title: Preoperative preparation in children: a cross-sectional study.
abstract: OBJECTIVE
  To evaluate the effectiveness of a behavioral preparation program on reducing anxiety in children and their parents prior to elective surgery.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A children's hospital.
  
  
  METHODS
  143 children undergoing outpatient surgery, and their parents.
  
  
  METHODS
  A behavioral preoperative preparation program.
  
  
  RESULTS
  Overall anxiety in children and their parents did not differ significantly between the group that received the preoperative program and the group that did not (p = NS). Children older than 6 years were least anxious on separation from their parents if they participated in the preparation program more than 5 to 7 days prior to surgery, moderately anxious if they did not receive preparation, and most anxious if they received the preparation 1 day prior to surgery (P = 0.04). Multivariable regression analysis (for overall model, F = 2.14, p = 0.02) revealed that although the preparation program itself was not a predictor of a child's behavior on separation to the operating room, the interaction between child's age and timing of the program (p = 0.003), and child's previous hospitalization were predictors of children's anxiety response. Similarly, in the preoperative holding area, independent predictors of anxiety included timing of the preparation program, age of child, and the child's baseline temperament characteristics.
  
  
  CONCLUSIONS
  The results highlight the complexities in assuming that a behavior-based preoperative preparation program is effective for all pediatric outpatients. The effects of such an intervention vary with the child's age, the timing of the intervention, and a history of previous hospitalization.
authors.affiliation: Department of Anesthesiology, Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06510-8051, USA.
authors.forename: Z N
authors.initials: ZN
authors.lastname: Kain
authors.forename: L C
authors.initials: LC
authors.lastname: Mayes
authors.forename: L A
authors.initials: LA
authors.lastname: Caramico
mesh_terms: D000556:Ambulatory Surgical Procedures; D001007:Anxiety / Q000523:psychology; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D011300:Preoperative Care; D012044:Regression Analysis; D012919:Social Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013694:Temperament