Children's anticipation of impending surgery. Shifts in object-representational paradigms

The authors used Rorschach assessments of the quality of object-representations to measure psychological shifts in children facing surgery. Fifteen children, ages 7 to 11, were given the Rorschach test three times: one week prior to elective hernia surgery, the day before the surgery, and 3 weeks after hospitalization. These children were compared with a nonsurgical group of 13 children matched for age and IQ and tested at the same time intervals. The authors hypothesized that the two groups would have similar Rorschach Mutuality of Autonomy (MOA) scale scores at Times 1 and 3, but would differ substantially at Time 2. This hypothesis was confirmed using the Mann-Whitney U test. Within the surgical group, there was an overall significant difference in MOA scores over time, and, as hypothesized, these children's scores at Time 2 were significantly more malevolent than at Time 1 (p less than .003). The effects of surgery were somewhat attenuated by Time 3, but the Time 3 MOA scores were still more malevolent than at Time 1 (p = .05) and were not significantly different from those at Time 2 (p = .18). The authors highlight the need to amply prepare children for even minor surgical procedures.