Preoperative psychological preparation for children undergoing ENT operations: a comparison of two methods

A psychological preparation programme was developed for outpatient surgery in children. The purpose of this study was to determine if the programme co uld increase retrieval of information and reduce anxiety prior to ENT surge ry. After ethical committee approval, 160 children and their parents were i ncluded. Eighty children (group 1) received conventional verbal information from an ENT nurse, and another 80 children (group 2) received specific inf ormation, including role-play, from a nurse anaesthetist at a preadmission visit. Children's and parents' experience of premedication, operation theat re (OR), i.v.-needle insertion and induction of anaesthesia were evaluated from a self-rating questionnaire. The questionnaire included ratings for an xiety and satisfaction with information and care. The results indicate a cl ear improvement of the preoperative acquisition of knowledge in all age gro ups. When it comes to alleviation of fear, a positive effect of the prepara tion programme was noticed, especially among the younger children (< 5 year s), while preoperative anxiety overall was a significantly smaller problem among the older children. The effects of the programme were also related to previous experience of anaesthesia and most beneficial among young childre n with such experience. Overall, the most negative procedure reported by th e children was the i.m. injection for premedication (a routine which was ab andoned as a result of the study), followed by the insertion of the i.v.-ne edle. The parents experienced watching their child fall asleep during induc tion of anaesthesia as most negative, followed by the insertion of the i.v. -needle. Parents also reported more satisfaction and less anxiety after hav ing received specific information and preparation preoperatively. It was co ncluded that this preoperative preparation programme is useful in all age g roups with regard to information, while alleviation of anxiety and fear was seen mainly among the younger children with previous experience of anaesth esia.