Predictors of Pre-operative Anxiety in Indian Children
- 32 Downloads
To identify the predictors of pre-operative anxiety in school-going children in India.
A prospective observational study was done at a tertiary care teaching hospital. Children aged 7–12 y scheduled for elective surgery and their parents were enrolled. Pre-operative anxiety in children and parents was assessed using STAI-C and STAI-P questionnaires respectively. The child’s anxiety in pre-op room, at the time of parental separation and induction of anesthesia were assessed using m-YPAS scale. Possible predictors of anxiety under ‘individual’, ‘social’ and ‘healthcare’ domains were analyzed using logistic regression. The quality of mask induction of anesthesia was assessed using Induction Compliance Checklist.
Sixty children completed the study successfully. Receiver operating characteristic (ROC) curve indicted mYPAS score ≥ 30 (observed score) to identify children with high anxiety as identified by STAI-C ≥37 (self-reported score). The incidence of high anxiety escalated from pre-operative time (48%) to the time of parental separation (72%) and increased further at anesthetic induction (95%). Parental anxiety (p = 0.03) and socioeconomic background (p = 0.03) were significant predictors of the child’s pre-operative anxiety. The presence of >4 people at induction (p = 0.002), but not pre-operative anxiety, was found significantly more in children with poor quality of mask induction.
The incidence of peri-operative anxiety in Indian children is significant. Parental anxiety and socioeconomic background were found significant predictors of high pre-operative anxiety in our set-up.
KeywordsPre-operative anxiety Pediatric anesthesia Predictors of anxiety Anesthetic induction Developing country setting
RM: Data acquisition, analysis, drafting of the manuscript; SY and NBP: Data interpretation and critical revision of the manuscript; AK: Data analysis, interpretation and critical revision of manuscript; PJM: Concept and design of the study, data analysis and interpretation, manuscript preparation and critical revision; will act as guarantor for this paper.
Compliance with Ethical Standards
Conflict of Interest
- 2.Vernon DT, Foley JM, Sipowiwcz R, Shutman J. The psychological responses of children to hospitalization and illness. Springfield: Thomas Books; 1965. p. 1–5.Google Scholar
- 8.Spielberger CD, Gorsuch RL, Lushene RE, Vagg PR, Jacobs GA. Manual for state-trait anxiety inventory. California, USA: Consulting Psychologists press; 1983.Google Scholar
- 11.Malhotra S, Randhawa A. A schedule for measuring temperament in children. Preliminary data on development and standardization. Indian J Clin Psychol. 1982;9:203–10.Google Scholar
- 13.Lerman J, Sampathi V, Watt S. Induction, maintenance and emergence from anesthesia. In: Gregory GA, Andropoulas DB, editors. Gregory’s Pediatric Anesthesia. 5th ed. West Sussex: Blackwell Publishing Ltd; 2012. p. 330–60.Google Scholar
- 18.Wollin SR, Plummer JL, Owen H, Hawkins RM, Materazzo F. Predictors of preoperative anxiety in children. Anesth Intensive Care. 2003;31:69–74.Google Scholar
- 19.The World Bank-Country and lending groups [Internet]. 2016[cited 2016 Mar 27]. Available at: http://data.worldbank.org/about/country-and-lending-groups#Lower_middle_income.
- 20.Jain A, Runa P. Social sector and economic reforms (with special reference to public health). Int Res J Social Sci. 2014;3:38–42.Google Scholar