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Psychological Issues in Paediatric Surgery 87
Evidence-Based Research
Table 14.1 presents evidence-based research on the effect on anxiety of
using preoperative preparation for parents of elective surgery patients.
Table 14.1: Evidence-based research.
The effect of videotaped preoperative information on
Title parental anxiety during anesthesia induction for elective
paediatric procedures
Authors McEwen A, Moorthy C, Quantock C, Rose H, Kavanagh R
The Royal Alexandra Hospital for Sick Children, Dyke Road,
Institution
Brighton, UK
Reference Pediatr Anesth 2007; 17:534–539
Problem Cost effectiveness of routine antenatal screening.
Intervention Preoperative preparation for parents.
Comparison/ Parents were randomly assigned to either the experimental
control group, which was exposed to an 8-minute preoperative
(quality of preparation video in addition to normal preoperative
procedures; or the control group, which received only the
edvidence) normal preoperative preparation.
Statistically significant differences were found between
parents who were exposed to normal preparation and those
Outcome/ who, in addition to this, watched an 8-minute video. Parents
who watched the video in comparison to controls showed
effect
significantly greater reductions in their desire for information
as well as their levels of anxiety (as measured by the
Preoperative Anxiety and Information Scale).
This study shows an innovative cost-effective approach
to addressing parental anxiety in regard to children who
Historical are awaiting surgery. A well-presented 8-minute video had
significance/ the additional effect of providing answers to questions that
comments parents may have had, and a reduction in the desire for
information was also evident in this group.

Key Summary Points

1. Many children and their parents experience high levels 6. Various preparatory programmes exist, but they are
of distress when awaiting an invasive paediatric surgical not universally helpful. Programmes need to take into
procedure. consideration the child’s age, sex, previous hospital
experience, and temperament, as well as factors that are
2. Anxiety is the most commonly reported stress-related emotion related to parental status, well-being, and anxiety level.
that is experienced.
3. Preoperative anxiety is associated with a number of negative 7. Many programmes that have proven effective in a clinical
research setting must be effectively transferred to routine
postsurgical outcomes.
clinical settings.
4. Many of Africa’s less resourced countries have peculiar 8. With the peculiarities of the African continent, it is crucial for
challenges that heighten the level of the anxiety experience.
further research to be done in the area of presurgical stress
5. Reducing the level of distress is paramount in facilitating and anxiety.
postsurgical recovery for the child. 9. We must raise the bar to every African child having access to a
well-thought-out preoperative programme.

References

1. Landolt M, Boehler U, Schwager C, Schallberger U, Nuessli R. 4. Li HCW, Lam HYA. Paediatric day surgery: impact on Hong Kong
Post traumatic stress disorder in paediatric patients and their Chinese children and their parents. J Clin Nurs 2003; 12:882–887.
parents: findings from an exploratory study. J Paed Child Health 5. LeRoy S, Elixson, EM, O’Brien P, Tong E, Turpin S, Uzark K.
1998; 34:539–543.
Recommendations for preparing children and adolescents for
2. Landolt MA, Vollrath M, Ribi K. Incidence and associations of invasive cardiac procedures: a statement from the American
parental and child posttraumatic stress symptoms in paediatric Heart Association Pediatric Nursing Subcommittee of the Council
patients. J Child Psychol Psychia 2003; 44:1199–1207. on Cardiovascular Nursing in collaboration with the Council
on Cardiovascular Diseases of the Young. Circulation 2003;
3. Hug M, Tonz M, Kaiser G. Parental stress in paediatric day-case 108:2550–2564.
surgery. Ped Surg Intl 2005; 2:94–99.