Predicting Children's Presurgical Anxiety and Subsequent Behavior Changes

Abstract

Addressed, in two studies, issues of children's medical anxiety having implications for efficient psychological preparation. Study 1 assessed behavioral distress and physiological arousal of 4- to 10-year-old, unprepared, nonsedated children (N = 50) as they separated from parents, waited in the operating room, and were given general anesthesia for minor surgery. Anxiety intensity varied widely among children and was most intense at mask presentation. Mother's prediction of uncooperative behavior and a history of prior surgery were the best predictors. Study 2 examined anxiety of 37 children prior to surgery and behavior changes 2 weeks later. At follow-up, minor or transient problems were common; 4 children developed significant problems. Elevated presurgical anxiety predicted later problems, but only among children hospitalized after surgery. Findings suggest that presurgical anxiety and later behavior problems are partially predictable.

Behavioural changes in children following day‐case surgery: a 4‐week follow‐up of 551 children

“…In spite of the increasing tendency to perform surgery as day-cases and psychological aspects being more often taken into consideration, the incidence of behavioural changes has remained around 50% since the 1950s [5]. The changes are mostly transient, but in some children they persist for several weeks, months or even years [1,3,6,7]. Even though the age ranges in many studies have been narrow, changes in behaviour have occurred more often in young children [3,4,7].…”

“…Even though the age ranges in many studies have been narrow, changes in behaviour have occurred more often in young children [3,4,7]. Anaesthetic techniques have not affected the incidence [8,9], but a relation to previous operations has been seen [6,10,11]. Our purpose was to assess the incidence and quality of behavioural changes seen in children after day-case surgery and to find out the significance of some factors in the children themselves and their previous experiences of health care on the incidence.…”

Ansiedade, a criança e os pais

“…Other authors have shown that children with poor previous hospital experiences were more stressed or less cooperative during anesthetic induction 25 . So, anxiety during anesthesia may increase anxiety during next hospital experience.…”

“…Outros autores mostraram que crianças, com experiên-cias hospitalares prévias ruins, apresentavam-se com maior estresse ou menos colaborativas durante a indução da anestesia 25 . Assim, a ansiedade durante uma anestesia pode aumentar a ansiedade durante a próxima experiência hospitalar.…”

Preoperative Psychological Preparation of Children

“…Expectations of parental separation, pain or uncomfortable feeling, lack of control, lack of uncertainty regarding sleep, the presence of technical staff with masks, non-child-focused environment are threatening for children. Factors related to children are age, developmental maturity, previous experience with medical procedures and diseases and personal coping with anxiety and parental anxiety (10)(11)(12)(13). Environmental conditions related with the operating room are medical staff communication, light intensity, noise level generated by the staff and device and the number of medical personnel who interact with the child.…”