The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind randomised controlled trial.
OBJECTIVE
To evaluate the effect of a structured preoperative preparation on child and parent state anxiety, child behavioural change and parent satisfaction.


BACKGROUND
It is estimated that around 50-70% of hospitalised children experience severe anxiety and distress prior to surgery. Children who are highly anxious and distressed preoperatively are likely to be distressed on awakening and have negative postoperative behaviour. Although education before surgery has been found to be useful mostly in North America, the effectiveness of preoperative preparation programme adapted to the Australian context remains to be tested.


METHODS
This single-blind randomised controlled study was conducted at a tertiary referral hospital for children in Western Australia.


METHODS
Following ethics approval and parental consent, 73 children and one of their carers (usually a parent) were randomly assigned into two groups. The control group had standard practice with no specific preoperative education and the experimental group received a preoperative preparation, including a photo file, demonstration of equipment using a role-modelling approach and a tour.


RESULTS
The preoperative preparation reduced parent state anxiety significantly (-2·32, CI -4·06 to -0·56, p = 0·009), but not child anxiety (-0·59, CI -1·23 to 0·06, p = 0·07). There was no significant difference in child postoperative behaviour or parent satisfaction between the groups. There was a significant two-point pain score reduction in the preoperative preparation group, when compared with the control group median 2 (IQR 5) and 4 (IQR 4), respectively (p = 0·001).


CONCLUSIONS
Preoperative preparation was more efficient on parent than child. Although the preoperative preparation had limited effect on child anxiety, it permitted to decrease pain experience in the postoperative period.


CONCLUSIONS
Parents should be actively involved in their child preoperative preparation.
Clinical Development Nurse for Operating Theatres, Princess Margaret Hospital for Children, Subiaco, Australia. wendy.fincher@health.wa.gov.au
Wendy
W
Fincher
Jane
J
Shaw
Anne-Sylvie
AS
Ramelet
D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000517:prevention & control*; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D010287:Parent-Child Relations; D010290:Parents / Q000193:education / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D012016:Reference Values; D018570:Risk Assessment; D016037:Single-Blind Method; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014904:Western Australia