To tell or not: parental thoughts on disclosure of urologic surgery to their child

Abstract

Purpose:Literature pertaining to surgical disclosure to the pediatric patient is lacking. We hypothesized parents would find it difficult to disclose urologic surgery to a child.Materials and Methods:Parents of patients <5 years old undergoing urologic surgery were contacted for telephone survey. Parents were asked about future plans of surgical disclosure, comfort with disclosure, and any support received.Results:98 parents consented to study participation. 87% of surgeries were on the genitalia with 62% being minor genitalia surgery (i.e. circumcision). 70% of parents would tell their child about minor genital surgery while 84% would tell about major genital surgery (p=0.07). 4 of 20 parents of children undergoing hypospadias repair (major genital surgery) did not plan to tell their child about surgery. All parents of children undergoing non-genital surgery would tell. Of all parents planning to tell their children about surgery, only 14% were nervous. 34% of parents would find guidance in talking to their child helpful despite the majority (90%) stating no guidance had ever been provided.Conclusions:Parents seem comfortable discussing urologic surgeries with a child but about 1/3 would appreciate further counseling. 20% of parents of children undergoing hypospadias repair hope to avoid telling their child.

‘If I knew what was going to happen, it wouldn’t worry me so much’: Children’s, parents’ and health professionals’ perspectives on information for children undergoing a procedure

“…The interviews from this study highlight the important gatekeeping role parents have in facilitating their child’s access to information and how unintentionally parents can disempower their child by limiting access to information and assuming the role of an information filter (Birnie et al, 2014) or communication broker (Young et al, 2003). In this study, some parents reported being reluctant to talk to their child about the planned procedure or had concerns that information about an invasive procedure may increase their child’s anxiety; these concerns reflect previous work with parents whose child was due to have surgery (Bray et al, 2014; Ching et al, 2015; Smith and Callery, 2005). The timing of information provision is particularly important for school-aged children, who benefit most from information provided about a week before a procedure, hence enabling them to have time to process and understand information and rehearse coping strategies (Jaaniste et al, 2007).…”

Reducing Children’s Preoperative Fear with an Educational Pop‐up Book: A Randomized Controlled Trial

“…This pop‐up book balanced families’ educational needs with outpatient workflow and resource constraints. Caregivers often feel unprepared to explain surgery, and they may maladaptively avoid disclosing the upcoming surgery to the patient; 50 this book provides a structured format for caregiver‐child discussion. As surgical volumes shift from well‐funded inpatient hospitals to outpatient centers, 51‐53 families and providers need educational resources compatible with efficient care delivery 54 .…”