title: Children's drawings as a measure of anxiety level: a clinical pilot study.
abstract: BACKGROUND
  No simple method exists to distinguish children in need for premedication. The present study was planned to detect preoperative anxiety levels of children by rating their drawings.
  
  
  METHODS
  Sixty ASA I children aged 4-7 years undergoing adenoidectomy were divided into AGIT and CALM groups according to agitation level observed during venous cannulation. All children drew a picture at three different times: (i) just after arrival in the day-case unit, (ii) 10 min before operation and, (iii) prior to leaving for home. The children were also randomized to three premedication groups: group D, rectal diazepam 0.5 mg x kg(-1); group P, 0.9% NaCl 0.1 ml x kg(-1) rectally; group NT, no premedication. Five features (size of the drawing, form of the drawing line, colors used, mark of the pen and clarity of the picture) from the children's drawings were rated with a 3-point scale. The ratings of each feature were made to form a sum score of anxiety ranging from 0 to 10. In the analysis of variance for repeated measures both the premedication group and agitation score were taken into the model as factors.
  
  
  RESULTS
  The anxiety score of the drawings of the agitated children (during venous cannulation) was significantly higher already after arrival in the hospital [AGIT 4.76 (95% CI: 3.56-5.96) Vs CALM 3.67 (95% CI: 2.97-4.37) P = 0.029], but there were no statistical differences between the different premedication groups.
  
  
  CONCLUSIONS
  When routine sedative premedication is not used the drawings of the children might detect the children needing sedative premedication.
authors.affiliation: Department of Anaesthesiology, District Hospital of Valkeakoski, Tampere, Finland. arto.puura@pshp.fi
authors.forename: Arto
authors.initials: A
authors.lastname: Puura
authors.forename: Kaija
authors.initials: K
authors.lastname: Puura
authors.forename: Michael
authors.initials: M
authors.lastname: Rorarius
authors.forename: Päivi
authors.initials: P
authors.lastname: Annila
authors.forename: Hanna
authors.initials: H
authors.lastname: Viitanen
authors.forename: Gerhard
authors.initials: G
authors.lastname: Baer
mesh_terms: D000233:Adenoidectomy; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011229:Preanesthetic Medication