PREOPERATIVE PREPARATION IN CHILDREN - A CROSS-SECTIONAL STUDY

Study Objective: To evaluate the effectiveness of a behavioral prepara tion program on reducing anxiety in children and their parents prior t o elective surgery. Design: Cross-sectional study. Setting: A children 's hospital. Patients: 143 children undergoing outpatient surgery and their parents Interventions: A behavioral preoperative preparation pro gram. Measurements and Results: Overall anxiety in children and their parents did not differ significantly between the group that received t he preoperative program and the group that did nor (p = NS). Children older than 6 years were least anxious on separation from their parents if they: participated in the preparation program more than 5 to 7 day s prior to surgery moderately anxious if they did not receive preparat ion, and most anxious if they received the preparation I day prior to surgery (p = 0.04). Multivariable regression analysis (for overall mod el, F = 2.14, p = 0.02) revealed that although the preparation program itself was not a predictor Of a child's behavior on separation to the operating room, the interaction between child's age and timing of the program (p = 0.003), and child's Previous hospitalization were predic tors of children's anxiety response. Similarly, in the preoperative ho lding area, independent predictors of anxiety included timing of the p reparation program, age of child, and the child's baseline temperament characteristics. Conclusions: The results highlight the complexities in assuming that a behavior-based preoperative preparation program is effective for all pediatric outpatients. Tile effects of such an inter vention vary with the child's age, the timing of the intervention, and a history of previous hospitalization.