Factors associated with parental anxiety in elective pediatric surgery

Parental perioperative anxiety is another critical aspect during the challenging times before the child's operation. The primary aim of this study was to examine factors associated with parental anxiety in the preoperative setting. Secondary aims were to compare anxiety levels between parents of surgical and non-surgical pediatric patients and to assess the internal consistency and construct validity of the State-Trait Anxiety Inventory (STAI) scales in this population.

In this comparative cross-sectional study we included 196 parents. A total of 98 parents from the surgical group (84% mothers and 16% fathers) and 98 participants from the non-surgical group (74% mothers and 26% fathers) completed questionnaires aimed at assessing anxiety (State-Trait Anxiety Inventory-STAI, Form Y), functional health literacy (Test of Functional Health Literacy in Adults Short Form-STOFHLA) and general questionnaire specifically designed for this research.

Greater healthcare satisfaction was associated with lower, and higher ASA score and greater overall concern were associated with higher STAI-S scores in the surgical group, while parent`s age 30-40 years and good or very good household material condition were associated with lower STAI-S scores in the non-surgical group. The proportion of parents with higher levels of anxiety (STAI-S > 50) in the surgical and non-surgical group was 54% vs. 10%, respectively. Multivariable modeling confirmed that primary and secondary educational level, insufficient information regarding child`s health, obtaining information regarding child's health through conversations with friends/acquaintances who are not health workers, and higher concern score were associated with the presence of higher anxiety among parents whose children were scheduled for surgical intervention. In the non-surgical group only the presence of a serious medical condition in another child was related to lower anxiety (OR = 0.063, 95%CI OR = 0.01-0.38, p = 0.002). Internal consistency was excellent for both STAI-State and STAI-Trait scales (Cronbach's α > 0.90), while exploratory factor analysis supported the construct validity of the instrument confirming the expected two-factor structure.

Primary and secondary educational level, insufficient information regarding child`s health, obtaining information from informal sources, and higher concern score were associated with the presence of higher anxiety among parents whose children were scheduled for surgical intervention.