Effectiveness of Social Robots in Relieving Children's and Adolescents' Anxiety, Pain, Fear and Stress in Perioperative Nursing: A Systematic Review and Meta-Analysis

J Clin Nurs. 2026 Jun 20. doi: 10.1111/jocn.70411. Online ahead of print.

ABSTRACT

AIM: To assess how social robots impact anxiety, pain, fear and stress in children and adolescents during perioperative nursing.

DESIGN: A systematic review and meta-analysis of randomised controlled trials and quasi-experimental studies.

METHODS: Following Joanna Briggs Institute guidelines, eligible studies included participants under 21 undergoing surgery or perioperative care, used social robot interventions with comparators, assessed anxiety, pain, fear and stress, and employed randomised or quasi-experimental designs. Two independent reviewers screened and extracted data.

DATA SOURCES: A systematic search was conducted in April 2024 and updated twice (December 2024, October 2025) across CINAHL, Web of Science, Scopus, PubMed, Cochrane CENTRAL, Medic, PsycArticles, Institute of Electrical and Electronics Engineers and grey literature sources (Google Scholar, Mednar).

RESULTS: Seven studies (663 participants) showed heterogeneity in social robotic interventions. A meta-analysis of two studies (302 participants) found a significant reduction in children's and adolescents' post-operative anxiety, whereas a narrative synthesis identified three studies reporting reduced perioperative anxiety. However, the interventions had little or no effect on perioperative pain, fear or stress.

CONCLUSION: This review suggests that social robotic interventions may reduce perioperative anxiety in children and adolescents, potentially serving as non-pharmacological distraction tools in paediatric care. Evidence for their effects on pain, fear and stress is limited, highlighting the need for further research to identify effective interventions and clarify their role in perioperative nursing.

IMPACT: This review highlights social robotic interventions as promising non-pharmacological tools for reducing perioperative anxiety in children and adolescents.

REPORTING METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis Without Meta-Analysis reporting guidelines.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

TRIAL REGISTRATION: This review was registered in PROSPERO, the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO/view/CRD42024549796).

PMID:42322312 | DOI:10.1111/jocn.70411