title: Prediction of preoperative anxiety in children: who is most accurate?
abstract: BACKGROUND
  In this investigation, we sought to assess the ability of pediatric attending anesthesiologists, resident anesthesiologists, and mothers to predict anxiety during induction of anesthesia in 2 to 16-yr-old children (n = 125).
  
  
  METHODS
  Anesthesiologists and mothers provided predictions using a visual analog scale and children's anxiety was assessed using a valid behavior observation tool the Modified Yale Preoperative Anxiety Scale. All mothers were present during anesthetic induction and no child received sedative premedication. Correlational analyses were conducted.
  
  
  RESULTS
  A total of 125 children aged 2-16 yr, their mothers, and their attending pediatric anesthesiologists and resident anesthesiologists were studied. Correlational analyses revealed significant associations between attending predictions and child anxiety at induction (r(s) = 0.38, P < 0.001). Resident anesthesiologist and mother predictions were not significantly related to children's anxiety during induction (r(s) = 0.01 and 0.001, respectively). In terms of accuracy of prediction, 47.2% of predictions made by attending anesthesiologists were within one standard deviation of the observed anxiety exhibited by the child, and 70.4% of predictions were within two standard deviations.
  
  
  CONCLUSIONS
  We conclude that attending anesthesiologists who practice in pediatric settings are better than mothers in predicting the anxiety of children during induction of anesthesia. Although this finding has significant clinical implications, it is unclear if it can be extended to attending anesthesiologists whose practice is not mostly pediatric anesthesia.
authors.affiliation: Center for the Advancement of Perioperative Health, University of California, Irvine, California, USA.
authors.forename: Jill E
authors.initials: JE
authors.lastname: MacLaren
authors.forename: Caitlin
authors.initials: C
authors.lastname: Thompson
authors.forename: Megan
authors.initials: M
authors.lastname: Weinberg
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fortier
authors.forename: Debra E
authors.initials: DE
authors.lastname: Morrison
authors.forename: Danielle
authors.initials: D
authors.lastname: Perret
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000523:psychology; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D004644:Emotions; D005260:Female; D006282:Health Personnel; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology; D008297:Male; D009035:Mothers; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012919:Social Behavior; D013694:Temperament; D016896:Treatment Outcome