Original Article

The effectiveness of the robotic game kit on anxiety among hospitalized preschool children: A non-randomized controlled trial


 Background & Aim: Hospitalization is a challenging experience all children go through in their life, which leads to their utmost anxiety. In this sense, interactive games and activities can help ease this psychological burden. Therefore, we endeavored to determine the effectiveness of a robotic game kit (RGK) on the anxiety of hospitalized preschoolers.
Methods & Materials: This non-randomized controlled clinical trial was conducted in a pediatric hospital, Iran between March and July 2019. 59 participants were assigned to intervention (n=30) or control (n=29) groups through available sampling. Inclusion criteria were Iranian native children aged 3-7 years with communication ability. The RGK was applied in eight sessions at least seven consecutive days of hospitalization. The collected data by using the demographic information form and the preschool anxiety scale (PAS) were analyzed in descriptive, chi-square, t-test, the one-way ANCOVA (analysis of covariance), and multivariate analysis of covariance (MANCOVA).
Results: Two groups were homogenous in terms of demographic variables (p>0.05). There was no statistically significant difference between the mean score of PAS before the intervention in the intervention 46.33±15.81 and control groups 37.24±19.65 (p=0.055). the mean score of PAS in the intervention group was significantly lower compared to the control groups (P=0.030). Also, using the RGK was effective in two subscales related to separation anxiety and physical injury fears  (P=0.034).
Conclusion: The modern RGKs could have a significant place in pediatric health care in hospitals. It is thus an undeniable fact that high-quality comprehensive care can be boosted through RGK based interventions for children encountering stressful situations.


1. Nurfadillah H. Description Of Hospitalization Stress Of Children's Age Pre-School. Comprehensive Health Care. 2018;2(3):117-23.
2. Saharan P. Assess the Effectiveness of Play Interventions on Anxiety Among Hospitalized Children in Selected Hospital of Yamuna Nagar, Haryana: An Experimental Study. International Journal for Advance Research and Development. 2017;2(11):88-94.
3. Mirghaed MT, Gorji HA, Panahi S. Prevalence of psychiatric disorders in Iran: A systematic review and meta-analysis. International Journal of Preventive Medicine. 2020;11.
4. CDC. Centers for Disease Control Prevention, Data and statistics on children’s mental health. Retrieved 21st June. 2019.
5. Mowlavi P, Mohammadi M, Nadr Mohammadi Moghadam M, Khaleghi A, Mostafavi A. Prevalence of psychiatric disorders in children and adolescents in Ardabil province: A population-based study. Journal of Ardabil University of Medical Sciences. 2018;18(2):240-51.
6. Gomes GLL, Dantas AMN, da Nóbrega MML. Content validation of operational definitions of hospitalization anxiety in children. International Journal of Development Research. 2020;10(03):34413-7.
7. Delvecchio E, Salcuni S, Lis A, Germani A, Di Riso D. Hospitalized children: anxiety, coping strategies, and pretend play. Frontiers in public health. 2019;7:250.
8. Li WH, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC pediatrics. 2016;16(1):1-9.
9. Soniya S, Solomon RJ. Effectiveness of Play Therapy on Anxiety among Hospitalized Preschool Children. Asian Journal of Nursing Education and Research. 2019;9(2):193-6.
10. Anandhukrishnan T, Sivan A, Difna BK, Raj R, Sangeetha S, Saritha S, et al. Effectiveness of Play on Anxiety among Hospitalized Children. Asian Journal of Nursing Education and Research. 2018;8(2):225-9.
11. Megdadi Ali, Alami Minoo. Sociological Cognitive Robotics: Secrets and Needs. Iranian Engineering Education Quarterly. 2016;18(70):76-55.
12. Marchetti A, Di Dio C, Manzi F, Massaro D. Robotics in clinical and developmental psychology. Reference module in neuroscience biobehavioral psychology. 2020.
13. Pamungkas AC. penerapan terapi bermain lego untuk mengurangi kecemasan pada anak usia prasekolah saat hospitalisasi di rsud dr. soedirman kebumen: Stikes muhammadiyah gombong; 2019.
14. Ashori M. Effectiveness of LEGO Therapy on the Mother-Child Relationship of Preschool Deaf Children. Quarterly Journal of Social Work. 2019;8(1):35-44.
15. Lewis TT, Kim H, Darcy-Mahoney A, Waldron M, Lee WH, Park CH. Robotic uses in pediatric care: A comprehensive review. Journal of Pediatric Nursing. 2020;58:65-75.
16. Jafary Manesh H, Ranjbaran M, Vakilian K, Zand K, Tajik R. Survey of levels of anxiety and depression in parents of children with chronic illness. Iranian Journal of Psychiatric Nursing (IJPN). 2014;1(4):45-53.
17. Ebrahimzade K, Agashteh M, Berenjkar A. The Effectiveness of Parent Management Training Compared With Drug Therapy on Reducing Anxiety in Preschool Children. Iranian Journal of Pediatric Nursing. 2017;3(4):41-8.
18. Ghanbari Saeed, Khanmohamadi Maryam. Preschool Anxiety Scale (PAS):questionnaire, Instruction and scoring Evolutionary Psychology of Iranian Psychologists. 2014(41):117-5.
19. Ghanbari S, Khanmohamadi M, Khodapanahi M, Mazaheri A, Gholamali Lavasani M. Study of psychometric properties of preschool anxiety scale. Journal of psychology. 2011;15:222-34.
20. Gentile DA, Oberg C, Sherwood NE, Story M, Walsh DA, Hogan M. Well-child visits in the video age: pediatricians and the American Academy of Pediatrics’ guidelines for children's media use. Pediatrics. 2004;114(5):1235-41.
21. Mungalim SM, Rismawati RR. The Effect of Lego Play Activity Therapy on Anxiety Levels of Preschool Children (3-6 years) due to Hospitalisation. Jurnal Ilmiah Keperawatan Indonesia. 2020;3(1):57-66.
22. Ashori M. Lego Therapy for Children with Autism Spectrum Disorders: Theoretical bases, Application, Implementation Levels and Effectiveness. Exceptional Education Journal. 2019;6(155):31-8.
23. Yoo SY, Cho H, Kim YY, Park JH, Yoo SY, Cho H, et al. Levels of Partnership between Nurses and Parents of Hospitalized Children and the Quality of Pediatric Nursing Care as Perceived by Nurses. Child Health Nursing Research. 2020;26(1):64-71.
24. Koukourikos K, Tzeha L, Pantelidou P, Tsaloglidou A. The importance of play during hospitalization of children. Materia socio-medica. 2015;27(6):438.
25. Lau EX, Rapee RM, Coplan RJ. Combining child social skills training with a parent early intervention program for inhibited preschool children. Journal of Anxiety Disorders. 2017;51:32-8.
26. Moerman CJ, van der Heide L, Heerink M. Social robots to support children’s well-being under medical treatment: A systematic state-of-the-art review. Journal of Child Health Care. 2019;23(4):596-612.
27. Rossi S, Larafa M, Ruocco M. Emotional and Behavioural Distraction by a Social Robot for Children Anxiety Reduction During Vaccination. International Journal of Social Robotics. 2020:1-13.
28. Dehghan Z, Reyhani T, Mohammadpour V, Aemmi SZ, Shojaeian R, ASGHARI NSM. The Effectiveness of Dramatic Puppet and Therapeutic Play in Anxiety Reduction in Children Undergoing Surgery: A Randomized Clinical Trial. 2017.
29. Burns-Nader E. The effects of medical play on reducing anxiety, fear and Procedure distress in schoolaged children going to visit the doctor. Unpublished doctoral dissertation, University of Alabama, Tuscaloosa: AB. 2011.
30. Hiwale S, Ganvir VD. Assess the Effectiveness, of Group Play Therapy for Preschool Children on Reduction of Preschooler Separation Anxiety Disorder. International Journal of Science and Research (IJSR). 2019;8(8):157-60.
31. Coufal P. Development of Competencies of Elementary School Pupils Using Educational Robotic Kits. The European Journal of Social Behavioural Sciences. 2020;27(1):3073-82.
32. Jung SE, Won E-s. Systematic review of research trends in robotics education for young children. Sustainability. 2018;10(4):905.
33. Mollamohammadi F, Yazdkhasti F. Effect of play therapy on reduction of social anxiety and increasing social skills in preschool children in Omidiyeh. International Journal of Educational and Psychological Researches. 2017;3(2):128.
IssueVol 8 No 4 (2021): Autumn QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/npt.v8i4.6703
robotic; pediatric nursing; games; anxiety; hospitalized children

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How to Cite
Pourteimour S, Kazemi S. The effectiveness of the robotic game kit on anxiety among hospitalized preschool children: A non-randomized controlled trial. NPT. 8(4):273-283.