The effect of therapeutic play on the levels of fear and anxiety in children receiving high-flow nasal cannula oxygen therapy in the Pediatric Intensive Care Unit during their treatment adherence process

In high-flow nasal cannula oxygen therapy, heated and humidified oxygen is given to the child through a nasal cannula. Children may be uncomfortable with the oxygen and nasal cannula and may want to remove it. In this case, children may experience anxiety and fear. Therefore, this study was conducted to evaluate the effect of therapeutic play on fear and anxiety levels and behaviors during the adaptation to treatment in children receiving high-flow nasal cannula oxygen therapy. This research was conducted as an experimental study with a pre-test post-test control group. The study was conducted in the pediatric intensive care unit of a public hospital in Sivas province between June and December 2024. The sample of the study consisted of 96 children (experimental group=48, control group=48) receiving high-flow nasal cannula oxygen therapy in the pediatric intensive care unit. Data were collected using the Descriptive Information Form, Child Fear Scale, Child Anxiety Scale-Conditioning and Child Observation Form. Children in the experimental group received therapeutic play before high-flow nasal cannula oxygen therapy. Chi-Square analysis, Fisher Exact, Independent Groups T-Test, General Linear Model for Repeated Measures were used in the evaluation of the data. In the study, it was determined that the fear and anxiety levels of the children in the experimental group decreased compared to the children in the control group and the difference between the groups was statistically significant (p=0.000). It was found that the conditions and behaviors of the children in the experimental group such as removing the nasal cannula, crying and restlessness during treatment decreased compared to those in the control group and the difference between the groups was statistically significant (p=0.000). In children receiving high-flow nasal cannula oxygen therapy, it is seen that therapeutic play has a positive effect on reducing the level of fear and anxiety and on their behaviors in the process of adaptation to treatment. Keywords: Therapeutic play, high flow nasal cannula, children, fear, anxiety