interacting with dogs and experiencing their unconditional acceptance help reduce children’s stress and physical pain levels as well as stress in families. The key themes that emerged from this review included the human–animal bond, children’s attachment styles, hospitalisation and environmental considerations, the AAT methods used, and the effects of AAT. Conclusion This review revealed many benefits of the presence of a therapy dog during psychotherapy sessions, including reducing anxiety, increasing positive emotions, and enabling social interactions for children with anxiety. Counsellors and psychotherapists can feel confident to undertake the required training and implement the necessary systems to accommodate a therapy dog in their therapeutic setting in order to support children with anxiety. It is noteworthy that the positive effects of dog-assisted therapy were not consistent throughout the literature, and most research studies focused on children in hospital settings. Therefore, further research is required regarding the effectiveness and clinical implications of the nature, type of intervention, length, and duration of dog-assisted therapy.

Pengaruh Video Kartun dan Video Animasi terhadap Tingkat Kecemasan Anak Usia Prasekolah (3-6 Tahun) yang Menjalani Hospitalisasi di RS PKU Muhammadiyah Yogyakarta

This study aimed to determine the effect of cartoon videos and animated videos on the anxiety level of preschool-aged children undergoing hospitalization at PKU Muhammadiyah Yogyakarta Hospital. The research method applied a quasi experimental design in the form of a non-equivalent control group design. The sampling technique was purposive sampling with 30 samples divided into 2 groups. Analysis of the data used the Wilcoxon and Mann Whitney test with a questionnaire measuring anxiety in preschoolers. The results of the study with a p value of 0,000 (p &lt;0,05) which means that there is an effect of cartoon videos and animated videos on the level of anxiety of preschool-aged children undergoing hospitalization at PKU Muhammadiyah Yogyakarta Hospital.

Evaluation of subclinical cardiovascular risk in drug-naive pediatric patients with anxiety disorders.

This study examined subclinical atherosclerosis in drug-naïve children with anxiety disorders using non-invasive measures to investigate the clinical features associated with subclinical atherosclerosis. A total of 37 drug-naive children and adolescents with anxiety disorders and 37 healthy controls were included in the study. The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI-T and STAI-S) were used to assess children's depression and anxiety levels. Carotid artery intima-media (cIMT), epicardial adipose tissue (EAT), and periaortic adipose tissue (PAT) thicknesses, which are indicators of subclinical atherosclerosis, were obtained by echocardiographic measurements. Multivariate analysis of covariance (MANCOVA) revealed a significant main effect on cIMT, EAT thickness, and PAT thickness, independent of confounding factors such as age, sex, body mass index, mean blood pressure, and family income (Pillai's Trace V = .76, F (1, 72) = 35.60, P < .001, ηp2 = .76). Analysis of covariance (ANCOVA) showed that cIMT, EAT thickness, and PAT thickness values were significantly higher in the anxiety disorder group compared to the the control group (P < .001). In partial correlation analysis, a positive correlation was observed between STAI-T and cIMT and EAT thickness. In linear regression analyses, age and STAI-T were significantly correlated with cIMT and EAT thickness levels. These results suggest that subclinical cardiovascular risk is significantly increased in children and adolescents with anxiety disorders.

Efek Biblioterapi Dalam Menurunkan Kecemasan Pada Anak Usia Sekolah (7 – 12 tahun) Saat Perawatan Di Rumah Sakit

Background: The child has difficulty in understanding why they are sick, hospitalization can cause separation anxiety in children, which includes protest, despair, discharge, loss of control so it needs bibliotherapy. Bibliotherapy is the use of the book as a medium of therapy to minimize stressors, prevent the loss, reduce anxiety, and support children coping. Aims: The purpose of this study was to determine the effect Biblio therapy against anxiety levels in school-age children (7-12 years) in the Children's Room of Blambangan Banyuwangi Hospital. Methods: Pre-experimental research design using the technique of one group pre-post test design. A sample of 20 children with accidental sampling technique. Data obtained from observations before and after giving bibliotherapy, and then do the scoring, tabulating, and statistical tests using Wilcoxon match pair test. Results: Manually obtained calculation number 199&gt; 52 = Ho is rejected and Ha is accepted, meaning that there are differences in anxiety levels before and after biblio therapy which means there is a significant effect of bibliotherapy on anxiety levels in school-aged children (7–12 years) in the Children's Room of Blambangan Hospital Banyuwangi. Conclusions: Billion therapy can be applied as one of the nursing interventions in the hospital to decrease the problem of children to keep children happy and cooperative during hospitalization.

Addressing fears of children with Williams syndrome: therapist and child behavior in the context of a novel play-and humor-infused exposure therapy approach.

Many children with Williams syndrome struggle with fears and phobias that significantly impact their daily lives. Yet, there is sparse literature about the impact of behavioral interventions to treat anxiety and phobias among children with Williams syndrome. Using observational coding of intervention videos, the current study examines patterns of the therapist's use of play and humor and relations to child behavioral responses for four children with Williams syndrome who were identified as treatment responders to humor- and play-infused exposure therapy for fears and anxieties. Sessions were coded for therapist behaviors (exposure with or without play/humor, stimulus type used during exposure, passive or invited attention to feared stimulus, and spontaneous parent participation in exposure) as well as positive, negative, and neutral child behaviors (verbalizations and behaviors). Temporal patterns between therapist and child behaviors were analyzed using lag sequential analyses. The results showed that tolerance of feared stimuli improved for two of the four children following this play- and humor-infused exposure therapy approach, and the remaining two participants demonstrated progress beyond tolerating the feared stimulus and showed increased positive behaviors with the feared stimulus across sessions. Findings also showed patterns of therapist attunement to the child's anxiety level demonstrated through efforts to flexibly adjust the degrees of exposure. Therapist-initiated invited attention behaviors, indicative of the therapist's use of narration and priming, were associated with child tolerance and positive behaviors during exposure to the feared stimulus. Limitations of this study include a very small sample size, short duration of intervention, and a single-subject research design, which limit the generalizability of findings. Implications and future directions of this research are discussed.

The Effect of Play Therapy on Children's Anxiety Level Age 4-6 years During Hospitalization at the Kronjo Health Center

Anxiety is an emotional state characterized by consistent fear, tense mood, unstable state of mind, and increased blood pressure and body chemistry. This includes the cognitive perception of the behavioral, physical and social aspects of the emotion. Anxiety makes children uncooperative and creates difficulties in carrying out treatment. Usually children are more anxious during the waiting period before treatment and this time can be used for behavior management to minimize anxiety. Children's distraction provides an effective relaxing experience during painful treatment. Cognitive behavioral therapy (CBT) is a form of active distraction, in which children are encouraged to engage in activities that calm them from anxiety. Passive distraction includes audiovisual (AV) distraction, in which children remain still and engage in visual and auditory scenes. The aim of writing several systematic reviews is to compare the provision of image recognition play therapy in children aged 4-6 years. As a comparison or comparison is without play therapy. The outcome or outcome that is measured is anxiety. Articles were searched through the database from 2019 - 2020. Searches were obtained from the PUBMED database. The keywords used are “Play Therapy And Anxiety” or “Cognitive Behavioral Play Therapy (CBT) and Anxiety” Free full text in English or Indonesian. The subjects used were children aged 4-6 years. The research design was a randomized controlled trial. Based on the results of the study that the application of therapeutic games to children who are hospitalized reduces preoperative anxiety and can reduce postoperative pain, improve behavior and attitudes, and reduce anxiety during a hospital stay. Conclusion: play therapy has a beneficial impact on the care of hospitalized children and should be implemented in pediatric units after assessing the resources and training required for pediatric nurses.

Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions.

The COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time. We used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents. Our results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children's anxiety was best explained by child-related factors such as children's concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents. The present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises.

Is the traditional placement of stainless steel crowns in primary teeth more painful than the non-preparation Hall technique?

Is the anxiety level and pain experience in young children the same for the traditional method of stainless crowns placement that might require local anesthetic and excavation of decay compared to the Hall technique that requires no preparation and no anesthetic injections? A randomized controlled study of 2 groups (43 and 54) children 4-8 years old with proximal decay in primary first molars. Each child had one tooth restored with the Hall technique (HT) and the second tooth received a conventional stainless crown (CT) (with or without local anesthesia, as needed) and all crowns were cemented with a GIC resin type cement less than a month of each other. The order of the placement was reversed with the allocation randomly concealed. A visual Wong-Baker Pain Scale with six cartoon faces was used to record pain levels. Data were analyzed using SPSS (version 25). After computing univariate descriptive statistics, differences among proportions were examined using cross-tabulations and χ2 tests (α = 0.05). Analysis of variance was conducted for parametric analysis, and the Wilcoxon signed-rank test was used for within-group, and the Mann-Whitney U-test was used for between-group, nonparametric analysis. The pain scores did not differ by treatment type. The majority of children (58.3%) reported low procedural pain for both treatments leaving 47.7% reporting moderate to high procedural pain. Using local anesthetic with CT did not change the results. The pain scores were similar for both procedures. HT has been recommended as less traumatic and but this might not be true for all children.