Analysing a family-centred preoperative intervention programme: a dismantling approach

Area of Science:

• Pediatric Anesthesiology
• Child Psychology
• Healthcare Intervention Research

Background:

• The ADVANCE family-centered preoperative intervention program effectively reduces children's preoperative anxiety.
• The full ADVANCE program's complexity may limit its widespread hospital implementation.
• A dismantling approach was used to identify core effective components of ADVANCE.

Purpose of the Study:

• To identify the key effective components of the ADVANCE intervention.
• To determine which elements of ADVANCE most significantly impact preoperative anxiety in children.
• To inform the development of more implementable preoperative preparation programs.

Main Methods:

• A follow-up study involving 96 children (aged 2-10) from the original ADVANCE trial.
• Assessment of baseline characteristics, parental adherence to ADVANCE components, and child/parental anxiety levels.
• Analysis of the association between parental adherence and child anxiety.

Main Results:

• Higher parental adherence to ADVANCE was linked to lower child preoperative anxiety.
• Practicing with the anesthesia mask at home and using distraction in the holding area were significant anxiety-reducing components.
• Children with adherent parents showed stable, low anxiety throughout the preoperative period.

Conclusions:

• Practicing with the anesthesia mask (shaping and exposure) is a beneficial component.
• Parental use of distraction in the surgical setting is another key effective component.
• These components can be incorporated into future preoperative preparation programs for improved anxiety management.