Family Engagement With Pediatric Anesthetic Records: A Qualitative Study of Provider-Guardian Communication and...

In recent years, health systems worldwide have increasingly expanded patient and guardian access to clinical records. While adult patient perspectives on anesthetic records have been explored, little is known about how pediatric guardians interpret and engage with their child's anesthetic documentation.

To explore how guardians of pediatric patients engage with their child's anesthetic record and to identify elements they perceive as meaningful, confusing, or emotionally impactful.

We conducted a qualitative study using semi-structured video conference interviews between April 2023 and August 2024 with guardians of pediatric patients undergoing outpatient surgery under general anesthesia at a quaternary academic pediatric hospital. Twenty English-speaking guardians of children classified as American Society of Anesthesiologists Physical Status I-II and receiving anesthesia via endotracheal tube or supraglottic airway were recruited using a semi-purposive convenience sampling approach. During interviews, guardians reviewed their child's record via screen share and provided real-time feedback. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive and deductive thematic coding until thematic saturation was reached.

Guardians identified several elements of the anesthetic record as meaningful, including medications administered, provider involvement, event timelines, and their child's reactions to anesthesia. However, they reported confusion due to unexplained abbreviations, medical jargon, non-chronological data presentation, unclear visual formatting, and perceived inaccuracies. Interpretation was influenced by guardians' comfort level with health information, emotional state, and considerations unique to pediatric care. Emotional responses ranged from reassurance to anxiety; while some guardians found the record useful for future care planning, others described elements as distressing or difficult to interpret.

Guardians face substantial barriers when interpreting pediatric anesthetic records. As patient-accessible records become increasingly common across health systems globally, improving anesthetic record design is essential. Plain-language summaries, visual annotations, and pediatric-specific contextual guidance could improve comprehension, reduce misinterpretation, and facilitate better collaboration between guardians and clinicians during perioperative care.