title: Can Intraoperative Text Messages Reduce Parental Anxiety of Children Undergoing Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis?
abstract: METHODS
  A prospective, nonrandomized study.
  
  
  OBJECTIVE
  To evaluate the effectiveness of periodic intraoperative text messages (SMS) in reducing parental anxiety level during posterior spinal fusion (PSF) surgery for adolescent idiopathic scoliosis (AIS) patients.
  
  
  BACKGROUND
  No studies have reported the use of intraoperative SMS to reduce level of anxiety in parents of patients who are undergoing AIS corrective surgery.
  
  
  METHODS
  Parents of 50 AIS patients were studied at two centers. Group 1 did not receive any SMS whereas those in Group 2 received periodic SMS. Parents' anxiety were assessed using a validated Visual Analog Scale for anxiety (VAS-A) and the anxiety component of the Hospital Anxiety Depression Score (HADS). The assessment was carried out at five different periods: (P1) 6 hours before the surgery; (P2) at separation in the operation theatre; (P3) 1 hour after commencement of surgery; (P4) immediately after completion of surgery; (P5) 1 day postsurgery.
  
  
  RESULTS
  A total of 96 parents (47 fathers, 49 mothers) were involved in this study. Both groups were comparable in terms of demographics and education level. The mean VAS for Group 1 peaked at P2 and the HADS scores peaked at P3. The anxiety level of Group 1 remained high at P2, P3, and P4. There was a steady decline in parental anxiety in Group 2 from P1 to P5. There were significantly lower mean VAS score and HADS score for both father and mother in Group 2 during P3 and P4. The mean HADS scores for parents in Group 1 at P2 and P3 were higher than 8, which indicate abnormal anxiety.
  
  
  CONCLUSIONS
  The anxiety levels of parents receiving the SMS were significantly lower than parents who did not receive any messages. Thus, intraoperative SMS is an effective intervention to decrease parental anxiety of AIS patients undergoing PSF surgery.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mun Keong
authors.initials: MK
authors.lastname: Kwan
authors.forename: Chee Kidd
authors.initials: CK
authors.lastname: Chiu
authors.forename: Chiao Chin
authors.initials: CC
authors.lastname: Gan
authors.forename: Chris Yin Wei
authors.initials: CY
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D060145:Text Messaging