Coping with pediatric ambulatory surgery: Effectiveness of parent-implemented behavioral distraction strategies

Abstract

This study evaluated two behavioral distraction interventions for parents of pediatric ambulatory surgery patients. One hundred and one children, 4 to 8 years of age, and their parents were randomly assigned to one of three groups, written behavioral distraction guidelines (n = 34), didactic session plus written behavioral guidelines (n = 33), and standard procedure control (n = 34). Baseline assessment of child and parent anxiety took place immediately prior to surgery. Intervention effects were measured on child outcomes including distress, cooperation, and postoperative pain, and on parent outcomes including their perceptions of intervention helpfulness and satisfaction with the surgical experience. Control parents received standard care. Intervention parents received, in addition, written behavioral guidelines describing the use of distraction to reduce children's preoperative distress as well as age-appropriate toys to use during the preoperative period. One group of parents also participated in a brief didactic session on the use of distraction techniques. While no differences were found between the control and the distraction with didactic instruction groups, the group that received written instructions alone showed significantly more distress behaviors prior to surgery compared to the control and didactic instruction groups. Although parents responded positively to the didactic session, it appeared that a structured parent-implemented behavioral distraction program as described in this study was not more effective than standard care.