Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery

Area of Science:

• Pediatric Psychology
• Surgical Stress Measurement
• Childhood Anxiety Research

Background:

• Perioperative stress and anxiety negatively impact children's emotional well-being.
• Cortisol levels and children's drawings are potential indicators of surgical stress and anxiety.
• Assessing these indicators is crucial for understanding the pediatric surgical patient experience.

Purpose of the Study:

• To quantify anxiety and stress levels in children undergoing surgery.
• To investigate the correlation between objective stress markers (salivary cortisol) and subjective anxiety assessments (children's drawings).
• To evaluate the Swedish version of the Child Drawing: Hospital manual as a subjective measure.

Main Methods:

• Included 93 children scheduled for day surgery.
• Collected salivary cortisol samples preoperatively on the day of surgery.
• Requested children to create a drawing of a person at the hospital.

Main Results:

• No significant association was found between salivary cortisol concentrations and the Child Drawing: Hospital (CD:H) score.
• Objective and subjective measures of stress did not correlate in this cohort.
• This suggests different aspects of the child's experience are being captured.

Conclusions:

• Children's drawings and salivary cortisol reflect distinct aspects of fear, anxiety, or stress during the perioperative period.
• These methods may capture different dimensions of a child's response to hospitalization and surgery.
• Further research is needed to understand the complementary roles of these measures.