Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Effectiveness of Multimodal Preoperative Preparation Program on Children Undergoing Surgery


Affiliations
1 Department of Child Health Nursing, Yenepoya Nursing College, Yenepoya University, India
2 Department of Medical Surgical Nursing, Laxmi Memorial College of Nursing, India
3 Department of Paediatrics, Yenepoya Medical College Hospital, India
     

   Subscribe/Renew Journal


Background:

The advanced era of technological development in child healthcare has resulted in more paediatric procedures being performed in various settings. Millions of children undergo surgery every year which is a stressful event. Many non pharmacological strategies are being used to manage the preoperative fear and anxiety in children. The current study aims to assess the effectiveness of multimodal preoperative preparation program (MPPP) on children undergoing surgery in terms of its effect on the psycho physiological parameters. Methods: A quasi experimental study was conducted in a selected multi speciality hospital. Using the purposive sampling technique, a total of 110 children aged 8-12 years were assigned to non intervention (n = 55) and intervention (n = 55) groups respectively. The MPPP was administered to intervention group. The children in the non intervention group received the routine preoperative care. Child’s fear and anxiety was assessed on admission, prior to shifting the child to OT, 24 hours and 48 hours after surgery where as child’s pulse, respiration, blood pressure, oxygen saturation was assessed on admission, prior to shifting the child to OT, 6 hours, 12 hours, 24 hours and 48 hours after surgery and pain was assessed at 24 and 48 hours after surgery. Significant Findings of the Study: Mean fear and anxiety scores of children were significantly lower in intervention group than that of non intervention group (p<0.05). Among the physiological parameters, only pulse, respiration and blood pressure showed significant difference (p<0.05) between the groups, whereas oxygen saturation and pain scores did not differ significantly (p>0.05). The study also found that there is a significant association between the psycho physiological parameters of children with the selected demographic variables (p<0.05). A positive correlation was found between the psychological and physiological parameters of children undergoing surgery. Conclusion: The MPPP is effective on psycho physiological parameters of children undergoing surgery in terms of decreasing the fear and anxiety, stabilizing the physiological parameters of children and can be used in preparing school aged children for surgery and can be practised in the clinical setup.


Keywords

Multimodal Preoperative Preparation Program, Children, Fear, Anxiety, Physiological Parameters.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Chari P. Sen I. Perioperative concerns. Indian J Anaesth. 2004; 48(5):387-93.
  • Wilson D, Hockenberry MJ. Nursing Care of Infants and Children. 8th ed. New Delhi: Elsevier Private Limited; 2007.
  • Vagnoli L, Caprilli S, Robiglio A, Messeri A. Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study. Pediatrics. 2005; 116(4):e563-567.
  • Shirley PJ, Thompson N, Kenward M, Johnston G. Parental anxiety before elective surgery in children. Anaesthesia. 1998; 53: 956–9
  • Debora DOC, Guilherme C, Vinícius FZGD, Schapira W, Lígia ADSTM. Impact of preanesthetic information on anxiety of parents and children. Revista Brasileira de Anestesiologia. 2013; 63(6): 473-482.
  • Rayen R, Muthu MS, Rao CR, Sivakumar N. Evaluation of physiological and behavioral measures in relation to dental anxiety during sequential dental visits in children. Indian J Dent Res 2006; 17:27-34.
  • Kain A. preoperative anxiety and post operative nausea and vomitting in children: is there an association? Pediatric Anesthesia. 2000; 90:571-5.
  • Christine T, Ken S, Ken G. The Influence of Adult Behaviors on Child Coping During Venipuncture: A Sequential Analysis. Research in Nursing and Health. 2011; 34 : 116–131.
  • Kain ZN, Wang SM, Mayes LC, Krivutza DM, Teague BA. Sensory stimuli and anxiety in children undergoing surgery: a randomized, controlled trial. Anesthesia and Analgesia. 2001; 92: 897–903.
  • Visintainer MA, Wolfer JA. Psychological preparation for surgical pediatric patients: The effect on children’s and parents’ stress responses and adjustment. Pediatrics. 1975; 56: 187- 202.
  • Jacek L, Agnieszka P, Tomasz W. Management of perioperative stress in children and parents. Part I - The preoperative period. Anaesthesiology Intensive Therapy. 2012; 44(3): 165–169.
  • Kain ZN, Mayes LC, O’Connor TZ, Cicchetti DV. Preoperative anxiety in children. Predictors and outcomes. Arch Pediatr Adolesc Med. 1996; 150:1238–45.
  • Jill B, Darlena W, Linda P, Barbara P, Wacky W. Use of Distraction Through Humor to Reduce Preoperative Anxiety in Children and Their Parents. Journal of Peri Anesthesia Nursing 2014; 29(4): 285–291.
  • Akanidomo J, Ibanga Hannah B, Ibanga. Psychological Issues in Paediatric Surgery. Paediatric Surgery: A Comprehensive Text for Africa. [Internet] Global Help, 2011.[cited2015April4]Availablefromwww.globalhelp.org/publications/books/help_pedsurgeryafrica14.pdf.
  • O'Shea, Maria C, Ann K, Ann. The perceived effectiveness of a pre- admission visit for children. The Journal of Perioperative Practice. 2011; 2(7); 244-248.
  • Schwartz BH, Albino JE, Tedesco LA. Effects of psychological preparation on children hospitalized for dental operations. Journal of Pediatrics.1983; 102(4):634-638.
  • Broome ME, Lillis PP, Smith MC. Pain interventions with children: a meta-analysis of research. Nursing Research. 1989; 38: 154–158.
  • Cassady JF, Wysocki TT, Miller KM, Cancel DD, Izenberg N: Use of a preanesthetic video for facilitation of parental education and anxiolysis before pediatric ambulatory surgery. Anesth Analg 1999; 88: 246–250.
  • Rassin M, Gutman Y, Silner D: Developing a computer game to prepare children for surgery. AORN J. 2004; 80: 1095–1096, 1099–1102.
  • Glazebrook CP, Lim E, Sheard CE, Standen PJ: Child temperament and reaction to induction of anaesthesia: Implications for maternal presence in the anaesthetic room. Psychology Health. 1994; 10: 55–67.
  • Robinson S. Children’s books: a resource for children’s nursing care. Paediatric Nursing. 2002; 14: 26–31.
  • Kain ZN, Caramico LA, Mayes LC, Genevro JL, Bornstein MH, Hofstadter MB. Properative preparation programs in children: A comparative examination. Anesthesia and Analgesia. 1998; 87(6):1249-1255.
  • Zahr LK. Therapeutic play for hospitalized preschoolers in Lebanon. Pediatric Nursing. 1998; 23(5):449-454.
  • Schulz JB, Raschke D, Dedrick C, Thompson M. The effects of a preoperational puppet show on anxiety levels of hospitalized children. Child Health Care. 1981; 9(4):118-121.
  • LaMontagne L, Hepworth JT, Salisbury MH, Cohen F. Effects of coping instruction in reducing young adolescents' pain after major spinal surgery. Orthopaedic Nursing. 2003; 22(6):398-403.
  • LaMontagne LL, Hepworth JT, Cohen F, Salisbury MH. Cognitive-Behavioral intervention effects on adolescents' anxiety and pain following spinal fusion surgery. Nursing Research. 2003; 52(3):183-190.
  • Durst LM. Preoperative teaching videotape: The effect on children's behavior. AORN Journal. 1990; 52(3):576-584.
  • Margolis JO, Ginsberg B, Dear GL, Ross AK, Goral JE, Bailey AG. Paediatric preoperative teaching: Effects at induction and postoperatively. Paediatric Anaesthesia. 1998; 8:17-23.
  • Felder-Puig R, Maksys A, Noestlinger C. Using a children's book to prepare children and parents for elective ENT surgery: Results of a randomized clinical trial. International Journal of Paediatric Otorhinolaryngology. 2003; 67:35-41.
  • Hockenberry MJ, Wilson D. Wong’s nursing care of infants and children. 8th ed. St. Louis: Mosby Elsevier; 2007.
  • Donna K. Child Life Council Evidence-Based Practice Statement. Preparing Children and Adolescents for Medical Procedures[Internet] 2013.[Cited2013May5].Available from http://www.childlife.org/files/EBPAssessmentStatementComplete.pdf.
  • Peterson L, Shigetomi, C. The use of coping techniques to minimize anxiety in hospitalized children .Behavior Therapy. 2006, 12(1):1-14.
  • Brewer S, Gleditsch SL, Syblik D, Tietjens ME, Vacik HW. Paediatric anxiety; child life intervention in day surgery. Journal of Paediatric Nursing 2006. 21(2): 13-22.
  • Rogaieh K, Zeinab F, Ali NN, Zahra G, Mehran A. Effectiveness of orientation tour on children’s anxiety before elective surgeries. Japan Journal of Nursing Science. 2014; 11: 10–15.
  • Jeongwoo L, Jihye L, Hyungsun L, Seon S, Rae L, Dong et al. Cartoon Distraction Alleviates Anxiety in Children During Induction of Anesthesia. Anesthesia Analgesia. 2012 Nov; 115:1168-1173.
  • Fernandes SC, Arriaga P, Esteves F. Providing preoperative information for children undergoing surgery: a randomized study testing different types of educational material to reduce children’s preoperative worries. Health education research. 2014; 29(6): 1058-76.
  • Preethy D, Aparna B, Anice G, Renu G, Ashley D. Parental anxiety during children’s surgery: the effect of preoperative cognitive behavioural programme. International journal of law, psychology and human life. 2013; 2(1):1-7.
  • Hee HI, Lim EHL, Tan QC, Bao ZY, Loh KWT. Effect of preoperative education on behaviour of children during induction of anaesthesia: a randomised clinical trial of efficacy. Anaesth Intensive Care. 2012; 40: 795-802.
  • Peterson L, Shigetomi, C. The use of coping techniques to minimize anxiety in hospitalized children .Behavior Therapy. 2006, 12(1):1-14.
  • McEven A, Moorthy C, Quantock C, Rose H, Kavanagh R. The effect of videotaped preoperative information on parental anxiety during anesthesia induction for elective paediatric procedures. Pediatr Anesth. 2007; 17:534-539.
  • Mamatha SP, Vijaykumar, Santhosh P, Sundeep PT. Effectiveness of hospital based intervention on parenting stress among mothers of pediatric surgery children in south India. International Journal of World Research. 2014; 1(11):25-34.
  • Esra C, Demet S, Mustafa ND, Burcak T, Neslihan E, Isik A. Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children. Journal of International Medical Research. 2014; 42(2): 572–580.
  • Hall A. Client education in: Fundamentals of nursing. St. Louis, MO: Elsevier, 2009.

Abstract Views: 375

PDF Views: 0




  • Effectiveness of Multimodal Preoperative Preparation Program on Children Undergoing Surgery

Abstract Views: 375  |  PDF Views: 0

Authors

Priya Reshma Aranha
Department of Child Health Nursing, Yenepoya Nursing College, Yenepoya University, India
Larissa Martha Sams
Department of Medical Surgical Nursing, Laxmi Memorial College of Nursing, India
Prakash Saldanha
Department of Paediatrics, Yenepoya Medical College Hospital, India

Abstract


Background:

The advanced era of technological development in child healthcare has resulted in more paediatric procedures being performed in various settings. Millions of children undergo surgery every year which is a stressful event. Many non pharmacological strategies are being used to manage the preoperative fear and anxiety in children. The current study aims to assess the effectiveness of multimodal preoperative preparation program (MPPP) on children undergoing surgery in terms of its effect on the psycho physiological parameters. Methods: A quasi experimental study was conducted in a selected multi speciality hospital. Using the purposive sampling technique, a total of 110 children aged 8-12 years were assigned to non intervention (n = 55) and intervention (n = 55) groups respectively. The MPPP was administered to intervention group. The children in the non intervention group received the routine preoperative care. Child’s fear and anxiety was assessed on admission, prior to shifting the child to OT, 24 hours and 48 hours after surgery where as child’s pulse, respiration, blood pressure, oxygen saturation was assessed on admission, prior to shifting the child to OT, 6 hours, 12 hours, 24 hours and 48 hours after surgery and pain was assessed at 24 and 48 hours after surgery. Significant Findings of the Study: Mean fear and anxiety scores of children were significantly lower in intervention group than that of non intervention group (p<0.05). Among the physiological parameters, only pulse, respiration and blood pressure showed significant difference (p<0.05) between the groups, whereas oxygen saturation and pain scores did not differ significantly (p>0.05). The study also found that there is a significant association between the psycho physiological parameters of children with the selected demographic variables (p<0.05). A positive correlation was found between the psychological and physiological parameters of children undergoing surgery. Conclusion: The MPPP is effective on psycho physiological parameters of children undergoing surgery in terms of decreasing the fear and anxiety, stabilizing the physiological parameters of children and can be used in preparing school aged children for surgery and can be practised in the clinical setup.


Keywords


Multimodal Preoperative Preparation Program, Children, Fear, Anxiety, Physiological Parameters.

References