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Prediction of preoperative anxiety in children: who is most accurate?
Jill E MacLaren1, Caitlin Thompson, Megan Weinberg
1Center for the Advancement of Perioperative Health, University of California, Irvine, California, USA.
Insights
Pediatric attending anesthesiologists accurately predicted children's anxiety during anesthesia induction, outperforming resident anesthesiologists and mothers. This finding highlights the importance of experienced clinicians in managing pediatric patient anxiety.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Medical Education
Background:
- Assessing children's anxiety during anesthesia induction is crucial for patient well-being.
- Previous studies have explored predictors of preoperative anxiety in pediatric patients.
- Understanding who can best predict this anxiety can inform clinical practice.
Purpose of the Study:
- To evaluate the predictive accuracy of pediatric attending anesthesiologists, resident anesthesiologists, and mothers regarding children's anxiety during anesthesia induction.
- To compare the performance of these groups in predicting child anxiety.
Main Methods:
- A total of 125 children (aged 2-16 years) undergoing anesthesia induction were studied.
- Anesthesiologists (attending and resident) and mothers provided anxiety predictions using a visual analog scale.
- Children's anxiety was objectively measured using the Modified Yale Preoperative Anxiety Scale.
Main Results:
- Attending anesthesiologists' predictions showed a significant association with children's actual anxiety levels (r(s) = 0.38, P < 0.001).
- Predictions by resident anesthesiologists and mothers were not significantly correlated with child anxiety.
- Attending anesthesiologists' predictions were within one standard deviation of observed anxiety in 47.2% of cases and within two standard deviations in 70.4% of cases.
Conclusions:
- Attending anesthesiologists in pediatric settings demonstrate superior ability in predicting children's anxiety during anesthesia induction compared to mothers.
- This enhanced predictive capacity has clinical implications for managing pediatric perioperative anxiety.
- Further research is needed to determine if this predictive accuracy extends to anesthesiologists not specializing in pediatric care.
Background:
In this investigation, we sought to assess the ability of pediatric attending anesthesiologists, resident anesthesiologists, and mothers to predict anxiety during induction of anesthesia in 2 to 16-yr-old children (n = 125).
Methods:
Anesthesiologists and mothers provided predictions using a visual analog scale and children's anxiety was assessed using a valid behavior observation tool the Modified Yale Preoperative Anxiety Scale. All mothers were present during anesthetic induction and no child received sedative premedication. Correlational analyses were conducted.
Results:
A total of 125 children aged 2-16 yr, their mothers, and their attending pediatric anesthesiologists and resident anesthesiologists were studied. Correlational analyses revealed significant associations between attending predictions and child anxiety at induction (r(s) = 0.38, P < 0.001). Resident anesthesiologist and mother predictions were not significantly related to children's anxiety during induction (r(s) = 0.01 and 0.001, respectively). In terms of accuracy of prediction, 47.2% of predictions made by attending anesthesiologists were within one standard deviation of the observed anxiety exhibited by the child, and 70.4% of predictions were within two standard deviations.
Conclusions:
We conclude that attending anesthesiologists who practice in pediatric settings are better than mothers in predicting the anxiety of children during induction of anesthesia. Although this finding has significant clinical implications, it is unclear if it can be extended to attending anesthesiologists whose practice is not mostly pediatric anesthesia.
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