Parental satisfaction with being present in the operating room during the induction of anesthesia prior to pediatric neurosurgical intervention: a qualitative analysis

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>Parental presence in the operating room during the induction of anesthesia (PPIA) has been shown to decrease parent and child anxiety and increase satisfaction with patient experience in outpatient otolaryngological procedures, such as tympanostomy tube placement. PPIA for other procedures, such as a major neurosurgical intervention, has been a practice at the authors’ institutions for many years. This practice is not universally accepted across the United States, and the potential benefits for patients and families have not been formally evaluated. The aim of this study is to provide a qualitative analysis of parental and patient satisfaction with PPIA at the authors’ institution.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>All patients younger than 18 years who underwent surgical intervention at the authors’ institution between August 2013 and December 2015 were identified. All surgeries were performed by a single neurosurgeon. A random sample of 96 parents were contacted by telephone for a qualitative, semiscripted interview; 42 parents completed the interviews. The interview consisted of a validated satisfaction assessment in addition to a standardized open-ended questionnaire. Thematic analysis was performed until saturation was achieved, and responses were coded into the predominant themes. Member checking was performed, and a thick description was created.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>The predominant themes identified with PPIA were 1) perception of induction as traumatizing or distressing to witness, 2) positive feelings regarding having been present, 3) satisfaction regarding the overall experience with surgery, 4) variable feelings in parents who decided not to attend induction, and 5) mixed feelings in the interactions with the care team. Parents expressed an array of positive, negative, and neutral impressions of the experience; however, overall, most experiences were positive. Most parents would choose PPIA again if their child required additional surgery.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>This is the first study to evaluate the benefit of PPIA for pediatric neurosurgical patients. The results show a unique insight into medical communication and patient satisfaction with high-risk surgeries. PPIA may be able to help shape an environment of trust and increase satisfaction with perioperative care.</jats:p></jats:sec>

Effect of parental presence on anxiety during induction of anaesthesia in children undergoing elective day case surgery

“…We found in our study that majority of parents who accompanied their children to the induction room were satisfied with their experience and would be willing to do so if their children require surgery in the future. This is in agreement with a previous study [38].…”

Psychological Stress and Nursing Intervention of Sick Children

“…They are easily excited, wailing and willful, and love to lose temper [8]. Reasonable requirements of children should be satisfied as far as possible, and explanations should be given for those who cannot be satisfied [9]. Young children are most afraid of being separated from their parents.…”

“…Choose a monitor among them and have regular meetings. When there are conflicts, education guides them to solve them by themselves, so that they are placed in a comfortable and stable environment, reducing adverse stimuli from the outside world, and enriching their spiritual life [16].…”

Supporting paediatric patients: Parental presence in the anaesthetic journey

“…The network states that the anaesthetist, in conjunction with parents and staff, have the final decision on the presence of parents during induction. Parental presence offers benefits to both the child and parents when planned and negotiated with the health care team and is an important aspect of holistic care 25 . When a defined process that is backed up by hospital policy and education has not been introduced, medical and nursing staff may find the presence of parents challenging 26 .…”