Effect of therapeutic play using a toy nebulizer and toy mask on a child's fear and anxiety levels

Purpose: This study aimed to examine the effect of therapeutic play using a toy nebulizer and mask before inhaler treatment on children's fear and anxiety levels in a pediatric emergency department.Design and method: This randomized controlled clinical trial included 84 children aged 3-8 years who were admitted to the pediatric emergency department with respiratory system disease. This study was registered in the Clinical Trials database.Therapeutic play was applied to the children in the therapeutic play group with a toy nebulizer, toy mask, and amigurumi doll, after which the children received treatment with these devices. The children in the control group received nebular treatment using a standard nebulizer and a mask. The children were required to answer the 'Children's Fear Scale' (CFS) and 'Children's Anxiety Metre-State' (CAM\\S) before and after treatment.Results: Fear and anxiety levels were significantly lower in the therapeutic play group than in the control group (p = 0.001). A statistically significant difference was found between the two groups regarding acceptance of the mask used during treatment and adaptation to the treatment (p = 0.001).Conclusions: Therapeutic play with a toy nebulizer and mask effectively reduced fear of hospitals and related anxiety in children. Practice implications: Playing therapeutic play with a toy nebulizer and toy mask during nebulization is a promising strategy to reduce children's fear and anxiety.