title: Threat perception, anxiety and noncompliance with preoperative fasting instructions among mothers of children attending elective same day surgery.
abstract: OBJECTIVE
  The current study examined possible links between threat perception, anxiety, conscientiousness and parental noncompliance with preoperative fasting instructions for their children.
  
  
  METHODS
  100 mothers of children about to undergo an ambulatory elective surgery were divided to two equal groups based on compliance/noncompliance with pre surgery fasting requirements. Logistic regression analysis was preformed to predict compliance/noncompliance. In addition a logistic model estimating the effect of anxiety and conscientiousness levels, and their interaction, on the probability of fasting was performed.
  
  
  RESULTS
  Mothers who did not comply with fasting requirements perceived the procedure as more threatening, were more anxious and had lower conscientiousness levels. Additionally, mother's anxiety prior to surgery mediated the association between mothers' threat perception and compliance. Finally, conscientiousness moderated the anxiety and compliance association so that high conscientiousness levels reduced the effect of anxiety, elevating the likelihood of anxious mothers to comply with fasting guidelines.
  
  
  CONCLUSIONS
  Based on these findings we recommend medical staff to make significant efforts to identify highly anxious parents as early as possible during the preoperative process. Innovative assessment and intervention tools should be developed in order to conduct a smooth medical operation and reduce the chance of unnecessary and costly surgery cancelation.
authors.affiliation: School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel; The Child Psychiatry Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Electronic address: yonikushnir@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kushnir
authors.affiliation: General Health Services (Clalit).
authors.forename: Ranit
authors.initials: R
authors.lastname: Djerassi
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Sofer
authors.affiliation: Department of Public Health, Ben-Gurion University of the Negev, Israel.
authors.forename: Talma
authors.initials: T
authors.lastname: Kushnir
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D005215:Fasting; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D009035:Mothers / Q000523:psychology*; D010349:Patient Compliance; D011300:Preoperative Care / Q000379:methods*
keywords: Anxiety; Avoidance; Elective surgery; Parental Compliance; Preoperative instructions