TERAPI DISTRAKSI SEBAGAI INTERVENSI UNTUK MENURUNKAN KECEMASAN PRAOPERASI PADA ANAK: LITERATURE REVIEW
Keywords:
Anak-anak, Kecemasan, Distraksi, Pre-operasi
Abstract
Latar belakang: Kecemasan adalah respons alami terhadap stres, dialami oleh 41,7%–75,44% anak sebelum operasi. Kondisi ini dapat meningkatkan kebutuhan analgesik, memperlambat pemulihan, memicu trauma, serta berdampak jangka panjang pada kognisi dan emosi.
Tujuan: Untuk mengeksplorasi penggunaan teknik distraksi yang efektif dalam mengurangi kecemasan sebelum operasi pada anak-anak.
Metode: Metode pencarian jurnal menggunakan kriteria yang relevan mencakup PICOT. Basis data yang digunakan seperti PubMed, ScienceDirect, ProQuest, dan EBSCO. Proses seleksi mengikuti pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), dan evaluasi kritis dilakukan menggunakan asesmen kritis dengan daftar periksa RCT CASP & JBI CASP untuk Quasi-Experimental. Dari 1.788 artikel, 15 artikel dipilih untuk review ini.
Hasil: Hasil menunjukkan bahwa beberapa terapi distraksi dapat diterapkan, seperti; distraksi musik, animasi, video game, distraksi video, boneka jari, audiovisual imersif dengan virtual reality, permainan terapeutik, kartun distraks, sangat signifikan mengurangi kecemasan praoperasi.
Kesimpulan: Temuan ini menunjukkan bahwa terapi distraksi apa pun dapat mengurangi kecemasan praoperasi pada anak. Strategi ini juga direkomendasikan untuk mengurangi kecemasan pada anak yang akan menjalani operasi, meningkatkan persiapan praoperasi, serta membantu anak saat memasuki ruang operasi dan induksi anestesi.
References
Agbayani, C. J. G., Fortier, M. A., & Kain, Z. N. (2020). Non-pharmacological methods of reducing perioperative anxiety in children. BJA Education, 20(12), 424–430. https://doi.org/10.1016/j.bjae.2020.08.003
Ahmadipour, M., Sattari, H., & Nejad, M. A. (2022). Incidence and risk factors related to anxiety of children and adolescents before elective surgery. European Journal of Translational Myology, 32(2). https://doi.org/10.4081/ejtm.2022.10449
Aramendi, J. F., & Emparanza, J. I. (2015). A summary of evidence of the effectiveness of physical exercise on cardiovascular diseases. Revista Andaluza de Medicina Del Deporte, 8(3), 115–129. https://doi.org/10.1016/j.ramd.2015.02.004
Ayan, G., & Sahin, O. (2023). Effect of a therapeutic play-based training program on pre-and post-operative anxiety and fear : A study on circumcision surgery in Turkish Muslim children. https://doi.org/10.1016/j.jpurol.2023.04.032
Bandyopadhyay, S., Kaur, M., Sinha, R., Muthiah, T., & Ayub, A. (2024). Effect of video distraction on preoperative anxiety scores in pediatric patients undergoing general anesthesia in ophthalmic daycare procedures : A randomized controlled trial. 133–139. https://doi.org/10.4103/joacp.joacp
Bayar, F. G., Sümeyye, Ş., & Kudubes, A. (2024). The efficacy of finger puppets, distraction cards, and kaleidoscope for reducing anxiety in children undergoing day surgery. 77. https://doi.org/10.1016/j.pedn.2024.05.007
Bumin Aydın, G., Yüksel, S., Ergil, J., Polat, R., Akelma, F. K., Ekici, M., Sayın, M., & Odabaş, Ö. (2017). The effect of play distraction on anxiety before premedication administration: a randomized trial. Journal of Clinical Anesthesia, 36, 27–31. https://doi.org/10.1016/j.jclinane.2016.04.044
Capurso, M., & Ragni, B. (2016). Psycho-educational preparation of children for anesthesia: A review of intervention methods. Patient Education and Counseling, 99(2), 173–185. https://doi.org/10.1016/j.pec.2015.09.004
CASP - RCT. (2020). Critical Appraisal Skills Programme - RCT. 4–7. https://casp-uk.net/casp-tools-checklists/
Dahlquist, L. M., Pendley, J. S., Landthrip, D. S., Jones, C. L., & Philip Steuber, C. (2002). Distraction intervention for preschoolers undergoing intramuscular injections and subcutaneous port access. Health Psychology, 21(1), 94–99. https://doi.org/10.1037/0278-6133.21.1.94
Dwairej, A. (2019). Video game distraction and anesthesia mask practice reduces children's preoperative anxiety : A randomized clinical trial. June, pp. 1–12. https://doi.org/10.1111/jspn.12272
Feiner, J. R., & Sinskey, J. L. (2022). Pediatric Distraction on Induction of Anesthesia with Virtual Reality (PEDI-VR) and Perioperative Anxiolysis: A Randomized Controlled Trial. 132(3), 798–806. https://doi.org/10.1213/ANE.0000000000005004.Pediatric
Filipe, M. G., Veloso, A. S., & Frota, S. (2023). Executive Functions and Language Skills in Preschool Children: The Unique Contribution of Verbal Working Memory and Cognitive Flexibility. Brain Sciences, 13(3). https://doi.org/10.3390/brainsci13030470
Getahun, A. B., Endalew, N. S., Mersha, A. T., & Admass, B. A. (2020).
Gezginci, E., Suluhan, D., & Caliskan, M. B. (2021). Is tablet-based interactive distraction effective on pain and anxiety during circumcision in children? A randomized controlled trial. Turkish Journal of Urology, 47(6), 518–525. https://doi.org/10.5152/tud.2021.21228
Golitaleb, M., Harorani, M., Garshasbi, M., Akbari, M., Jamilian, H., Barati, N., Habibi, D., & Hoseini, T. (2023). Comparing the Effect of Music and Puzzle-Solving on Anxiety Before Surgery in Children: A Randomized Clinical Trial. Turkish Archives of Pediatrics, 58(2), 136–141. https://doi.org/10.5152/TurkArchPediatr.2023.22203
Grigoropoulou, M., Kapetanakis, E. I., Attilakos, A., Charalampopoulos, A., Dimopoulou, A., Vamvakas, E., Mavrigiannaki, E., & Zavras, N. (2023). Investigating Non-Pharmacological Stress Reduction Interventions in Pediatric Patients Confirmed with Salivary Cortisol Levels: A Systematic Review. Pediatric Reports, 15(2), 349–359. https://doi.org/10.3390/pediatric15020031
Heikal, S., & Stuart, G. (2020). Anxiolytic premedication for children. BJA Education, 20(7), 220–225. https://doi.org/10.1016/j.bjae.2020.02.006
Hou, H., Li, X., Song, Y., Ji, Y., Sun, M., Wang, D., Jiao, J., Qu, J., & Gu, H. (2023). Effect of interactive, multimedia-based home-initiated education on preoperative anxiety in children and their parents: a single-center randomized controlled trial. BMC Anesthesiology, 23(1), 1–11. https://doi.org/10.1186/s12871-023-02055-7
Joanna Briggs Institute. (2019). Critical Appraisal Tools for Quasi-Experimental in JBI Systematic Reviews. JBI Rev Man. https://jbi.global/critical-appraisal-tools
Koo, C. H., Park, J. W., Ryu, J. H., & Han, S. H. (2020). The effect of virtual reality on preoperative anxiety: A meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 9(10), 1–12. https://doi.org/10.3390/jcm9103151
Liu, W., Xu, R., Jia, J., Shen, Y., Li, W., & Bo, L. (2022). Research Progress on Risk Factors of Preoperative Anxiety in Children: A Scoping Review. International Journal of Environmental Research and Public Health, 19(16). https://doi.org/10.3390/ijerph19169828
Millett, C. R., & Gooding, L. F. (2017). Comparing active and passive distraction-based music therapy interventions on preoperative anxiety in pediatric patients and their caregivers. Journal of Music Therapy, 54(4), 460–478. https://doi.org/10.1093/jmt/thx014
Nur Oktavia Hidayati, Sutisnu, A. A., & Nurhidayah, I. (2021). Efektivitas Terapi Bermain Terhadap Tingkat Kecemasan Anak Yang Menjalani Hospitalisasi. Jurnal Keperawatan BSI, 9(1), 61–67.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372. https://doi.org/10.1136/bmj.n71
Patel, A., Schieble, T., Davidson, M., Tran, M. C. J., Schoenberg, C., Delphin, E., & Bennett, H. (2006). Distraction with a handheld video game reduces pediatric preoperative anxiety. Paediatric Anaesthesia, 16(10), 1019–1027. https://doi.org/10.1111/j.1460-9592.2006.01914.x
Prado, I. M., Carcavalli, L., Abreu, L. G., Serra-Negra, J. M., Paiva, S. M., & Martins, C. C. (2019). Use of distraction techniques for managing anxiety and fear in pediatric dental practice: A systematic review of randomized controlled trials. International Journal of Paediatric Dentistry, 29(5), 650–668. https://doi.org/10.1111/ipd.12499
Prasetyo, S. N. (2010). Konsep Dan Proses Keperawatan Nyeri. Graha ilmu.
Rajeswari, S. R., Chandrasekhar, R., Vinay, C., Uloopi, K. S., & Rojaramya, K. S. (2019). Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children. 3–6.
Teruel, J., Stafford, G., Brown, J., Jones, B., Hopkins, M., Johnson, A., Edenfield, J., Guo, A., Schammel, C., Renfro, S., & Nilsson, A. (2021). Reduction of perioperative anxiety using a handheld video game device: A randomized study. Perioperative Care and Operating Room Management, 24(July), 100203. https://doi.org/10.1016/j.pcorm.2021.100203
Tordet, C., Erhel, S., Dodeler, V., Gonthier, C., Nardi, N., Rouxel, G., & Wodey, E. (2023). The benefits of experiencing flow through distracting activities : Flow reduces preoperative anxiety in children before surgery but not postoperative difficulties. Psychology & Health, 0(0), 1–20. https://doi.org/10.1080/08870446.2023.2220714
Turgut, A., Öztürk, H., & Ilçe, A. (2024). The Effect of Immersive Virtual Reality Application on Anxiety, Pain, and Parental Satisfaction in the Perioperative Process of Children : A Randomized Controlled Trial ✩. xxxx. https://doi.org/10.1016/j.pmn.2024.06.002
Uysal, G., Düzkaya, D. S., & Bozkurt, G. (2023). The effect of watching videos using virtual reality during operating room transfer on the fear and anxiety of children aged 6 – 12 undergoing inguinal hernia surgery : A randomized controlled trial. 72. https://doi.org/10.1016/j.pedn.2023.06.022
Wang, X., Zhang, J., Xin, H., Tan, W., Liu, Y., & Wan, J. (2023). Effectiveness of two distraction strategies in reducing preoperative anxiety in children in China : A randomized controlled trial. Journal of Pediatric Nursing, p. 68, e8–e15. https://doi.org/10.1016/j.pedn.2022.10.013
West, N., Christopher, N., Stratton, K., Görges, M., & Brown, Z. (2020). Reducing preoperative anxiety with Child Life preparation before intravenous induction of anesthesia: A randomized controlled trial. Paediatric Anaesthesia, 30(2), 168–180. https://doi.org/10.1111/pan.13802
Xu, S., Zhang, Z., Wang, A., Zhu, J., Tang, H., & Zhu, X. (2018). Effect of Self-efficacy Intervention on Quality of Life of Patients with Intestinal Stoma. Gastroenterology Nursing, 41(4), 341–346. https://doi.org/10.1097/SGA.0000000000000290
Yang, Y., Zhang, M., Sun, Y., Peng, Z., Zheng, X., & Zheng, J. (2022). Effects of advance exposure to an animated surgery-related picture book on preoperative anxiety and anesthesia induction in preschool children: a randomized controlled trial. BMC Pediatrics, 22(1), 1–8. https://doi.org/10.1186/s12887-022-03136-1
Yi, H., & Lee, H. (2022). Intervention to Reduce Anxiety Pre-and Post-Eye Surgery in Pediatric Patients in South Korea: A Preliminary Quasi-Experimental Study. Children, 9(1). https://doi.org/10.3390/children9010065
Zainal Abidin, H., Omar, S. C., Mazlan, M. Z., Hassan, M. H., Isa, R., Ali, S., Hassan, S. K., & Marzuki, A. (2021). Postoperative Maladaptive Behavior, Preoperative Anxiety and Emergence Delirium in Children Undergone General Anesthesia: A Narrative Review. Global Pediatric Health, 8. https://doi.org/10.1177/2333794X211007975
Ahmadipour, M., Sattari, H., & Nejad, M. A. (2022). Incidence and risk factors related to anxiety of children and adolescents before elective surgery. European Journal of Translational Myology, 32(2). https://doi.org/10.4081/ejtm.2022.10449
Aramendi, J. F., & Emparanza, J. I. (2015). A summary of evidence of the effectiveness of physical exercise on cardiovascular diseases. Revista Andaluza de Medicina Del Deporte, 8(3), 115–129. https://doi.org/10.1016/j.ramd.2015.02.004
Ayan, G., & Sahin, O. (2023). Effect of a therapeutic play-based training program on pre-and post-operative anxiety and fear : A study on circumcision surgery in Turkish Muslim children. https://doi.org/10.1016/j.jpurol.2023.04.032
Bandyopadhyay, S., Kaur, M., Sinha, R., Muthiah, T., & Ayub, A. (2024). Effect of video distraction on preoperative anxiety scores in pediatric patients undergoing general anesthesia in ophthalmic daycare procedures : A randomized controlled trial. 133–139. https://doi.org/10.4103/joacp.joacp
Bayar, F. G., Sümeyye, Ş., & Kudubes, A. (2024). The efficacy of finger puppets, distraction cards, and kaleidoscope for reducing anxiety in children undergoing day surgery. 77. https://doi.org/10.1016/j.pedn.2024.05.007
Bumin Aydın, G., Yüksel, S., Ergil, J., Polat, R., Akelma, F. K., Ekici, M., Sayın, M., & Odabaş, Ö. (2017). The effect of play distraction on anxiety before premedication administration: a randomized trial. Journal of Clinical Anesthesia, 36, 27–31. https://doi.org/10.1016/j.jclinane.2016.04.044
Capurso, M., & Ragni, B. (2016). Psycho-educational preparation of children for anesthesia: A review of intervention methods. Patient Education and Counseling, 99(2), 173–185. https://doi.org/10.1016/j.pec.2015.09.004
CASP - RCT. (2020). Critical Appraisal Skills Programme - RCT. 4–7. https://casp-uk.net/casp-tools-checklists/
Dahlquist, L. M., Pendley, J. S., Landthrip, D. S., Jones, C. L., & Philip Steuber, C. (2002). Distraction intervention for preschoolers undergoing intramuscular injections and subcutaneous port access. Health Psychology, 21(1), 94–99. https://doi.org/10.1037/0278-6133.21.1.94
Dwairej, A. (2019). Video game distraction and anesthesia mask practice reduces children's preoperative anxiety : A randomized clinical trial. June, pp. 1–12. https://doi.org/10.1111/jspn.12272
Feiner, J. R., & Sinskey, J. L. (2022). Pediatric Distraction on Induction of Anesthesia with Virtual Reality (PEDI-VR) and Perioperative Anxiolysis: A Randomized Controlled Trial. 132(3), 798–806. https://doi.org/10.1213/ANE.0000000000005004.Pediatric
Filipe, M. G., Veloso, A. S., & Frota, S. (2023). Executive Functions and Language Skills in Preschool Children: The Unique Contribution of Verbal Working Memory and Cognitive Flexibility. Brain Sciences, 13(3). https://doi.org/10.3390/brainsci13030470
Getahun, A. B., Endalew, N. S., Mersha, A. T., & Admass, B. A. (2020).
Magnitude and Factors Associated with Preoperative Anxiety Among Pediatric Patients: Cross-Sectional Study
. Pediatric Health, Medicine and Therapeutics, Volume 11, 485–494. https://doi.org/10.2147/phmt.s288077Gezginci, E., Suluhan, D., & Caliskan, M. B. (2021). Is tablet-based interactive distraction effective on pain and anxiety during circumcision in children? A randomized controlled trial. Turkish Journal of Urology, 47(6), 518–525. https://doi.org/10.5152/tud.2021.21228
Golitaleb, M., Harorani, M., Garshasbi, M., Akbari, M., Jamilian, H., Barati, N., Habibi, D., & Hoseini, T. (2023). Comparing the Effect of Music and Puzzle-Solving on Anxiety Before Surgery in Children: A Randomized Clinical Trial. Turkish Archives of Pediatrics, 58(2), 136–141. https://doi.org/10.5152/TurkArchPediatr.2023.22203
Grigoropoulou, M., Kapetanakis, E. I., Attilakos, A., Charalampopoulos, A., Dimopoulou, A., Vamvakas, E., Mavrigiannaki, E., & Zavras, N. (2023). Investigating Non-Pharmacological Stress Reduction Interventions in Pediatric Patients Confirmed with Salivary Cortisol Levels: A Systematic Review. Pediatric Reports, 15(2), 349–359. https://doi.org/10.3390/pediatric15020031
Heikal, S., & Stuart, G. (2020). Anxiolytic premedication for children. BJA Education, 20(7), 220–225. https://doi.org/10.1016/j.bjae.2020.02.006
Hou, H., Li, X., Song, Y., Ji, Y., Sun, M., Wang, D., Jiao, J., Qu, J., & Gu, H. (2023). Effect of interactive, multimedia-based home-initiated education on preoperative anxiety in children and their parents: a single-center randomized controlled trial. BMC Anesthesiology, 23(1), 1–11. https://doi.org/10.1186/s12871-023-02055-7
Joanna Briggs Institute. (2019). Critical Appraisal Tools for Quasi-Experimental in JBI Systematic Reviews. JBI Rev Man. https://jbi.global/critical-appraisal-tools
Koo, C. H., Park, J. W., Ryu, J. H., & Han, S. H. (2020). The effect of virtual reality on preoperative anxiety: A meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 9(10), 1–12. https://doi.org/10.3390/jcm9103151
Liu, W., Xu, R., Jia, J., Shen, Y., Li, W., & Bo, L. (2022). Research Progress on Risk Factors of Preoperative Anxiety in Children: A Scoping Review. International Journal of Environmental Research and Public Health, 19(16). https://doi.org/10.3390/ijerph19169828
Millett, C. R., & Gooding, L. F. (2017). Comparing active and passive distraction-based music therapy interventions on preoperative anxiety in pediatric patients and their caregivers. Journal of Music Therapy, 54(4), 460–478. https://doi.org/10.1093/jmt/thx014
Nur Oktavia Hidayati, Sutisnu, A. A., & Nurhidayah, I. (2021). Efektivitas Terapi Bermain Terhadap Tingkat Kecemasan Anak Yang Menjalani Hospitalisasi. Jurnal Keperawatan BSI, 9(1), 61–67.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372. https://doi.org/10.1136/bmj.n71
Patel, A., Schieble, T., Davidson, M., Tran, M. C. J., Schoenberg, C., Delphin, E., & Bennett, H. (2006). Distraction with a handheld video game reduces pediatric preoperative anxiety. Paediatric Anaesthesia, 16(10), 1019–1027. https://doi.org/10.1111/j.1460-9592.2006.01914.x
Prado, I. M., Carcavalli, L., Abreu, L. G., Serra-Negra, J. M., Paiva, S. M., & Martins, C. C. (2019). Use of distraction techniques for managing anxiety and fear in pediatric dental practice: A systematic review of randomized controlled trials. International Journal of Paediatric Dentistry, 29(5), 650–668. https://doi.org/10.1111/ipd.12499
Prasetyo, S. N. (2010). Konsep Dan Proses Keperawatan Nyeri. Graha ilmu.
Rajeswari, S. R., Chandrasekhar, R., Vinay, C., Uloopi, K. S., & Rojaramya, K. S. (2019). Effectiveness of Cognitive Behavioral Play Therapy and Audiovisual Distraction for Management of Preoperative Anxiety in Children. 3–6.
Teruel, J., Stafford, G., Brown, J., Jones, B., Hopkins, M., Johnson, A., Edenfield, J., Guo, A., Schammel, C., Renfro, S., & Nilsson, A. (2021). Reduction of perioperative anxiety using a handheld video game device: A randomized study. Perioperative Care and Operating Room Management, 24(July), 100203. https://doi.org/10.1016/j.pcorm.2021.100203
Tordet, C., Erhel, S., Dodeler, V., Gonthier, C., Nardi, N., Rouxel, G., & Wodey, E. (2023). The benefits of experiencing flow through distracting activities : Flow reduces preoperative anxiety in children before surgery but not postoperative difficulties. Psychology & Health, 0(0), 1–20. https://doi.org/10.1080/08870446.2023.2220714
Turgut, A., Öztürk, H., & Ilçe, A. (2024). The Effect of Immersive Virtual Reality Application on Anxiety, Pain, and Parental Satisfaction in the Perioperative Process of Children : A Randomized Controlled Trial ✩. xxxx. https://doi.org/10.1016/j.pmn.2024.06.002
Uysal, G., Düzkaya, D. S., & Bozkurt, G. (2023). The effect of watching videos using virtual reality during operating room transfer on the fear and anxiety of children aged 6 – 12 undergoing inguinal hernia surgery : A randomized controlled trial. 72. https://doi.org/10.1016/j.pedn.2023.06.022
Wang, X., Zhang, J., Xin, H., Tan, W., Liu, Y., & Wan, J. (2023). Effectiveness of two distraction strategies in reducing preoperative anxiety in children in China : A randomized controlled trial. Journal of Pediatric Nursing, p. 68, e8–e15. https://doi.org/10.1016/j.pedn.2022.10.013
West, N., Christopher, N., Stratton, K., Görges, M., & Brown, Z. (2020). Reducing preoperative anxiety with Child Life preparation before intravenous induction of anesthesia: A randomized controlled trial. Paediatric Anaesthesia, 30(2), 168–180. https://doi.org/10.1111/pan.13802
Xu, S., Zhang, Z., Wang, A., Zhu, J., Tang, H., & Zhu, X. (2018). Effect of Self-efficacy Intervention on Quality of Life of Patients with Intestinal Stoma. Gastroenterology Nursing, 41(4), 341–346. https://doi.org/10.1097/SGA.0000000000000290
Yang, Y., Zhang, M., Sun, Y., Peng, Z., Zheng, X., & Zheng, J. (2022). Effects of advance exposure to an animated surgery-related picture book on preoperative anxiety and anesthesia induction in preschool children: a randomized controlled trial. BMC Pediatrics, 22(1), 1–8. https://doi.org/10.1186/s12887-022-03136-1
Yi, H., & Lee, H. (2022). Intervention to Reduce Anxiety Pre-and Post-Eye Surgery in Pediatric Patients in South Korea: A Preliminary Quasi-Experimental Study. Children, 9(1). https://doi.org/10.3390/children9010065
Zainal Abidin, H., Omar, S. C., Mazlan, M. Z., Hassan, M. H., Isa, R., Ali, S., Hassan, S. K., & Marzuki, A. (2021). Postoperative Maladaptive Behavior, Preoperative Anxiety and Emergence Delirium in Children Undergone General Anesthesia: A Narrative Review. Global Pediatric Health, 8. https://doi.org/10.1177/2333794X211007975
Published
2024-11-05
How to Cite
Anas Kiki Anugrah, Renaldi M, Nurul Jannah, & Supriadin. (2024). TERAPI DISTRAKSI SEBAGAI INTERVENSI UNTUK MENURUNKAN KECEMASAN PRAOPERASI PADA ANAK: LITERATURE REVIEW. Jurnal Mitrasehat, 14(4), 850-865. https://doi.org/10.51171/jms.v14i3.728
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