Research Progress on Risk Factors of Preoperative Anxiety in Children: A Scoping Review

Abstract

Background: Preoperative anxiety has adverse effects on children and negative impacts on postoperative rehabilitation. Anesthesiologists can accurately identify children with preoperative anxiety, and individualized intervention can effectively improve their psychological state and clinical prognosis. However, a comprehensive summary of the current available evidence has yet to be conducted. Searches were conducted in Medline databases from inception to March 2022. Primary studies that reported preoperative anxiety in children and its attendant effects on postoperative recovery and prognosis were screened and included. Among the 309 publications identified, 12 related studies (n = 3540 patients) met the eligibility criteria. The incidence of preoperative anxiety in children in the included studies ranged from 41.7% to 75.44%. While 16 influencing factors were identified, only 5 factors had a significant impact on preoperative anxiety in children: younger age (n = 8), parental anxiety (n = 7), negative previous hospitalizations (n = 3), less sociableness (n = 2), and surgical setting (n = 1). The current scoping review identified risk factors for preoperative anxiety in children. Healthcare workers should identify and manage preoperatively anxious children. There are still some factors that are controversial, and large-scale clinical studies are needed.

Factors Related to Anxiety in Paediatric Patients and Their Parents before and after a Modified Ravitch Procedure—A Single-Centre Cohort Study

“…The current study showed—similar to a recent study conducted in children and adolescents after thoracic surgery—that a negative correlation between age and postoperative anxiety exists [ 21 ]. Younger children are more susceptible to developing anxiety because of their poorer cognitive and communication abilities, greater reliance on other people, no self-control, little life experience and incomprehension of the principles of the health care system [ 11 ].…”

“…Several studies have examined which sociodemographic and clinical factors are correlated with perioperative anxiety in children and adolescents undergoing elective surgery, as well as in their parents. Liu et al identified a younger age, the level of parental anxiety, negative previous hospitalisations, less sociableness and the surgical setting as the risk factors which had a significant impact on the children’s anxiety before surgery [ 11 ]. On the other hand, the results of the investigation conducted by Caumo et al revealed that high levels of preoperative anxiety in children and the intensity of postoperative pain were the risk factors for anxiety during the postoperative period [ 12 ].…”

Effect of oral esketamine on preoperative sedation and venipuncture analgesia in pediatric patients: a prospective randomized double-blind controlled clinical trial

“…Indeed, preoperative anxiety can negatively impact surgical outcomes and cause short-or long-term psychiatric issues. Various factors, such as pain, parent-child separation, types of surgery, and the degree of cooperation, could affect preoperative anxiety in children [14]. Studies have investigated different pharmacological or non-pharmacological methods to decrease pain and improve cooperation to minimize preoperative anxiety in pediatric patients.…”

Validity of the modified‐Distraction‐Short‐Scale and Verbal‐Numeric‐Anxiety‐Fear‐Rating‐Scale for children in a preoperative setting

“…The perioperative setting is a well-known site of pediatric anxiety and distress. Two reviews reported that approximately one third to one half of all children experience preoperative anxiety and fear and that the presence of high anxiety and stress in children can result in uncooperative behavior, such as withdrawal, aggression, or regression, 1,2 as well as poor postoperative outcomes, such as emergence delirium and long-term trauma-related symptoms such as difficulty separating from parents, night terror, or enuresis. 1 Child age, temperament, behavioral problems, previous negative experience(s) with surgical procedures and hospitalizations, parental education level, and parental anxiety are factors associated with preoperative anxiety in children.…”

“…1 Child age, temperament, behavioral problems, previous negative experience(s) with surgical procedures and hospitalizations, parental education level, and parental anxiety are factors associated with preoperative anxiety in children. 2 In perioperative care, anesthesia induction is associated with the highest level of anxiety, regardless of whether it is administered via an intravenous cannulation or inhaled through a breathing anesthetic mask. [2][3][4] Minimizing distress in children during the perioperative period is an important goal for all healthcare professionals working with children.…”