Highlights
- •Nurses' preoperative guidance, either only verbally or verbally with a playful comic book, proved beneficial in reducing parental anxiety.
- •Education information, performed on the day of surgery, failed to reduce self-reported preoperative anxiety in children and adolescents upon admission to the operating room.
- •Using educational materials to minimize children's anxiety remains controversial, and requires conducting multicenter studies in high, middle and low-income countries.
Abstract
Background
Reducing preoperative anxiety can help optimize surgical care.
Aim
To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined
with a comic book on preoperative anxiety in children and their parents.
Methods
We conducted a randomized parallel, two-group controlled clinical trial in the pediatric
ward and a blinded anxiety assessment in the operating room of a Brazilian hospital.
Individuals aged 6–14 years undergoing surgical procedures of up to 4 h for the first
time were included in the study. Parents who were adults, literate, and able to communicate
verbally were included. The primary outcome was the children's anxiety, measured by
the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified
Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety,
assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the
intervention (IG; n = 60) and control (CG; n = 60) groups.
Findings
The two groups were homogeneous. The median age of the children was 8 years. No significant
differences were observed in the CAQ and VAS scores between the two assessment time
points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly
decreased in both groups.
Application to practice
Preoperative guidance by nurses, either verbal only or verbal information with a comic
book proved beneficial in reducing parental anxiety. However, both interventions,
performed on the day of surgery, failed to reduce preoperative anxiety in children
and adolescents upon admission to the operating room. We recommended the process of
preparing the child should begin after scheduling the surgery.
Keywords
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Article info
Publication history
Published online: July 20, 2022
Accepted:
July 8,
2022
Received in revised form:
July 6,
2022
Received:
March 2,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
