The Effect of a Walkway Used in Postoperative Mobilization on Children's Pain, Fear, and Time to Initiate Mobilization

Early mobilization is defined as the patient's ability to stand up and walk as soon as possible after surgery or after illness, depending on the type of operation performed and the course of the disease. Early mobilization is considered and recommended as one of the factors that accelerate recovery. One study indicated that initiating movement and mobilization early reduced surgical stress, muscle atrophy, complications, hospital stay, and care costs. Other studies have also reported that early mobilization accelerates the functioning of the Gastrointestinal System (GIS), prevents thromboembolic complications, and speeds up recovery. To minimize complications after surgery and optimize the child's health, the Enhanced Recovery After Surgery (ERAS) protocol can be applied. These protocols, also known as "Fast-Track," were first implemented in 2001. Early mobilization is one of the most important components of the ERAS approach. According to the ERAS protocol, the patient needs to be mobilized for two hours on the day of surgery and for a total of six hours on subsequent days until discharge.

Although the benefits of early mobilization after surgery and its contribution to the recovery process are known, one study reported that early mobilization attempts were infrequent for patients after surgery (Rafeeqi and Pearson, 2021). Another study also indicated that patients need assistance with mobilization after surgical operations. At this point, nurses are key in initiating the early mobilization process to improve the quality of postoperative care. It is essential that early mobilization is initiated by the nurse, followed by encouraging the child to move independently. The surgical nurse should support the patient to achieve the highest possible level of independence and help improve their well-being.

Randomized controlled trials that comprehensively assess both physical performance and psychological comfort (pain and fear) simultaneously during mobilization in postoperative children are limited. This study is designed as a randomized controlled trial to prove the effectiveness of low-cost, easy-to-implement, and concrete play materials such as "Walking Tracks" (Mat Mats), which are distraction-based and suitable for children's developmental characteristics, in contrast to expensive and technology-based mobilization initiatives in the literature. It aims to fill the evidence gap that holistically evaluates both physical and psychological recovery. This study aims to improve both physical and psychological recovery in a holistic way by transforming mobilization in children from a "task" into a "game". The population of the study, which is planned as a randomized controlled trial, will consist of 74 children aged 4-10 years who underwent abdominal surgery in the Pediatric Surgery Department of Mersin University Hospital.

Methodology

Study Design: A randomized controlled experimental design will be employed.