الفهرس 
overview of preschool Age childrenOnly 14 pages are availabe for public view
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Abstract
Postoperative pain is a consequence of tissue damage from surgical incision. Immediately after tissue damage, sensory nerve endings are suddenly exposed to a variety of cellular breakdown products and inflammatory mediators that trigger acute nociceptive activity. Unrelieved and persistent postoperative pain can be detrimental to a child’s physical, psychological, and social well-being, it can cause physical problems such as chronic pain syndromes, it can also cause psychological symptoms such as distress, sleeplessness, needle phobia, depression. The alleviation of postoperative pain are core responsibilities for healthcare professionals (Mahna, Ouda, & Sadek, 2020 The modalities used in relieving acute postoperative pain include pharmacologic and non-pharmacologic management. Pharmacologic medications such as analgesics, local anesthesia, sedatives, and general anesthesia have life threatening side effects as respiratory distress. Non- pharmacological interventions included virtual reality, video games distraction devices, child life therapy, directed play, digital tablet games, cartoons, hypnosis, music therapy. and acupuncture. (Puntillo, Giglio, & Giustino, 2021 Purpose of the Study To evaluate the effect of video games on postoperative pain among Preschool Children. Research Hypothesis: Research hypothesis was formulated to achieve the purpose of the study: Postoperative pain level will be alleviated for studied preschool children after engaging in video games than before Research Design: A quasi-experimental design (one group pretest/posttest) was utilized to fulfill the purpose of the study Research Settings: The study was conducted in the pediatrics surgical unit at Beni-Suef University Hospital. Subjects: A purposive sample of hospitalized children who were attending over a period of six months in hospital. Who agree to participate in the study and meet the following criteria of sample were included in the study Inclusion Criteria for Children: Age was 3-6 years scheduled for surgical procedure. 2. Conscious and able to communicate 3. No history of trauma, multiple painful procedures, or frequent encounters with needles. Exclusion Criteria for Children . Hearing, vision impairments and mental retardation that make child unable to use video games. . Motor disability that would interfere with using the video game equipment. . Children requires for emergency management. Children have attention-deficit disorder, that make child easy distract and unable to focus on video games. Instruments for Data Collection In order to achieve the purpose of this study, three instruments were utilized for the data collection. Instrument One: A structured interviewing questionnaire (pre- and posttest) it was designed by the researcher in Arabic language after reviewing the related literature; El-Sharkawoy & Morsy, (2001) and Mokble. (2007). It was applied through interviewing the children with their mothers and consists of three parts: Part One: Personal characteristics of studied children included age, gender, level of education and residence. Part Two: It include three subparts. A- Medical assessment sheet of studied children included medical diagnosis, type of surgery, type of anesthesia, duration of surgery and operation complications. B-Analgesia administration included: Name, dose and time of the last analgesic administered. C-Vital signs included: pulse and respiration, researcher measured children’s vital signs (respiration and pulse) after four hours at first day of surgical operation pre-, during and post applying video games distraction technique. Part Three: Video games knowledge including: type of video games (as action, sport and panting games), length of time that child was engaged in video games after surgery during first day of the post-operative period. The researcher was displaying portable multimedia devices, such as smart phones, tablet was readily available at low cost, and age-appropriate video games Instrument Two: Observational Scale for Measuring Postoperative Pain, the Toddler-Preschooler Postoperative Pain Scale, (TPPPS)It was adopted by the researcher Tarbell, Cohen, & Marsh (1992 Consists of 7 items divided into 3 pain behavior categories: (1) vocal pain expression as verbal pain complaint, cry, moan (2) facial behavior like open mouth, squint, close eyes, brow, and furrow forehead (3) body behavior as restlessness motor behavior/stroking or touching painful area. Researcher was observing child’s pain behavior pre- and post-applying video games intervention as distraction technique over 5-minutes observation period. Scoring System: Scores on the scale range from 0 to The pain behavior items were scored as ’1’ if the behavior was present during a 5-minutes observation interval and as ’0’ if the behavior was not present. Maximum score obtained is that indicate high pain intensity (Tarbell, Cohen & Marsh., 1992). Scoring items included mild pain (0- 2), moderate pain and severe pain Instrument Three: Behavioral Scale for Evaluating Post-operative Pain in Young Children, Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS): It was adopted by the researcher McGrath et al., (2003). It can be used to monitor the effectiveness of interventions for reducing the pain and discomfort, it included 6 categories of behavior: cry, facial, verbal, torso, touch, and leg. Child’s pain behavior during displaying video games was observed by researcher. Scoring System: It includes categories of behavior. Each is a separate category and ranging from 0-2 or 1-3. And calculated for pain score ranging from minimum to maximum score (4- 13) (McGrath et al., 1984). Scoring items included mild pain (0- 4), moderate pain (5- 8) and severe pain (9-13 The main results of the study showed that: 1. About half (52.27%) of the studied children age ranged from 5 ≤ 6 years old and about two third (65.91%) of the studied children were male. 2. The majority (88.63%) of the studied children were under general anesthesia 3. There were a highly statistically significant difference between the studied children regarding their vital signs (respiratory and heart rate) pre-, during and post-playing video games. 4. All (100%) of the studied children liked playing video games. 5. There were highly statistical significant differences between pain intensity pre-, during and posttest playing video games Total mean scores of pains in studied children were and 1.32 ± 0.88) pre-, during and post playing video games respectively There was a statistically significant correlation between studied children‘s vital signs and pain intensity pre- and post-playing video games. There were not any statistically relation between personal characteristics and pain intensity during playing video games among studied children. There were statistically significant relations between children education and pain intensity pre- and post-playing video games among studied children (p < 0.05). The study concluded that Implementation of video games had significant effect in alleviation of post- operative pain level among studied preschool children on posttest than on Pretest Based on the previous findings and conclusion, the following recommendations are suggested a- Application of video games as distraction technique to minimize post- operative pain intensity over the first post-operative day in children must be implemented. b- Ongoing health education programs based on application of video games distraction technique for parents should be implemented to manage post-operative pain. c- Provision of training program for nurses about the video games distraction in the care of children during postoperative phase to manage children‘s pain Recommendations for Education: b- New modalities for pediatric pain management as video game distraction children should be a part of nursing curriculum in education program. c- Resources such as articles, journals, computers, and internet should be accessible in the units for staff members to develop their knowledge and practice Recommendation for Future Nursing Research: a- Replication of this study with larger sample at different pediatric department so that the results could be generalized.