Psychological preparation for surgery pediatric patients: the effects on children's and parents' stress responses and adjustment.

This clinical experiment tested variations of psychological preparation and supportive care designed to increase the adjustment of children (and their parents) hospitalized for elective surgery. Eighty-four children, aged 3 to 12, admitted for tonsillectomies were randomly assigned to one of three treatment conditions or to a control group: (1) a combination of systematic preparation, rehearsal, and supportive care conducted prior to each stressful procedure; (2) a single-session preparation conducted after admission, and (3) consistent supportive care given by one nurse at the same points as in the first condition, but including no systematic preparation or rehearsal. The children's hospital adjustment was measured by blind ratings of behavioral upset and cooperation during the blood test, medication injection, transport to surgery, induction, and postoperative fluid intake and by recovery room medications and pulse rates and time to first voiding. Post-hospital adjustment was assessed with Vernon et al.'s Post Hospital Behavior Inventory. Parent outcome measures included self-ratings for anxiety and satisfaction with information and care. As hypothesized, the results demonstrated that children who received condition one showed significantly less upset and more cooperation and their parents reported significantly greater satisfaction and less anxiety than did children or parents in the other groups. Younger children were significantly more upset and less cooperative than older children.

Pediatric surgical patients' and parents' stress responses and adjustment as a function of psychologic preparation and stress-point nursing care.

The purpose of this study was to test the hypotheses that children who receive systematic psychologic preparation and continued supportive care, in contrast to those who do not, would show less upset behavior and more cooperation in the hospital and fewer post-hospital adjustment problems and that their parents would be less anxious and more satisfied with information and care received. Eighty children scheduled for minor surgery and their parents were randomly assigned to experimental and control conditions. The experimental intervention consisted of accurate information about sequences of events, sensory experiences, role expectations and appropriate responses, previews of procedures through play techniques, and supportive care given at critical points pre- and postoperatively. Significant differences between experimental and control children and parents on ratings of upset behavior, cooperation with procedures, pulse before and after painful procedures, resistance to induction, time to first voiding, posthospital adjustment, and parental anxiety and satisfaction with information and care consistently supported the hypotheses. Results were also analyzed in relation to the age and sex of the children and whether parents roomed with the children.