Pediatric Preoperative Anxiety, Pediatric Coping
Conditions
Keywords
Preoperative education, Patient education, Preoperative anxiety, Pediatric outpatient surgery, Pediatric anesthesia
Brief summary
The study evaluated an educational pop-up book about general anesthesia induction as an interactive, child-focused preoperative education resource for pediatric patients undergoing outpatient surgery. The study's objectives were to evaluate the book as an educational tool and to understand the book's effects on patient and caregiver perceptions of the surgical experience. The study's hypotheses were that preoperative education from the pop-up book, compared to standard care, would more effectively reduce children's fear and expected pain, facilitate more positive views of the procedure and preoperative explanations, encourage adaptive coping strategies, reduce behavioral anxiety at anesthesia induction, and increase caregiver satisfaction with the surgical experience.
Interventions
OTHERPop-Up Book
Patients spent 5-10 minutes reading an illustrated pop-up book that promoted active learning about the process of general anesthesia induction.
Sponsors
Emory University
Children's Healthcare of Atlanta
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
An observer-rated behavioral anxiety outcome was masked (raters were blinded to patient group assignments). Other measures were patient self-report (unmasked).
Intervention model description
Patients were allocated via a block-randomized list to either the intervention arm (the educational pop-up book) or the control arm (standard care).
Eligibility
Sex/Gender
ALL
Age
5 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* Ages 5-12 (inclusive) * Undergoing outpatient medical procedures under general anesthesia with inhalation induction * English-speaking * Able to provide electronic consent/assent (legal guardian)
Exclusion criteria
* Patients with severe developmental disabilities * Unable to obtain electronic consent/assent from a legal guardian
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Observer-Rated Behavioral Anxiety at Anesthesia Induction as assessed by the modified Yale Preoperative Anxiety Scale-Short Form | Baseline anxiety was rated upon initial entry into the preoperative holding area; anxiety at induction was rated while patients received inhalational induction via an anesthesia mask. | Patients' behavioral anxiety at anesthesia induction was assessed relative to baseline using the observer-rated modified Yale Preoperative Anxiety Scale-Short Form. The scale ranges from 22.92-100; higher scores indicate greater anxiety (worse outcomes). Raters were preoperative nurses and circulating nurses blinded to group assignments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fear of Anesthesia Induction as assessed by the Children's Fear Scale | Fear was rated after education and before premedication was administered. | Patients self-reported their fear of anesthesia induction using the Children's Fear Scale. The scale ranges from 0-4; higher scores indicate greater fear (worse outcomes). |
| Expected Pain from the Anesthesia Mask and During Surgery as assessed by the Faces Pain Scale-Revised | Expected pain was rated after education and before premedication was administered. | Patients self-reported how much pain they expected (1) from the anesthesia mask and (2) while asleep for the surgical procedure using the Faces Pain Scale-Revised. The scale ranges from 0-5; higher scores indicate greater expected pain (worse outcomes). |
| Expectations about the Procedure, Attitudes about Anesthesia, and Views of Preoperative Explanations as assessed by a Likert-Scale Questionnaire | The outcomes were rated after education and before premedication was administered. | Patients self-reported their perceptions of the procedure and preoperative explanations (the pop-up book or provider consultation) using a 9-item Likert-scale questionnaire. The questionnaire was scored from 1-5; higher scores indicated more positive views (better outcomes). |
| Self-Reported Coping Strategies for Managing the Stress of Anesthesia Induction | Patients were interviewed after education and before premedication was administered. | In a prospective interview, patients reported coping strategies for managing the stress of anesthesia induction. Greater frequencies of adaptive coping strategies indicated better outcomes. |
| Caregiver Satisfaction with the Surgical Experience as assessed by a Likert-Scale Questionnaire | The questionnaire was administered after the patient underwent anesthesia induction. | Caregivers reported their satisfaction with the surgical experience using a 10-item Likert-scale questionnaire. The questionnaire was scored from 1-5; higher scores indicated more positive views (better outcomes). |
Countries
United States
Outcome results
None listed