Preoperative psychological preparation for children undergoing ENT operations: a comparison of two methods

Abstract

A psychological preparation programme was developed for outpatient surgery in children. The purpose of this study was to determine if the programme could increase retrieval of information and reduce anxiety prior to ENT surgery. After ethical committee approval, 160 children and their parents were included. Eighty children (group 1) received conventional verbal information from an ENT nurse, and another 80 children (group 2) received specific information, including role-play, from a nurse anaesthetist at a preadmission visit. Children's and parents' experience of premedication, operation theatre (OR), i.v.-needle insertion and induction of anaesthesia were evaluated from a self-rating questionnaire. The questionnaire included ratings for anxiety and satisfaction with information and care. The results indicate a clear improvement of the preoperative acquisition of knowledge in all age groups. When it comes to alleviation of fear, a positive effect of the preparation programme was noticed, especially among the younger children (< 5 years), while preoperative anxiety overall was a significantly smaller problem among the older children. The effects of the programme were also related to previous experience of anaesthesia and most beneficial among young children with such experience. Overall, the most negative procedure reported by the children was the i.m. injection for premedication (a routine which was abandoned as a result of the study), followed by the insertion of the i.v. -needle. The parents experienced watching their child fall asleep during induction of anaesthesia as most negative, followed by the insertion of the i.v.-needle. Parents also reported more satisfaction and less anxiety after having received specific information and preparation preoperatively. It was concluded that this preoperative preparation programme is useful in all age groups with regard to information, while alleviation of anxiety and fear was seen mainly among the younger children with previous experience of anaesthesia.

Parental Satisfaction Assessment After Paediatric Procedural Sedation: There Are Still Issues to Address

“…Nevertheless, it is not certain whether parental anxiety will reduce when they have more detailed information (20). On the other hand, it was indicated in some studies that the parents having detailed information on their children's state of health, the surgical procedure they would go through, and the potential risks of the procedure had lower anxiety (21,22). Thanks to specific preoperative information, parents could more easily deal with their anxiety and establish better collaborations not only with the healthcare professionals but also with the physicians (2,23).…”

Child Life Services

“…8,20,55 Information and opportunities to handle equipment help make the unpredictable events more manageable, reduce anxiety, and enable the child to plan and rehearse coping strategies. 57,58 Strategies used may include relaxation, visualization, guided imagery, and pain-management techniques. Such observations are shared with the rest of the health care team so that all are better prepared to respond supportively to the individual patient.…”

Adequacy of Preoperative Counseling and Informed Consent at Shree Birendra Hospital

“…However dissatisfaction will remain in patients and their family members [1][2][3] . There has been no research performed so far in our institution to analyze the adequacy of counselling to the patients undergoing surgery.…”