Online Patient Education Resources Do Not Improve Perioperative Stresses for Common Pediatric Orthopaedic Procedures

Anxiety and appropriate expectations for children having surgery are under investigation, and the utility of a perioperative online learning tool in attenuating anxiety in pediatric patients undergoing orthopaedic surgery has not been performed.

An online tool with preanswered queries, videos, and guidance developed in part by certified child life specialists (CCLSs) was implemented as part of a quality improvement initiative and made available to families during the preoperative period. Children who presented to the preoperative area for planned orthopaedic intervention prospectively completed a deidentified qualitative 10-question form developed by child life specialists (CLSs), centered around the helpfulness of the administered preoperative education and the anxiety level of the child. Younger children were assisted by parents in their responses as needed, and one of the queries asked if they had viewed the available CLS resource, collecting 50 nonviewed families and 50 viewed families to develop comparative cohorts.

The mean age of the cohort was 13.7 ± 2.9 years (range: 2-18 years). Fifty of the Not-Viewed cohort and 20 of the viewed cohort had data collected regarding the surgery performed, and all recorded events were outpatient procedures. As a continuous variable, the two cohorts were not different regarding level of anxiety (P = .141) or how prepared they felt for surgery (P = .564). As a categorical variable, those who viewed the online resources were 2.6× more likely to report being anxious than those who did not view it (P = .023). Although the online resource was deemed helpful when viewed, most families (95%) felt that the conversation with the preoperative nurse/CCLS worker/surgeon was the most useful in reducing anxiety.

A nonpersonal online preoperative learning tool does not reduce the stress or anxiety for children undergoing orthopaedic procedures as much as the face-to-face time spent with the nurse, CCLS provider, and surgeon. Further research on the utility of per-operative educational tools may be required to help improve anxiety involving surgery.

(1)Surgeon and the preoperative team including the preoperative nurse and certified child life specialist (CCLS) are the primary source of preparation for surgery.(2)An online preoperative learning tool did not reduce anxiety or increase preparedness among respondents.(3)Anxious families consumed the online resources at a higher rate than nonanxious families.

III (comparison cohort study).