Preoperative Education and Decreasing Preoperative Anxiety Among Children Aged 8 - 10 Years Old and Their Mothers

Abstract

Background:Preoperative anxiety is associated with adverse clinical, behavioral, and psychological outcomes. Various effective interventions targeting preoperative anxiety in children exist.Objectives:The aim of this study was to evaluate the educational intervention by residents on children and maternal anxiety and their satisfaction from anxiety management.Patients and Methods:After obtaining the institutional ethics committee approval and written informed parental consent, 36 ASA-I, II children (age range, 8 - 10 years) underwent small operations were included in this prospective randomized study. The participants were allocated into the intervention (n =18) and control (n =18) groups. Children in the first group were prepared routinely. In the second group children and their mothers received data about anesthesia and operation by the booklet. Children-maternal anxiety was assessed using the anxiety level form, at the night and in the morning before surgery. Few days after surgery mothers, residents, and children experiences and satisfaction from anxiety management were assessed in the focus group discussion.Results:Mean scores and standard deviations of state anxiety in the intervention group before and after training were 33.1 ± 5.5 and 30.8 ± 6, respectively (P = 0.06). In the control group it was 32 ± 6.5 on the night and 34.1 ± 6.7 in the morning before surgery (P = 0.00). Comparison between groups was not significant (P = 0.6) and (P = 0.1). The mean levels of anxiety in the control group mothers on the night before and in the morning of surgery were 39.2 ± 13.1 and 42.8 ± 14 (P = 0.00), respectively. In the intervention group, mothers’ anxiety before education was 41 ± 12.7 and after education it was 35.6 ± 9.5 (P = 0.04). Comparison between groups was not significant (P = 0.7) and (P = 0.1). According to the focus group discussions, booklet study, provided education, sympathy of medical team, spiritual issues and beliefs reduced anxiety and fear of surgery. Anesthesia and lack of knowledge of what will happen, crying and restlessness of children increased preoperative anxiety.Conclusions:In this study, the preoperative anxiety was reduced by explaining anesthesia and surgery to the mothers and children (in mothers it was significant P < 0.05). Since there is a direct relation between mothers’ and their children’s anxiety, using an effective method to reduce anxiety in children and their mothers together at the same time would be very useful for children and their mothers.

The effectiveness of age‐appropriate pre‐operative information session on the anxiety level of school‐age children undergoing elective surgery in Jordan

“…Moreover, story coloring booklet for children during the waiting period for surgery distracted them from the stressful hospital situation (Tanaka et al, 2011). It is documented that lack of knowledge of what will happen is the main cause of children anxiety before surgery (Copanitsanou & Valkeapää, 2014); Tabrizi et al, 2015). In the same stream, the current study intervention might increase knowledge of children in the intervention group about surgery.…”

“…Similarly, Chorney and Kain (2010) suggested that family contribution enhances communication, coordination, and unification of care provided which will positively impact children outcomes. Studies found that children who were prepared on the day before surgery reported a significantly decrease in the anxiety levels as compared with children who were not prepared (Kathalae, 2007, Vaezzadeh et al, 2011, Tabrizi et al, 2015. Inconsistent results were reported in former study as no difference in the anxiety levels of children were seen when children in the intervention groups practiced storytelling and coloring activities before surgery (Al-Yateem et al, 2016).…”

“…Australia (Fincher et al, 2012), Spain (Carmen, Francisca, Lucia, Maria, & Miguel, 2015), and Jordan and United Arab of Emirates (Al-Yateem et al, 2016). Inversely, no significant differences found in the anxiety levels among intervention and control groups after the study intervention (Lee et al, 2012;(Ji et al, 2016;Tabrizi et al, 2015). In the systematic review by Copanitsanou and Valkeapää (2014), the vast majority of children in the education groups reported lower anxiety scores in 12 out of the 16 studies which were included.…”

“…A study that used a booklet to prepare children about surgery showed a decline in the anxiety level of children in the intervention group. Additionally, the compassion manner of nurses and physicians reduced anxiety level of children before surgery (Tabrizi et al, 2015).…”

Pain Neuroscience Education: State of the Art and Application in Pediatrics

“…Again, the pain education booklet focused on pain management strategies rather than explaining the neuroscience of pain. More recently, Tabrizi and colleagues [50] investigated the use of an anesthesia education booklet to alleviate preoperative anxiety in children ages 8–10 and their parents. Whilst parents and children receiving the education intervention reported reduced preoperative anxiety, similar reductions were seen in a control group receiving routine preoperative preparation without education.…”