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[A transversal study on preoperative anxiety in children: use of the modified Yale scale.]
Alvaro Antônio Guaratini1, José Alvaro Marques Marcolino, Ayrton Bentes Teixeira
1Hospital Central, ISCMSP.
Insights
Preanesthetic evaluations cause higher anxiety in preschool children than clinical visits. The modified Yale Preoperative Anxiety Scale (YPAS-m) identified significantly higher anxiety levels and prevalence during preanesthetic assessments.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Medical Assessment Tools
Context:
- Anxiety in children is a significant concern during medical procedures.
- The modified Yale Preoperative Anxiety Scale (YPAS-m) is designed for assessing preoperative anxiety in young children.
- Previous studies have not specifically addressed anxiety during the preanesthetic evaluation phase.
Purpose:
- To evaluate and compare the level and prevalence of anxiety in preschool children during preanesthetic evaluations versus clinical evaluations.
- To utilize the modified Yale Preoperative Anxiety Scale (YPAS-m) for this assessment.
Summary:
- A transversal study involving 100 children (ASA I-II) compared anxiety levels using the YPAS-m in two groups: clinical evaluation (n=50) and preanesthetic evaluation (n=50).
- Results showed significantly higher median YPAS-m scores (50.0 vs. 23.4) and anxiety prevalence (81.6% vs. 16.7%) in the preanesthetic evaluation group.
- Demographic data were comparable between the groups.
Impact:
- Findings indicate that the preanesthetic evaluation setting is a more significant source of anxiety for preschool children than routine clinical visits.
- Highlights the need for targeted anxiety management strategies during preanesthetic consultations.
- The YPAS-m proves effective in differentiating anxiety levels in these distinct pediatric healthcare encounters.
Background And Objectives:
Scales can be useful to recognize anxiety states and to indicate ways to prevent complications due to elevated levels of anxiety. The modified Yale Preoperative Anxiety Scale (YPAS-m) was developed to evaluate anxiety in preschool children at the time of the anesthetic induction. It is an observational scale, being applied and completed in a short period of time. Studies on anxiety in children in the preoperative period do not mention anxiety at the preanesthetic evaluation. This transversal study tried to evaluate the level and prevalence of anxiety at the preanesthetic evaluation and in the clinical evaluation using the YPAS-m in preschool children.
Methods:
One hundred children, physical status ASA I and II were evaluated; G PED = 50 children undergoing clinical evaluation; G PEC = 50 children undergoing preanesthetic evaluation for surgery. The study was conducted at the pediatric clinic and preanesthetic evaluation waiting-room while the children waited for their appointment. Two observers applied the YPAS-m independently. Parameters analyzed included the demographic data; and median and percentage of patients with anxiety (YPAS-m > 30). Statistical analysis considered a p < 0.05 significant.
Results:
The groups were homogenous regarding the socio-demographic data. The mean ages were: G PED 4.25 and G PEC 4.67 years. There was a significant difference in the median of the YPAS-m (G PED 23.4 and G PEC 50.0) and on the prevalence of anxiety between both groups (G PED 16.7% and G PEC 81.6%).
Conclusions:
In children between 2 and 7 years the levels and prevalence of anxiety, evaluated by the YPAS-m, at the time of the outpatient preanesthetic evaluation are higher than at the time of the clinical evaluation.
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