Examining the impact of postoperative fall risk on psychosocial symptoms including pain, anxiety, hopelessness, anger, and aggression in hospitalized children.

OBJECTIVE

To examine the associations among postoperative fall risk, pain, and psychosocial symptoms, including anxiety, hopelessness, anger/aggression, developmental regression, and communication difficulties, in hospitalized children.

METHODS

This cross-sectional correlational study included 115 children aged 6-12 years who were hospitalized in the pediatric surgery unit of a tertiary-level training and research hospital between January 1 and June 1, 2025. Data were collected through structured face-to-face interviews using the Personal Information Form, the Humpty Dumpty Fall Scale, the Wong-Baker FACES Pain Rating Scale, and the Psychosocial Symptoms Identification Scale for Hospitalized Children.

RESULTS

Postoperative fall risk differed significantly by gender, educational status, and previous surgical history. Boys and children not yet attending primary school had higher fall risk scores. Children receiving routine postoperative information had higher fall risk and pain scores, whereas those undergoing neurosurgery had the highest fall risk and psychosocial symptom scores (p < 0.01). Higher fall risk was associated with higher psychosocial symptom scores, particularly anxiety, anger/aggression, and developmental regression, although not all psychosocial subdimensions differed significantly between fall risk groups. In an unadjusted regression model, postoperative pain was significantly associated with psychosocial symptom scores and explained approximately 20% of the variance.

CONCLUSION

Postoperative fall risk, pain, and psychosocial symptoms were significantly associated during the early postoperative period in hospitalized children. These findings support a holistic approach to pediatric postoperative care integrating fall risk assessment, pain management, psychosocial assessment, and family-centered support. Because of the cross-sectional design, causal relationships cannot be established. Further multicenter longitudinal studies are needed to support evidence-based pediatric nursing interventions.

IMPLICATIONS FOR PRACTICE: Pediatric nurses should integrate fall risk, pain, and psychosocial assessment into routine postoperative care. Identifying co-occurring risks can guide individualized safety precautions, pain management, and psychosocial and family-centered support, particularly for children with higher fall risk.