Reducing preoperative anxiety in parents of surgical patients

Caregivers' role regarding managing postoperative pain of hospitalised children (0-3 years)

Background

Acute postoperative pain is a common surgical symptom affecting 40% - 80% of patients. Postoperative pain produces much distress in children. Effective postoperative pain management is a human right. Various stakeholders, including caregivers, are involved in the management of children's postoperative pain. However, the role of the caregiver is accentuated during the child's discharge, with limited studies focusing on the role during hospitalisation.

Aim

This study aimed to describe how caregivers manage their children's (0-3 years) postoperative pain during hospitalisation and explore caregivers' expectations about how their hospitalised children's postoperative pain is managed.

Setting

The study setting was a regional hospital in Ghana.

Methods

The research employed a descriptive qualitative methodology. Purposive sampling was used to recruit caregivers. Data were collected using individual in-depth interviews. The transcripts were thematically analysed using Clarke and Braun's framework.

Results

The researchers identified four themes: caregiver's experiences of caring for children with postoperative pain, caregivers' assessment of children's postoperative pain, caregivers' assistance with management and expectations of the caregivers concerning the management of postoperative pain in their hospitalised children (0-3 years).

Conclusion

Caregivers in this study acknowledged the fact that the postoperative pain experienced by their children had a noteworthy emotional effect on them.

Contribution

Nurses must adequately educate caregivers on managing postoperative pain in hospitalised children (0-3 years). Again, the nurses must be with the child and the caregiver, as this enhances collaboration and adequate postoperative pain management in these children.

The effect of hospital preparatory education on parents: A randomised controlled trial

PURPOSE

The aim of the study was to determine whether hospital preparatory education has an effect on stress, psychological resilience and burnout levels in parents of paediatric patients.

DESIGN AND METHODS

This randomised controlled clinical trial with a pretest-posttest design included parents of children who were hospitalised in a paediatric clinic. Forty-six parents participated in the intervention group and 45 in the control group. The Personal Information Form, Resilience Evaluation Scale (RES), Parenting Stress Scale (PSS) and Parental Burnout Assessment (PBA) were used in the study. As the data were normally distributed, the dependent t-test was used for pre-test-post-test analyses within groups and the independent t-test was used for pre-test-post-test analyses between groups.

RESULTS

As a result of the study, it was determined that hospital preparatory education was effective in decreasing the stress levels of the parents of paediatric patients, increasing their psychological resilience levels and decreasing parental burnout.

CONCLUSIONS

Our results showed that the intervention was effective on parents. Therefore, we suggest that the intervention can be an effective and efficient way to support parents of paediatric patients.

IMPLICATIONS TO PRACTICE

Paediatric nurses, supported by psychiatric nurses, can deliver this intervention regularly to parents of all hospitalised children. This training can also be organised as a hybrid.

Understanding parental hurdles in accessing strabismus treatment

Purpose

To explore the parental factors that impede early intervention for strabismus and thus identify strategies for improving access to specialized care.

Methods

This hospital-based cross-sectional study included 110 parents of children under 19 years with strabismus receiving treatment at the squint clinic of a tertiary health care center in north India. A pre-validated survey questionnaire was administered to the participants, that had a section about the socio-demographics of the participants, another section addressed the parental knowledge about strabismus about diagnosis, and the need for an eye examination. It also sought information about referral source, the felt need for squint examination, and reasons for not seeking treatment.

Results

A total of 110 parents/guardians of strabismus patients (59 exotropes and 51 esotropes) were interviewed using a survey questionnaire. Parents themselves identified 80% of cases, and a substantial link (P ​< ​0.0001) was found between the education status of parents and the age of identification of strabismus. Fear of surgical outcomes (41.79%) was a significant barrier to timely surgery with a higher percentage of parents expressing fear of surgical outcomes (P ​= ​0.025). The cost of surgery (34.33%) and the non-availability of facilities (23.88%) also delayed the intervention.

Conclusions

It is essential to educate parents about the importance of strabismus therapy at an appropriate time, stressing its reconstructive rather than merely cosmetic nature, as there are notable gaps in their knowledge. Also, we need to do away with the fear of surgical outcomes of surgical interventions for strabismus.

Prediction of correlation between preoperative parents' anxiety and their child's anxiety before elective surgery under anaesthesia: An observational study

Background and Aims

Preoperative parental anxiety can have a profound impact on their children undergoing surgery. The present study was done to analyse the correlation between preoperative parental anxiety and their child's anxiety in paediatric patients undergoing elective surgery.

Methods

Paediatric patients aged 2-12 years, scheduled for elective surgeries under general anaesthesia, were included in the study. The child's behaviour and anxiety were assessed in the preoperative area using the modified Yale Preoperative Anxiety Scale (m-YPAS). The parent filled out the demographic questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) form in the preoperative area on the day of surgery. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) statistics software version 23.0 (IBM Corp, Armonk, NY, USA).

Results

A total of 150 children undergoing elective surgery were analysed. Our results showed a strong positive correlation between a child's m-YPAS and his/her parents' anxiety on the day of the surgery (STAI-state) (r = 0.545, P < 0.001). However, the correlation between a child's m-YPAS and his/her parents' anxiety levels (STAI-trait) was not found to be significant (r = 0.109, P = 0.188). A positive correlation was observed between a parent's STAI-state and STAI-trait (r = 0.366, P < 0.001). Factors like area of residence, type of surgery and previous hospitalisation had an influence on the anxiety levels of the child. The birth order of the child, previous hospitalisation and gender of the parent also influenced parental anxiety.

Conclusion

Parental anxiety has a significant impact on the child's anxiety during the preoperative period.

The effect of VR headsets used during burn dressing in children on satisfaction and anxiety level of their parents

PURPOSE

The aim of this study was to determine the effect of virtual reality used during burn dressing in children on the satisfaction and anxiety levels of their parents.

METHODS

The study, which was designed as a prospective randomized controlled trial, was carried out with the parents of children aged 5-10 years who visited the only burns unit of a hospital in the northern region of Turkiye between 5 July 2021 and 1 April 2022 for dressing. There were a total of 52 participants in the study, 26 in the control and 26 in the intervention group.

RESULTS

The mean age of the children was 7.31 ± 1.81 years in the intervention group and 7.08 ± 1.72 in the control group. After the dressing was applied to the children, the mean anxiety score of the parents of the children was found to be 0.09 ± 0.28 in the intervention group and 0.64 ± 0.53 in the control group. The mean nursing care satisfaction score of the parents in the intervention group was found to be 4.70 ± 0.50 while it was 2.80 ± 0.26 in the control group.

CONCLUSIONS

In the study, while the anxiety levels of the ones in the intervention group decreased after the dressing, their satisfaction levels with nursing care were found higher than the control group.

PRACTICE IMPLICATIONS

Nursing interventions that would reduce the pain and anxiety experienced by children during medical procedures are also effective in reducing the anxiety of parents, and therefore, they should be included in distraction efforts with their children.