Interventions for Parental Anxiety in Preparation for Pediatric Surgery: A Narrative Review.

Pooja Santapuram,Rachel Lane Walden,Amanda L Stone,Louise Alexander

doi:10.3390/children8111069

Pooja Santapuram, Rachel Lane Walden + Show 2 more

Open Access

https://doi.org/10.3390/children8111069

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Abstract

The preoperative experience can cause significant anxiety for both pediatric patients and their parents in the lead up to a surgical procedure. Pediatric anxiety in a preoperative setting has been shown to have significant negative downstream effects on the clinical outcomes of children and the healthcare system as a whole. Studies have found that preoperative parental anxiety has significant negative effects on children, regarding anxiety and emotional response. Therefore, interventions for parental preoperative anxiety are important to reduce the child’s anxiety. This review provides a brief overview of a broad range of strategies used to alleviate parental anxiety in a preoperative setting. Preoperative education, play-based interventions, music therapy, the presence of parents at induction of anesthesia, and integrative preoperative preparation programs have all demonstrated some evidence for reducing parental preoperative anxiety. The ultimate goal of using interventions for parental preoperative anxiety is to equip healthcare systems to better support families and optimize the perioperative outcomes of children.

Highlights

The preoperative surgical and anesthetic experience for many pediatric patients, as well as their parents, is stressful, and a common source of anxiety
Having parents present during anesthetic induction is a technique used at some institutions to try to reduce preoperative anxiety experienced by children and families
This program was found to be successful compared to other groups in lowering the incidence of emergence delirium, decreasing the analgesics required, and resulting in faster discharge times from the recovery room, suggesting that parent involvement and reduced parent anxiety could play a role in better postoperative outcomes for children

Summary

Introduction

The preoperative surgical and anesthetic experience for many pediatric patients, as well as their parents, is stressful, and a common source of anxiety. A randomized control trial comparing the efficacy of informational leaflets and counseling (i.e., clarification of doubts and reassurance of positive thoughts) to the standards of care for children undergoing surgery for congenital heart disease found a significant reduction in parental preoperative state anxiety, measured by the State Trait Anxiety Inventory (STAI), and a decrease in stress, measured by the Index of Clinical Stress (ICS) [20]. Similar findings were observed for parents of children undergoing ear, nose, and throat surgery, in which an informational visit during the preoperative period was shown to reduce parental anxiety by the Observational Scale of Behavioral Distress (OSBD-R) and STAI, as well as increased parental satisfaction of the treatment process through a postoperative treatment satisfaction questionnaire (PSQ-18). Similar findings were observed for parents of children undergoing ear, nose, and throat surgery, in which an informational visit during the preoperative period was shown to reduce parental anxiety by the Observational Scale of Behavioral Distress (OSBD-R) and STAI, as well as increased parental satisfaction of the treatment process through a postoperative treatment satisfaction questionnaire (PSQ-18). [21]

Paper-Based

Audiovisual

Parental Presence

Integrative Preparation Programs

Discussion

Findings