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Making surgery less scary for kids

Surgery can be traumatic for children – and their parents.

Surgery can be traumatic for children – and their parents. But it doesn’t have to be, with research released on how hospitals and the perioperative team can minimise the anxiety and trauma children face both before and after surgery.

Imagine being a young child and having a stranger take you from your parents arms to stick you with a needle. This happens every day in hospitals across the globe, leading to high levels of anxiety both before and after the surgery takes place.

Recognising the ongoing issues this trauma can cause, a University of California academic conducted extensive research to find ways to minimise the anxiety children face.

“Not only are anxiety and pain emotionally traumatic, but recent data indicates that high anxiety actually heightens postsurgical pain and can affect recovery,” says Dr Zeev Kain, chair of UC Irvine’s department of anaesthesiology and perioperative care.

His research, published in the journal Anaesthesiology, found a family-centred preoperative behavioural intervention not only reduced children’s anxiety before surgery, but also reduced the incidence of postoperative delirium, shortened discharge time after surgery, and reduced analgesic consumption after surgery.

“The family plays an important role in the experience of a young child undergoing surgery. A significant proportion of parents experience anxiety and distress before their child’s surgery,” says Kain.

“We have previously found a very high correlation between parental anxiety and child anxiety and concluded that future interventions must target parents in addition to children.”

As a result of that research, many hospitals in the US now allow parents in the operating room to hold the hand of small children while anesthesia is being administered. Sedative premedication is also now given to many children prior to surgery, decreasing the stress of separation from the parents. And parents are allowed in recovery rooms so they are there when their child wakes up.
Also from the research, Kain developed an internet site to help parents ease children’s anxiety, properly manage postsurgical pain and, ultimately, facilitate healing.

The web-based Tailored Intervention Preparation for Surgery (WebTIPS) site will provide detailed information for parents about surgical procedures and postoperative pain management. It will also develop a personalised plan for alleviating anxiety and pain, taking into account other medical and psychological factors, such as the parents’ coping and caring skills.

To access the service, parents will log into the site at least five days before surgery and fill out a questionnaire, including parents’ attitudes toward pain and their own anxiety over the surgery.

“The result will be a program specifically tailored to the child’s needs and the parents’ ability to provide care,” says Kain. “We want to provide the guidance for families to manage their children’s surgeries.”

WebTIPS will also feature individualised, downloadable podcasts and a 24-hour call-in service should parents need more assistance.

Kain created the site’s content, which will be integrated into a prototype web format ready for use in the US in 18 months. Once tested, the site will be made available to all hospitals and surgical centres.

“What’s wonderful about the site is that it will have a very large impact,” Kain says.

“All families will need is access to the site. It’s our belief that WebTIPS can help empower families to make surgery less stressful for their children and improve their recovery.”

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