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Home-Initiated-Programme-to-Prepare-for-Operation: evaluating the effect of an animation video on peri-operative
Tanuja Nair1, Candy S C Choo, Nur S Abdullah
1From CHAMPs (Child Life, Art and Music Therapy Programmes) (TN, NSA)- Allied Health Specialities Division, Department of Pediatric Surgery (CSCC, YC, SAN, LWC), Department of Paediatric Anaesthesia (SL), Psychology Service (LLET)- Allied Health Specialities Division, KK Women's and Children's Hospital, Singapore and Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya (SAN).
Insights
A home-based preparation program (HIPPO) did not significantly reduce pre-operative anxiety in children undergoing surgery. While child-friendly, HIPPO did not improve emotional manifestation or anxiety during anesthesia induction.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Child Psychology
Background:
- Pre-operative anxiety is common in children undergoing hospital admissions and surgeries.
- Existing hospital support measures have limited success in alleviating pediatric surgical anxiety.
- The challenge of managing pre-operative anxiety in young surgical patients persists.
Purpose of the Study:
- To evaluate the effectiveness of the Home-Initiated-Programme-to-Prepare-for-Operation (HIPPO) on children's emotional responses and anxiety.
- To assess HIPPO's impact on children undergoing surgical procedures.
Main Methods:
- A randomized controlled trial involving 130 children in a Singaporean tertiary pediatric hospital.
- The intervention group received a home preparation kit including an animated video and activity sheets, in addition to standard care.
- Outcomes measured included the Children's Emotional Manifestation Scale, parental and child anxiety (State-Trait Anxiety Inventory), and Induction Compliance Checklist.
Main Results:
- No statistically significant difference was found in the primary outcome (Children's Emotional Manifestation Scale) between the control and intervention groups.
- A secondary outcome showed a trend towards significance in reduced anxiety for 7-10 year olds in the intervention group (P=0.067).
- The Home-Initiated-Programme-to-Prepare-for-Operation (HIPPO) did not significantly reduce pre-operative anxiety or improve emotional manifestation.
Conclusions:
- The Home-Initiated-Programme-to-Prepare-for-Operation (HIPPO) was not effective in reducing pre-operative anxiety in children.
- Despite being accessible and affordable, HIPPO did not alleviate anxiety during the pre-operative waiting period or anesthesia induction.
- Further research may be needed to explore alternative or modified home-based preparation strategies for pediatric surgical patients.
Background:
Hospital admissions and surgical operations commonly trigger anxiety in young children. Despite employing numerous support measures in our hospital, such as a pre-operative play room, the encouragement of parental companionship during induction of anaesthesia and distraction therapy, allaying the anxiety of our young surgical patients remains a challenge.
Objectives:
To evaluate the effectiveness of a Home-Initiated-Programme-to-Prepare-for-Operation (HIPPO) on emotional manifestation and anxiety in children undergoing surgery.
Design, Setting And Patients:
One hundred and thirty children were randomly assigned to either control or intervention group between February 2018 and April 2019 in a tertiary paediatric hospital in Singapore.
Intervention:
In addition to our standard pre-operative workflow, the intervention group received an additional home preparation kit consisting of an animated video on preoperative preparation and age-specific preoperative preparation activity sheets.
Main Outcome Measures:
The primary outcome was the Children's Emotional Manifestation Scale score to evaluate behaviour and emotion in the children before and during induction of anaesthesia. Secondary outcomes evaluated anxiety levels in parents and children, the child's behaviour and degree of co-operation using the State-Trait Anxiety Inventory scores, State-Trait Anxiety Inventory Children scores, the Induction Compliance Checklist scores, the Visual Analogue Scale scores for anxiety and the feedback questionnaire.
Results:
The difference between the Children's Emotional Manifestation Scale score in control and intervention groups was not statistically significant. A promising difference was however observed in one of the secondary outcomes where the state-State-Trait Anxiety Inventory Children scores of 7 to 10-year olds in the intervention group almost reached significance; P = 0.067.
Conclusion:
Despite being a child-friendly, easily accessible and affordable tool for patient education, HIPPO did not reduce anxiety experienced by children in the pre-operative waiting area or during induction of anaesthesia.
Trial Registration:
ClinicalTrials.gov, identifier: NCT04271553.
