{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:37:51Z","timestamp":1786448271145,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":222,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This pretest\u2013posttest control group study allocated 102 children (5\u20138\u2009years) to intervention (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951) or control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951). The intervention group received 10\u201315\u2009min 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\u2010up Questionnaire). Data were analyzed using independent samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, and chi\u2010square tests; effect sizes were calculated with Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The therapeutic play group showed significantly lower fear (parent:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.97; child:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.91) and higher treatment compliance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than controls. Parent\u2010reported anxiety was lower (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.58); child\u2010reported anxiety did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A brief therapeutic play session before emergency nebulization significantly reduces fear and improves treatment compliance. This low\u2010cost intervention should be integrated into pediatric emergency care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70520","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:14:36Z","timestamp":1786446876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Therapeutic Play on Fear, Anxiety, and Treatment Compliance in Pediatric Emergency Nebulization"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5029-0195","authenticated-orcid":false,"given":"Hatice","family":"Yildiz","sequence":"first","affiliation":[{"name":"Pediatric Nursing Department, Institute of Health Sciences Ayd\u0131n Adnan Menderes University  Ayd\u0131n T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1402-5324","authenticated-orcid":false,"given":"Filiz","family":"Karaca Develi","sequence":"additional","affiliation":[{"name":"Pediatric Nursing Department, Institute of Health Sciences Ayd\u0131n Adnan Menderes University  Ayd\u0131n T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3517-1424","authenticated-orcid":false,"given":"Hakan","family":"Eker","sequence":"additional","affiliation":[{"name":"Pediatric Nursing Department, Institute of Health Sciences Ayd\u0131n Adnan Menderes University  Ayd\u0131n T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"31","article-title":"Fear and Loathing in the ER: Managing Procedural Pain and Anxiety in the Pediatric Emergency Department","volume":"97","author":"Merritt C.","year":"2014","journal-title":"Rhode Island Medical Journal"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2024.04.029"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1024907918807384"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11081080"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.556805"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.21518\/2079-701X-2022-16-1-82-87"},{"key":"e_1_2_11_8_1","first-page":"658","volume-title":"Wong's Nursing Care of Infants and Children","author":"Hockenberry M. 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