The Effect of Therapeutic Play on Fear, Anxiety, and Treatment Compliance in Pediatric Emergency Nebulization.

BACKGROUND: Nebulizer therapy frequently provokes fear and anxiety in young children, reducing treatment compliance. Although therapeutic play reduces procedural distress in various settings, its use during pediatric emergency nebulization has not been sufficiently investigated. METHODS: This pretest-posttest control group study allocated 102 children (5-8 years) to intervention (n = 51) or control (n = 51). The intervention group received 10-15 min of therapeutic play (toy, mask, stickers) before nebulization; controls received routine care. Outcomes were fear (Children's Fear Scale), anxiety (Children's State Anxiety Scale), and treatment compliance (Pediatric Nebulizer Therapy Follow-up Questionnaire). Data were analyzed using independent samples t-tests, Mann-Whitney U tests, and chi-square tests; effect sizes were calculated with Cohen's d. RESULTS: The therapeutic play group showed significantly lower fear (parent: p < 0.001, d = 0.97; child: p < 0.001, d = 0.91) and higher treatment compliance (p < 0.001) than controls. Parent-reported anxiety was lower (p = 0.005, d = 0.58); child-reported anxiety did not differ significantly. CONCLUSIONS: A brief therapeutic play session before emergency nebulization significantly reduces fear and improves treatment compliance. This low-cost intervention should be integrated into pediatric emergency care.