title: Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery.
abstract: BACKGROUND
  Perioperative procedures in children can impair their emotional status negatively with stress and/or anxiety. Cortisol concentrations and drawings could be helpful in gaining information about a child's levels of stress and/or anxiety when attending the hospital for surgery.
  
  
  OBJECTIVE
  The purpose of this study was to determine the degree of anxiety and stress as well as to explore the association between objective measures of stress (cortisol concentration in saliva) and subjective assessment of hospital anxiety (children's drawings) as interpreted by the Swedish version of the Child Drawing: Hospital manual.
  
  
  METHODS
  A total of 93 children scheduled for day surgery were included. Salivary cortisol was sampled preoperatively on the day of surgery at which time the children were also requested to make a drawing of a person at the hospital.
  
  
  RESULTS
  Results showed no association between salivary cortisol concentration and the CD:H score.
  
  
  CONCLUSIONS
  The drawings and salivary cortisol concentration preoperatively on the day of surgery reflect different components of the conditions of fear, anxiety, or stress emerging in the situation.
authors.forename: Berith
authors.initials: B
authors.lastname: Wennström
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Törnhage
authors.forename: Hans
authors.initials: H
authors.lastname: Hedelin
authors.forename: Salmir
authors.initials: S
authors.lastname: Nasic
authors.forename: Ingrid
authors.initials: I
authors.lastname: Bergh
mesh_terms: D000556:Ambulatory Surgical Procedures; D001007:Anxiety / Q000175:diagnosis; D001155:Art Therapy; D002648:Child; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D011300:Preoperative Care; D012463:Saliva / Q000737:chemistry*; D013315:Stress, Psychological / Q000175:diagnosis
chemical_list: D006854:Hydrocortisone
keywords: Child Drawing: Hospital manual; anxiety; cortisol; day surgery; preoperative stress