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Psychological preparation for surgery pediatric patients: the effects on children's and parents' stress responses and
Insights
A comprehensive psychological preparation program significantly improved children's hospital adjustment and reduced parental anxiety during elective surgery. This approach enhanced cooperation and satisfaction for pediatric patients undergoing tonsillectomies.
Area of Science:
- Pediatric Psychology
- Child Health Services Research
- Surgical Patient Care
Background:
- Hospitalization for elective surgery can cause significant distress for children and parents.
- Effective psychological preparation strategies are crucial for improving pediatric patient adjustment.
- Parental anxiety and satisfaction are key indicators of care quality in pediatric surgery.
Purpose of the Study:
- To evaluate the effectiveness of different psychological preparation and supportive care interventions for children undergoing elective surgery.
- To assess the impact of these interventions on children's in-hospital adjustment and post-hospital behavior.
- To measure the effects on parental anxiety and satisfaction with care.
Main Methods:
- Eighty-four children (aged 3-12) undergoing tonsillectomies were randomized into three treatment groups or a control group.
- Interventions included systematic preparation, rehearsal, supportive care, single-session preparation, or supportive care alone.
- Children's adjustment was assessed via behavioral ratings, medical data, and post-hospital inventories; parental outcomes included anxiety and satisfaction ratings.
Main Results:
- Children receiving combined preparation, rehearsal, and supportive care showed significantly less behavioral upset and more cooperation.
- Parents in the comprehensive preparation group reported significantly lower anxiety and higher satisfaction.
- Younger children exhibited greater distress and less cooperation compared to older children.
Conclusions:
- A multi-component psychological preparation program is highly effective in enhancing pediatric surgical patients' adjustment.
- This intervention positively impacts parental anxiety and satisfaction, improving the overall family experience.
- Tailoring psychological support based on age may further optimize outcomes for pediatric surgical patients.
Abstract:
This clinical experiment tested variations of psychological preparation and supportive care designed to increase the adjustment of children (and their parents) hospitalized for elective surgery. Eighty-four children, aged 3 to 12, admitted for tonsillectomies were randomly assigned to one of three treatment conditions or to a control group: (1) a combination of systematic preparation, rehearsal, and supportive care conducted prior to each stressful procedure; (2) a single-session preparation conducted after admission, and (3) consistent supportive care given by one nurse at the same points as in the first condition, but including no systematic preparation or rehearsal. The children's hospital adjustment was measured by blind ratings of behavioral upset and cooperation during the blood test, medication injection, transport to surgery, induction, and postoperative fluid intake and by recovery room medications and pulse rates and time to first voiding. Post-hospital adjustment was assessed with Vernon et al.'s Post Hospital Behavior Inventory. Parent outcome measures included self-ratings for anxiety and satisfaction with information and care. As hypothesized, the results demonstrated that children who received condition one showed significantly less upset and more cooperation and their parents reported significantly greater satisfaction and less anxiety than did children or parents in the other groups. Younger children were significantly more upset and less cooperative than older children.