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Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A
Marla Andréia Garcia De Avila1, Rafaela Aparecida Prata1, Francine Letícia Da Silva Jacob1
1Department of Nursing, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, Brazil.
Insights
Verbal guidance and comic books reduced parental anxiety before surgery but did not significantly lower children's preoperative anxiety. Early preparation after scheduling is recommended for pediatric patients.
Area of Science:
- Pediatric Surgery
- Anxiety Management
- Nursing Interventions
Background:
- Preoperative anxiety negatively impacts surgical care.
- Effective anxiety reduction strategies are crucial for pediatric patients and their families.
Purpose of the Study:
- To compare the efficacy of nurse-led verbal guidance versus verbal guidance combined with a comic book in mitigating preoperative anxiety.
- To assess the impact of these interventions on both children and their parents.
Main Methods:
- A randomized controlled trial was conducted with pediatric surgical patients (aged 6-14) and their parents.
- Participants were assigned to a control group or an intervention group receiving verbal guidance with or without a comic book.
- Anxiety levels were measured using validated scales for children (CAQ, VAS, mYPAS) and parents (Hamilton Anxiety Rating Scale).
Main Results:
- No significant difference in children's anxiety scores (CAQ, VAS, mYPAS) was found between the intervention and control groups.
- Parental anxiety significantly decreased in both groups following the interventions.
- The study involved 120 participants (60 per group) with a median child age of 8 years.
Conclusions:
- Nurse-led preoperative guidance, with or without a comic book, effectively reduces parental anxiety.
- These interventions, when administered on the day of surgery, did not alleviate preoperative anxiety in children.
- It is recommended to initiate child preparation processes earlier, ideally after surgery scheduling, to improve outcomes.
Background:
Reducing preoperative anxiety can help optimize surgical care.
Aim:
To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents.
Methods:
We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups.
Findings:
The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups.
Application To Practice:
Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.
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