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The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind
Wendy Fincher1, Jane Shaw, Anne-Sylvie Ramelet
1Clinical Development Nurse for Operating Theatres, Princess Margaret Hospital for Children, Subiaco, Australia. wendy.fincher@health.wa.gov.au
Insights
Structured preoperative preparation significantly reduced parent anxiety and postoperative pain in children. While it had less impact on child anxiety, involving parents is key for better outcomes.
Area of Science:
- Pediatric Surgery
- Anxiety Research
- Healthcare Management
Background:
- Hospitalized children (50-70%) experience severe preoperative anxiety and distress.
- High preoperative anxiety correlates with postoperative distress and negative behaviors.
- Preoperative education's effectiveness needs validation in Australian contexts.
Purpose of the Study:
- Evaluate structured preoperative preparation's impact on child and parent anxiety.
- Assess effects on child behavioral changes and parent satisfaction.
- Determine the efficacy of a tailored preoperative program.
Main Methods:
- Single-blind randomized controlled trial in Western Australia.
- 73 children and carers randomly assigned to control or experimental groups.
- Experimental group received photo files, role-modeling, and hospital tours.
Main Results:
- Significant reduction in parent state anxiety (p=0.009).
- No significant difference in child anxiety (p=0.07) or parent satisfaction.
- Significant two-point reduction in postoperative pain scores (p=0.001).
Conclusions:
- Preoperative preparation more effective for parents than children.
- Limited impact on child anxiety but reduced postoperative pain.
- Active parental involvement in preoperative preparation is recommended.
Aims:
To evaluate the effect of a structured preoperative preparation on child and parent state anxiety, child behavioural change and parent satisfaction.
Background:
It is estimated that around 50-70% of hospitalised children experience severe anxiety and distress prior to surgery. Children who are highly anxious and distressed preoperatively are likely to be distressed on awakening and have negative postoperative behaviour. Although education before surgery has been found to be useful mostly in North America, the effectiveness of preoperative preparation programme adapted to the Australian context remains to be tested.
Design:
This single-blind randomised controlled study was conducted at a tertiary referral hospital for children in Western Australia.
Methods:
Following ethics approval and parental consent, 73 children and one of their carers (usually a parent) were randomly assigned into two groups. The control group had standard practice with no specific preoperative education and the experimental group received a preoperative preparation, including a photo file, demonstration of equipment using a role-modelling approach and a tour.
Results:
The preoperative preparation reduced parent state anxiety significantly (-2·32, CI -4·06 to -0·56, p = 0·009), but not child anxiety (-0·59, CI -1·23 to 0·06, p = 0·07). There was no significant difference in child postoperative behaviour or parent satisfaction between the groups. There was a significant two-point pain score reduction in the preoperative preparation group, when compared with the control group median 2 (IQR 5) and 4 (IQR 4), respectively (p = 0·001).
Conclusions:
Preoperative preparation was more efficient on parent than child. Although the preoperative preparation had limited effect on child anxiety, it permitted to decrease pain experience in the postoperative period.
Relevance To Clinical Practice:
Parents should be actively involved in their child preoperative preparation.
