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Canadian Journal of Anaesthesia

, Volume 37, Issue 2, pp 177–182 | Cite as

Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children

  • Joan C. Bevan
  • Celeste Johnston
  • Margaret J. Haig
  • Guy Tousignant
  • Simon Lucy
  • Vanessa Kirnon
  • Irene K. Assimes
  • Ruben Carranza
Clinical Investigations

Abstract

Parental presence at induction of anaesthesia is desirable if it makes the child happier and more cooperative. This study evaluated the emotional and behavioural responses of children to being accompanied by a parent at induction of anaesthesia in a paediatric day-care surgical centre. One hundred and thirty-four patients (aged 2–10 yr, ASA physical status I or II) were divided into two groups by day of surgery, to have a parent present at induction of anaesthesia (treatment group), or to be unaccompanied (control group). Before, and at one week after surgery, the child’s fears and behaviour were scored by the Hospital Fears Inventory (HFI) and Behavioural Questionnaire (BQ), and parental anxiety by the Parents’ Questionnaire (PQ) before and at one week after surgery. The Global Mood Scale (GMS) was used to assess the child’s behaviour and the Visual Analogue Scale (VAS) to assess the parent’s anxiety on arrival for surgery and at induction of anaesthesia. All patients and parents were disturbed by the experience, but to the same degree in the treatment and control groups. Subgroups of “ calm ” and “ anxious ” parents were identified by a median split of their preoperative VAS scores. Children in the“ calm-treatment,” “ calm-control ” and“ anxious-control ” subgroups were similarly upset at induction. Children in the“ anxious-treatment ” subgroup were the most disturbed at induction, and significantly more than those in the“ anxious-control” subgroup. Preoperative parental anxiety levels also correlated with the child’s fears and behaviour one week after surgery. Therefore, parental anxiety should be assessed preoperatively to allow“calm” parents to be present at induction if they wish, and“anxious” parents to be excluded and receive counselling and support.

Key words

anaesthesia: paediatric induction: anaesthesia psychological responses 

Résumé

La présence des parents au moment de I’induction de I’anes-thesie est désirable si elle rend I’enfant plus heureux et plus coopératif. Cette étude a évalué les réponses émotionnelles et le comportement des enfants accompagnés de leurs parents lors de I’induction de I’anesthésie dans un centre de chirurgie périatrique externe. Cent trente-quatre patients âgés de 2–10 ans, ASA I ou II) ont été divisés en deux groupes, le groupe traitement fut accompagné alors que pour le groupe «contrôle», aucun parent n’accompagnait l’enfant. Avant et aprés une semaine de la chirurgie, les craintes de l’enfant et son comportement furent évalués par les tests de « Hospital Fears Inventory » (HFI) et le « Behavioural Questionnaire » (BQ) et l’anxiété des parents fut évaluée par le questionnaire des parents (PQ). Le test du « Global Mood Scale » (GMS) a ete utilise afm d’évaluer le comportement de l’enfant et le test du « Visual Analogue Scale » (VAS) fut utilisé afin d’évaluer l’anxiété des parents à l’arrivée de la chirurgie et à l’induction de l’anesthésie. Tous les patients et les parents étaient perturbés par l’expérience, mais au même degré entre le groupe « traitement » et le groupe « controle ». Des sous-groupes de parents « calmes » et « anxieux » ont ete identifiés. Les enfants des sous-groupes « calmes-traitement » et « calmes-contrôle » et « anxieux-contrôle » etaient perturbés d’une façon similaire lors de l’induction. Les enfants du groupe « anxieux-traitement » etaient les plus perturbés lors de l’induction et significativement plus que le sous-groupe « anxieux-contrôle ». L’état d’anxiété préopératoire des parents était aussi relié aux craintes de l’enfant et à son comportement une semaine après la chirurgie. Ainsi, l’anxiété parentérale doit être évaluée dans la période préopératoire afin de calmer les parents présents à l’induction s’ils le désirent et les parents anxieux doivent être exclus et doivent recevoir support et conseil.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Joan C. Bevan
    • 1
    • 2
  • Celeste Johnston
    • 1
    • 2
  • Margaret J. Haig
    • 1
    • 2
  • Guy Tousignant
    • 1
    • 2
  • Simon Lucy
    • 1
    • 2
  • Vanessa Kirnon
    • 1
    • 2
  • Irene K. Assimes
    • 1
    • 2
  • Ruben Carranza
    • 1
    • 2
  1. 1.Department of Nursing ResearchMontreal Children’s Hospital and McGill UniversityMontrealQuebec
  2. 2.Department of AnaesthesiaMontreal Children’s HospitalMontrealQuebec

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