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Parental Anxiety and Preoperative Anxiety in Children: A Dose-Response Association in the Perioperative Setting
Yiliminuer Aimaiti1, Yiru Wang2, Anqi Lai3
1School of Public Health, Fudan University, Shanghai, China.
Insights
Parental anxiety significantly increases children's preoperative anxiety, with higher parental anxiety levels correlating with greater child anxiety. Assessing parental anxiety can help identify at-risk children for better perioperative care.
Area of Science:
- Pediatric Anesthesiology
- Perioperative Nursing
- Child Psychology
Background:
- Preoperative anxiety in children is a common concern during surgical procedures.
- Parental anxiety is recognized as a potential influencing factor on a child's perioperative experience.
- Effective risk assessment strategies are crucial for optimizing pediatric surgical care.
Purpose of the Study:
- To investigate the association between parental anxiety and preoperative anxiety in pediatric patients.
- To evaluate the utility of parental anxiety as a predictor in perioperative risk assessment.
- To understand the role of parental anxiety in the context of child surgery.
Main Methods:
- A single-center, cross-sectional observational study.
- Postoperative telephone interviews with parents/guardians of children undergoing elective surgery.
- Numeric rating scales (0-10) used to assess parental and child preoperative anxiety levels.
Main Results:
- A significant positive correlation was found between parental anxiety and child preoperative anxiety.
- A dose-response relationship was observed, with moderate and severe parental anxiety linked to higher child anxiety.
- Including parental anxiety in risk models improved the identification of children with preoperative anxiety.
Conclusions:
- Parental anxiety is a practical and accessible indicator of a child's preoperative anxiety.
- Integrating parental anxiety assessment into nursing workflows can enhance early risk identification.
- Family-centered interventions can be more effectively targeted by considering parental anxiety levels.
Purpose:
This study aimed to examine the association between parental anxiety and preoperative anxiety in children and to clarify the role of parental anxiety in perioperative risk assessment.
Design:
This was a single-center cross-sectional observational study based on standardized postoperative telephone interviews with parents or legal guardians.
Methods:
Eligible children who underwent ophthalmologic or otolaryngologic surgery under general anesthesia between July and September 2025 and their parents or legal guardians were included. During standardized postoperative telephone interviews, parents or legal guardians rated their own anxiety and the child's anxiety during the preoperative waiting and preparation phase using a numeric rating scale (0-10). Child cooperation, perioperative supportive measures, and parental satisfaction were also recorded. Multivariable logistic regression and receiver operating characteristic analyses were used to examine the association between parental anxiety levels and child preoperative anxiety.
Findings:
Higher parental anxiety was independently associated with an increased likelihood of preoperative anxiety in children, demonstrating a clear dose-response relationship. Compared with minimal parental anxiety, moderate (score 4-6) and severe anxiety (score ≥7) were associated with progressively higher odds of child anxiety. Incorporation of parental anxiety into multivariable models improved discrimination for identifying children with preoperative anxiety. Children with higher anxiety were more likely to receive supportive preoperative care measures.
Conclusions:
Parental anxiety is a practical and easily assessable correlate of preoperative anxiety in children. Incorporating parental anxiety assessment into routine perioperative nursing workflows may support early risk identification and facilitate targeted, family-centered nursing interventions.
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