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Effect of interactive, multimedia-based home-initiated education on preoperative anxiety inchildren and their
Huiyan Hou1, Xie Li2, Yun'an Song1
1Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
Insights
Interactive multimedia interventions significantly reduced preoperative anxiety in pediatric patients undergoing strabismus surgery. This approach also improved anesthesia induction quality and positively impacted parental anxiety levels.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Medical Education Technology
Background:
- Preoperative anxiety in children is a significant concern for anesthesiologists.
- Effective interventions are needed to mitigate anxiety in pediatric patients before surgery.
Purpose of the Study:
- To evaluate the efficacy of interactive multimedia-based, home-initiated interventions in reducing preoperative anxiety in pediatric patients.
- To assess the impact of these interventions on anesthesia induction quality and parental anxiety.
Main Methods:
- A prospective study compared a multimedia intervention group with a control group (Q&A introduction) in children aged 4-9 years.
- Anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) at four time points.
- Parental anxiety was assessed using the Self-rating Anxiety Scale (SAS) and Visual Analog Scale (VAS).
Main Results:
- The intervention group showed significantly lower mYPAS-SF scores at all measured time points post-intervention (p < 0.001).
- Children receiving the multimedia intervention had higher rates of perfect induction compliance (18.4% vs 7.5%) and lower rates of poor compliance (2.6% vs 17.5%).
- Parental anxiety (VAS scores) was significantly reduced in the intervention group at T2 (p = 0.021).
Conclusions:
- Interactive multimedia-based home-initiated interventions are effective in reducing preoperative anxiety in children.
- These interventions improve anesthesia induction quality and may positively influence parental anxiety.
- This approach offers a promising strategy for enhancing the perioperative experience for pediatric patients and their families.
Background:
Anesthesiologists need to appreciate the impact of preoperative anxiety in children. The present study aimed to explore whether interactive multimedia-based home-initiated interventions could effectively relieve preoperative anxiety in pediatric patients.
Methods:
In this prospective study, we compared preoperative anxiety between two groups of children aged 4-9 years. Children in the control group received a question-and-answer (Q&A) introduction, and children in the intervention group received multimedia-based home-initiated preoperative education using comic booklets, videos, and coloring game books. Differences in anxiety between the two groups were evaluated by the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) at four time points: in the ophthalmology outpatient clinic before intervention as the baseline (T0); in the preoperative waiting area (T1); at the time of separating from their parents and moving to the operating room (T2); and at the time of anesthesia induction (T3). Parental anxiety was assessed by the Self-rating Anxiety Scale (SAS) and Visual Analog Scale (VAS) at T0 and T2. Other related information was collected by questionnaire.
Results:
Eighty-four children who underwent pediatric strabismus in our center between November 2020 and July 2021 were included in this study. An intention-to-treat (ITT) analysis was performed on data from 78 enrolled children. Children in the intervention group exhibited lower m-YPAS-SF scores at T1, T2, and T3 than those in the control group (all p < 0.001). By using a mixed-effect model with repeated measurement (MMRM) after adjusting the m-YPAS score at T0 as a covariate, the interventional effect in terms of themYPAS-SF score was also significant over time (p < 0.001). The percentage of children with perfect induction compliance (ICC = 0) in the intervention group was significantly higher than that in the control group [18.4% vs. 7.5%], and poor induction compliance (ICC>4) was lower (2.6% vs. 17.5%, p = 0.048). The mean parental VAS score at T2 in the intervention group was significantly lower than that in the control group (p = 0.021).
Conclusions:
Interactive multimedia-based home-initiated intervention could reduce preoperative anxiety in children and improve the quality of anesthesia induction based on ICC scores, which may in turn impose a positive impact on parental anxiety.
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