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Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients
Jong-Hyuk Lee1, Han-Kil Jung2, Gang-Geun Lee2
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
A smartphone app effectively reduces preoperative anxiety in children undergoing surgery. Combining the app with low-dose midazolam showed the greatest anxiety reduction, offering a simple, customizable intervention.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Digital Health Interventions
Background:
- Preoperative anxiety is common in children and associated with negative outcomes.
- Behavioral interventions are crucial for managing pediatric preoperative distress.
- Smartphone applications offer a novel approach to anxiety management.
Purpose of the Study:
- To evaluate the efficacy of a smartphone application in reducing preoperative anxiety in children.
- To compare the smartphone application intervention with traditional midazolam sedation.
- To assess the combined effect of midazolam and the smartphone application.
Main Methods:
- A randomized controlled trial involving 120 children (ages 1-10) undergoing elective surgery.
- Three groups: intravenous midazolam (M), smartphone application (S), and combined midazolam and smartphone (SM).
- Anxiety assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at multiple time points.
Main Results:
- All interventions reduced anxiety compared to baseline.
- The smartphone application group (S) showed significantly lower anxiety than the midazolam group (M).
- The combined group (SM) demonstrated the most significant reduction in anxiety (P < 0.01).
Conclusions:
- Smartphone application-based preoperative preparation is effective and customizable.
- This digital intervention offers a simple and accessible method for reducing pediatric preoperative anxiety.
- Combining smartphone interventions with low-dose sedation may optimize anxiety management.
Background:
Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used.
Methods:
A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room.
Results:
In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 ± 11.8 vs 41.0 ± 7.0, S group 59.2 ± 17.6 vs 36.4 ± 7.3, SM group 58.3 ± 17.5 vs 26.0 ± 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01).
Conclusions:
The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.
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