電子遊戲對降低兒童手術全期焦慮成效之系統性文獻回顧與統合分析

研究背景:手術全期焦慮(perioperative anxiety)在兒童是很常見的，其可能對兒童的生、心理產生負面的影響。近年研究指出，電子遊戲作為兒童常接觸之娛樂形式能提升兒童情緒調節、專注力與減緩焦慮的情形，過去雖有針對電子遊戲的系統性文獻回顧和統合分析，但所納入的研究數量有限，且多未針對電子遊戲介入進行深入探討，因此電子遊戲對降低兒童手術全其焦慮的成效尚無定論。研究目的: 本研究旨在探討電子遊戲對緩解手術全期兒童焦慮的影響與成效。研究方法: 本研究是以系統性回顧與統合分析方式，透過Cochrane、Medline、PubMed及Embase四個主要英文電子資料庫進行文獻搜索相關隨機臨床試驗文獻，檢索時間範圍設定自2010年01月01日到2025年09月30日。納入的文獻採用Revised Cochrane Risk-of Bias tool 2.0(RoB 2.0) 作為文獻品質評讀工具。本研究效果量計算採用勝算比，並採用 I² 檢定以量化文獻合併的異質性評估(heterogeneity)，使用Review Manager 5.4 (RevMan 5.4)軟體進行統合分析，計算其效果量及95%信賴區間。出版偏差則以漏斗圖及Egger，s test 回歸分析進行檢定。研究結果: 本研究共納入 7 篇隨機對照試驗進行系統性文獻回顧與統合分析。結果顯示，在介入前，實驗組與對照組的焦慮程度無明顯差異（MD = -4.48，95% CI = -13.65–4.69，p = .34）。然而，在麻醉誘導期間，電子遊戲介入組的焦慮顯著低於對照組（MD = -13.91，95% CI = -23.02– -4.80，p = .003），代表電子遊戲能有效減輕兒童於麻醉誘導時的焦慮反應。此外，在發表偏差方面，漏斗圖均呈現大致對稱分布，Egger's test 結果亦未達統計顯著（介入前：p = .141；麻醉誘導：p = .393），顯示研究未見明顯發表偏差。結論: 本研究發現電子遊戲的介入能有效降低兒童於麻醉誘導期間的焦慮，具明顯的臨床效益，且安全、可行、接受度高。

Background: Perioperative anxiety is common among children and may have negative impacts on both their physical and psychological well-being. Recent studies have shown that video games, a popular form of entertainment among children, may help improve emotional regulation, concentration, and reduce anxiety levels. Although previous systematic reviews and meta-analyses have explored the use of video games in medical settings, the number of included studies has been limited, and most did not focus specifically on video game interventions. Therefore, the effectiveness of video games in reducing perioperative anxiety in children remains inconclusive.Purpose: This study aims to investigate the effects and effectiveness of video games on relieving perioperative anxiety in children.Methods: This research is a systematic review and meta-analysis. Relevant randomized controlled trials (RCTs) were searched through four major English-language databases: Cochrane, Medline, PubMed, and Embase. The search period was from January 1, 2010, to September 30, 2025. The quality of the included studies was assessed using the Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2.0). The effect size was calculated using odds ratios (ORs), and heterogeneity was assessed using the I² statistic. Meta-analysis was conducted using Review Manager 5.4 (RevMan 5.4). Publication bias was evaluated using Egger’s regression test and funnel plot analysis.Results: This study included seven randomized controlled trials for the systematic review and meta-analysis. The findings revealed no significant difference in pre-intervention anxiety levels between the intervention and control groups (MD = -4.48, 95% CI = -13.65–4.69, p = .34). However, during anesthesia induction, children in the electronic game intervention group demonstrated significantly lower anxiety compared to the control group (MD = -13.91, 95% CI = -23.02– -4.80, p = .003), indicating that electronic games effectively reduced perioperative anxiety. Additionally, funnel plots showed generally symmetrical distributions, and Egger’s test revealed no significant publication bias (pre-intervention: p = .141; induction: p = .393).Conclusion: This study concludes that electronic game interventions effectively reduce anxiety in children during anesthesia induction, demonstrating clear clinical benefits. Electronic games represent a safe, feasible, and highly acceptable non-pharmacological strategy for managing perioperative anxiety in pediatric patients.