Randomised controlled trials (RCTs) and quasi-experimental studies that evaluated the effects of education compared with standard preparation for children aged two to 12 years old undergoing elective surgeries were eligible for inclusion. Outcomes of interest were effects on anxiety, emotional distress, arousal and fear.
Most of the studies were conducted in USA; one study was conducted in each of Austria, Sweden, China, Japan and UK. Studies were published between 1975 and 2009. Interventions included therapeutic play, preview and play with hospital equipment, formal preparation, provision of specific information, education booklets, videotapes, educational tours and role play. Children underwent elective surgical procedures such as tonsillectomy, adenoidectomy, herniorrhaphy, appendectomy, otolaryngology surgery, dental surgery under general anaesthesia, orthopaedic and plastic surgical procedures. Some studies included parents. Instruments for outcome assessment varied widely between studies.
The authors did not report how many reviewers selected studies for inclusion.