Treating perioperative anxiety and pain in children: a tailored and innovative approach

Abstract

Summary Millions of children undergo outpatient surgery in the United States each year; the overwhelming majority will experience significant perioperative anxiety and pain. Behavioral preparation programs focused on skills acquisition and modeling, considered essential for effective preparation, are no longer offered to most children and families in the outpatient surgery setting. Moreover, what little preparation does occur is typically generic in nature, rather than tailored to unique characteristics of the child and family. Untreated anxiety and pain have significant implications for children’s short- and long-term recovery and future interactions in the medical environment. The rapid growth of the World Wide Web and increasing access to Internet by families across the country provides an opportunity to develop tailored, Web-based behavioral preparation programs that can be accessed repeatedly at times convenient to the child and family, that include coping skills training and modeling, and that can provide unique output based upon child and parent characteristics known to impact perioperative pain and anxiety. In this review article we present a conceptual framework for a computer-based intervention that may transform the way we manage children and parents before and after surgery.

The experiences of children with autism spectrum disorder, their caregivers and health care providers during day procedure: A mixed methods study

“…In keeping with the need for individualized care plans, as previously mentioned, caregivers could individually adapt social story templates provided by hospitals to assist their children with ASD. Use of computer‐based tailored programs that are web based is gaining popularity for managing perioperative anxiety in children . Similar web‐based applications that use simple language, capable of being adapted for individual children with ASD, could be an effective, cheap, and accessible means of perioperative preparation with social stories.…”

“…Use of computer-based tailored programs that are web based is gaining popularity for managing perioperative anxiety in children. 33 Similar web-based applications that use simple language, capable of being adapted for individual children with ASD, could be an effective, cheap, and accessible means of perioperative preparation with social stories.…”

Postoperative behavior change in children: All sorted or a tangled mess of spaghetti?

“…Behavioral changes in children after anesthesia have been studied for many years but there is still no consensus on which behaviors are relevant and what impact they have on children and their families. A stressful experience as a child has the potential to create fear and anxiety surrounding future episodes of health care and this has been shown to extend to a reduction in compliance with medical treatment as an adult . Furthermore, there may be public health and economic impacts considering there is evidence that behavioral change results in increased general practitioner visits and parental time off work …”

“…A stressful experience as a child has the potential to create fear and anxiety surrounding future episodes of health care and this has been shown to extend to a reduction in compliance with medical treatment as an adult. 1 Furthermore, there may be public health and economic impacts considering there is evidence that behavioral change results in increased general practitioner visits and parental time off work. 2 During the 1950s, it was observed that some children had a change in their behavior after a general anesthetic.…”

Preoperative Psychological Preparation of Children

“…Novel trends for preoperative preparation in the future would be likely related to these two strategies. With advancing technology, it is possible for individuals undergoing surgery to obtain information via the internet (25). In particular, modelling and coping skill techniques can be applicable by well-designed internet service.…”