Internet-delivered, preoperative, preparation program (I-PPP): Development and examination of effectiveness
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Published on: August 1, 2019
Kristi D Wright1, Mateen Raazi2, Kirstie L Walker1
1Department of Psychology, University of Regina, Regina, SK, Canada.
Insights
The Internet-delivered, preoperative program (I-PPP) effectively reduced parent anxiety before surgery. This interactive online tool shows promise for preparing children and their families for outpatient surgical procedures.
Area of Science:
- Pediatric Surgery
- Health Psychology
- Digital Health Interventions
Background:
- Limited evidence-based, interactive, Internet-delivered preoperative preparation programs exist for children and parents.
- Preoperative anxiety in children undergoing surgery is a significant concern for patient and family well-being.
Purpose of the Study:
- To develop and evaluate the effectiveness of an Internet-delivered, preoperative program (I-PPP).
- To assess I-PPP's ability to alleviate preoperative anxiety in children undergoing outpatient surgery.
Main Methods:
- A two-study approach was employed: Study 1 involved program development and evaluation by parent/child dyads and healthcare professionals. Study 2 examined I-PPP's effectiveness with 32 children (3-7 years) and their parents undergoing outpatient surgery.
- Participants completed the I-PPP pre-surgery. Child anxiety was observer-rated, and parent anxiety was measured pre- and post-surgery. Post-operative behaviors were also assessed.
Main Results:
- Study 1 confirmed I-PPP acceptability and credibility, with minor revisions made.
- In Study 2, child anxiety scores remained stable. A significant reduction in parent anxiety was observed from pre- to post-surgery.
- Parents positively rated the I-PPP, although some children exhibited negative post-operative behaviors.
Conclusions:
- The Internet-delivered, preoperative program (I-PPP) is a viable and effective option for preoperative preparation.
- I-PPP demonstrates potential in reducing parental anxiety and preparing families for pediatric outpatient surgery.
Study Objective:
Limited evidence-based, interactive, Internet-delivered preoperative preparation programs for children and their parents exist. The purpose of this investigation was to develop and examine the effectiveness of the Internet-delivered, preoperative program (I-PPP) in alleviating prepoperative anxiety in children undergoing outpatient surgery. In Study 1, the I-PPP was developed and then evaluated by parent/child dyads and health care professionals. In Study 2, the effectiveness of I-PPP was examined.
Design:
This study was a development and effectiveness study.
Setting:
For Study 1, participants were recruited from the community. For Study 2, participants were recruited from the Royal University Hospital.
Patients:
In Study 1, participants were 9 parent/child dyads and 5 health care professionals. In Study 2, participants were 32 children (3-7years) scheduled for outpatient surgery and one parent for each child.
Intervention:
In Study 1, I-PPP modules were created and parent/child dyads and health care professionals evaluated I-PPP modules and treatment credibility. In Study 2, child patients and their parents completed the I-PPP prior to day of surgery.
Measurements:
Observer-rated anxiety of child participants was measured during the day surgery experience. Parent state anxiety was measured prior to completing I-PPP, pre- and post-surgery. Post-surgery parents provided comments regarding the I-PPP. Post-surgery child behaviour change was assessed.
Main Results:
For Study 1, ratings for I-PPP components and treatment credibility surpassed our acceptability criterion. Minor changes were made to I-PPP. For Study 2, mYPAS scores were stable across day surgery. mYPAS scores in current study at induction did not differ significantly from benchmark studies. Significant reduction in parent anxiety was observed pre- to post-surgery. Parents positively endorsed the program. Negative post-operative behaviours were observed in a proportion of children.
Conclusions:
Our findings suggest that I-PPP represents a viable option for preoperative preparation for children and their parents.
