The impact of parental health mindset on postoperative recovery in children.

Abstract

Mindset, or one's beliefs about the ability to change one's outcomes, has been studied in the educational domain but not in surgical settings. The purpose of this study was to examine the role of parental health mindset on children's recovery. Participants were part of a larger National Institutes of Health-funded trial that included 1470 children undergoing outpatient tonsillectomy and adenoidectomy. We used measures of parental coping style (Monitor Blunter Style Scale; MBSS) and medication attitudes (Medication Attitudes Questionnaire; MAQ) to validate the Health Beliefs Scale (HBS; Criterion validity, Cohen's kappa). HBS categorizes parents as having a growth mindset, or the belief that health can be changed, or a fixed mindset, which reflects the belief that individuals cannot change their health. Next, we identified demographic and personality variables (eg, temperament, anxiety) as predictors for the HBS. Finally, we examined the relationship between the HBS with postoperative outcomes. Findings supported criterion validity of the HBS. Parents with a growth mindset reported seeking out more medical information (MBSS, 7.15±3.32 vs 6.22±3.38, P<.001, CI=-1.387 to -0.471) and reported fewer misconceptions regarding analgesic use (MAQ, 22.11±4.09 vs 21.41±4.25, P=.035, CI=0.046 to 1.229). In assessing outcomes, we found that fixed-mindset parents rated their children's postoperative pain as more severe on days 1 (9.22±3.82 vs 8.37±3.71, P=.007, CI=0.234 to 1.459) and 3 (8.13±4.28 vs 7.27±4.28, P=.007, CI=0.094 to 1.638) and reported that their children received more doses of ibuprofen on postoperative day 1 (2.91±1.24 vs 2.44±1.44, P=.041, CI=0.089 to 0.848). There was no difference in children's self-reported pain scores between groups (P=.585). These findings, coupled with recent mindset intervention studies in the educational space, suggest that parent mindset is an important target for clinical intervention in the context of children's surgical recovery.