Impact of comfort theory–guided nursing care on anxiety reduction and recovery outcomes in pediatric strabismus surgery patients

Objective This study aimed to evaluate the effectiveness of Comfort Theory–guided nursing care in reducing perioperative anxiety and improving recovery outcomes among children undergoing strabismus surgery. The hypothesis was that a structured comfort-based nursing approach addressing physical, psychospiritual, sociocultural, and environmental needs would yield superior emotional and functional outcomes compared with conventional care. Methods A prospective study was conducted involving 184 pediatric patients scheduled for elective strabismus correction. Participants were randomly assigned to receive either routine nursing ( n = 92) or Comfort Theory–guided nursing interventions ( n = 92). The comfort-based model included individualized psychological preparation, environmental optimization, parental involvement, and continuous emotional support. Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS), pain using the Face–Legs–Activity–Cry–Consolability (FLACC) scale, and behavioral recovery using the Post-Hospitalization Behavior Questionnaire (PHBQ). Results Compared with routine care, the Comfort Theory group showed markedly lower anxiety both before induction (44.1 ± 8.9 vs. 61.5 ± 9.7, p < 0.001) and on postoperative day 1 (40.6 ± 7.5 vs. 53.4 ± 8.2, p < 0.001). Physiological stress responses were also blunted, with lower heart rate (100.2 ± 8.8 vs. 108.5 ± 9.2 bpm, p < 0.001) and mean arterial pressure (83.1 ± 6.7 vs. 88.4 ± 7.1 mmHg, p < 0.001) before induction. Postoperative pain scores were significantly reduced across all time points ( p < 0.001), and behavioral recovery improved, with lower PHBQ scores (7.4 ± 3.1 vs. 10.2 ± 3.7, p < 0.001). Children in the intervention group regained consciousness earlier (19.6 ± 3.8 vs. 22.4 ± 4.1 min, p < 0.001), resumed oral intake faster (4.9 ± 1.0 vs. 5.8 ± 1.2 h, p < 0.001), and had shorter hospital stays (3.4 ± 0.7 vs. 3.9 ± 0.8 days, p < 0.001). Conclusion Comfort Theory–guided nursing care may help alleviate perioperative anxiety, stabilize physiological stress responses, reduce postoperative pain, and support behavioral and functional recovery in pediatric strabismus surgery. As a holistic nursing approach, it may offer a practical framework for improving perioperative care; however, the findings should be interpreted in light of the single-center design, lack of full blinding, and multimodal nature of the intervention.