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The influence of appraisals in understanding children's experiences with medical procedures

Robyn Lewis Claar1, Lynn S Walker, Craig A Smith

  • 1Duke University Medical Center, Department of Psychiatry and Behavioral Science, Durham, North Carolina 27710, USA.

Journal of Pediatric Psychology
|September 14, 2002
PubMed

Insights

Understanding the esophagogastroduodenoscopy (EGD) procedure reduces children's anxiety and distress. Better appraisal of the EGD leads to less negative experiences and attitudes toward future medical procedures.

Area of Science:

  • Pediatric Psychology
  • Medical Procedure Anxiety
  • Cognitive Appraisal Theory

Background:

  • Children undergoing medical procedures often experience anticipatory anxiety and distress.
  • Cognitive appraisals significantly influence emotional responses to stressful events.
  • Understanding the factors affecting children's procedural experiences is crucial for improving care.

Purpose of the Study:

  • To investigate how cognitive appraisals impact anticipatory anxiety, procedural distress, and postprocedural evaluations in children undergoing esophagogastroduodenoscopy (EGD).
  • To explore the relationship between children's knowledge, appraisal of threat, and coping abilities concerning the EGD procedure.

Main Methods:

  • 100 children (ages 8-17) undergoing EGD completed self-report measures assessing knowledge, appraisal of aversiveness, coping ability, and state anxiety.
  • Distress during the EGD was evaluated using observer ratings.
  • Postprocedural evaluations, including pain and attitudes toward future procedures, were assessed via self-report one hour after the procedure.

Main Results:

  • Increased knowledge about the EGD was associated with lower perceived threat.
  • Lower perceived threat correlated with reduced anticipatory anxiety.
  • Reduced anxiety led to decreased procedural distress, pain, and more positive postprocedural evaluations and future procedural attitudes.

Conclusions:

  • Cognitive appraisals play a vital role in mediating the relationship between knowledge and anxiety in pediatric EGD patients.
  • An appraisal-based model effectively explains children's experiences with medical procedures.
  • Findings support tailored preparation strategies for children undergoing EGD to mitigate anxiety and distress.
Abstract

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