Investigation of the anxiety level of parents of pediatric patients planned to undergo an elective operation

Year 2020, Volume: 3 Issue: 3, 182 - 190, 31.12.2020

Resul Yılmaz , Selmin Ökesli Şule Arıcan , Gülçin Hacıbeyoğlu , Sema Tuncer

Abstract

Objective: Many surgical procedures are performed on children and variable reports have been made about the level of anxiety in parents whose children are hospitalized. Parents' knowledge of the disease and surgery, economic problems, care of other family members and problems related to their work life are situations that affect the anxiety of the parent. The aim of this study is to evaluate the prevalence of preoperative parental anxiety and related factors. Additionally, the aim is to examine the correlation of The State-Trait Anxiety Inventory (STAI) and Amsterdam Preoperative Anxiety, Information Scale, and State Anxiety Scale (APAIS) tests.
Methods: The parents of the children whose operation was planned under general anesthesia were included in the study. A questionnaire was applied to 300 volunteers aged between 18-65. Four forms were directed to the volunteers: parent information form, child information form, STAI (STAI-I and II) anxiety forms and APAIS anxiety form.
Results: The groups formed according to the APAIS scale included n=187 in Group P and n=113 in Group N. When the anxiety scores of the groups were compared, there was a significant difference in STAI-I, APAIS-B and APAIS-T. There was no difference between the groups in the evaluation of the groups based on sex, income level, income pattern, family structure, child age, child sex, surgical grade and the number of children in the family. In the correlation evaluation with anxiety, positive correlation was determined in all STAI and APAIS tests, while negative correlation was found with parental age.
Conclusion: In this cross-sectional study on parents of children who had anesthesia and surgery, we revealed the level of clinical anxiety and the relationship of some factors with anxiety. Pre-operative parental anxiety continues to exist as an important and under-researched problem of parents. This study shows that the STAI and APAIS tests yield similar results. Low parent and child age are also independent risk factors for anxiety.

Keywords

parental anxiety, preoperative anxiety, the state-trait anxiety inventory (STAI), amsterdam preoperative anxiety (APAIS)

Elektif Cerrahi Planlanan Pediatrik Hastaların Ebeveynlerinin Kaygı Düzeylerinin İncelenmesi

Abstract

Amaç: Çocuklara birçok cerrahi işlem uygulanmaktadır ve çocukları hastanede yatan ebeveynlerde anksiyete düzeyine ilişkin değişken raporlamalar yapılmıştır. Ebeveynlerin hastalık ve ameliyatla ilgili bilgileri, ekonomik sorunlar, diğer aile bireylerinin bakımı ve iş yaşamlarıyla ilgili sorunlar ebeveynin kaygısını etkileyen durumlardır. Bu çalışmanın amacı, preoperatif ebeveyn anksiyetesi düzeyini ve ilişkili faktörleri değerlendirmektir. Ek olarak, amaç, Durum-Sürekli Kaygı Envanteri (STAI) ile Amsterdam Preoperatif Anksiyete, Bilgi Ölçeği ve Durumluk Anksiyete Ölçeği (APAIS) testlerinin korelasyonunu incelemektir.
Materyal ve metod: Genel anestezi altında ameliyatı planlanan çocukların ebeveynleri çalışmaya dahil edildi. Yaşları 18-65 arasında değişen 300 gönüllüye anket uygulandı. Gönüllülere dört form yönlendirildi: ebeveyn bilgi formu, çocuk bilgi formu, STAI (STAI-I ve II) anksiyete formları ve APAIS anksiyete formu.
Bulgular: APAIS ölçeğine göre oluşturulan gruplar Grup P'de n = 187, Grup N'de n = 113'ü içeriyordu. Grupların anksiyete puanları karşılaştırıldığında STAI-I, APAIS-B ve APAIS'de anlamlı farklılık vardı -T. Grupların cinsiyet, gelir düzeyi, gelir düzeni, aile yapısı, çocuk yaşı, çocuk cinsiyeti, cerrahi sınıf ve ailedeki çocuk sayısına göre değerlendirilmesinde gruplar arasında fark yoktu. Anksiyete ile korelasyon değerlendirmesinde tüm STAI ve APAIS testlerinde pozitif, ebeveyn yaşı ile negatif korelasyon tespit edildi.
Sonuç: Anestezi ve cerrahi operasyona maruz kalan çocukların ebeveynlerini konu alan bu kesitsel çalışmada, klinik anksiyete düzeyini ve bazı faktörlerin anksiyete ile ilişkisi gösterildi. Ameliyat öncesi ebeveyn kaygısı, ebeveynlerin önemli ve yeterince araştırılmamış bir sorunu olarak var olmaya devam etmektedir. Düşük ebeveyn ve çocuk yaşı ebeveyen anksiyete yüksekliği için bağımsız risk faktörleridir. Çalışmada ayrıca STAI ve APAIS testlerinin benzer sonuçlar ortaya verdiği gösterilmiştir.

Keywords

ebeveyn anksiyetesi, preoperatif anksiyete, the state-trait anxiety inventory (STAI), amsterdam preoperative anxiety (APAIS)

References

• 1.Wray J, Lee K, Dearmun N, Franck L. Parental anxiety and stress during chil-dren’s hospitalisation: the Stay Close study. J Child Health Care 2011;15:163-74.
• 2. Hoetzenecker W, Guenova E, Krug M, Goetz A, Amarov B, Haefner H-M, et al.Parental anxiety and concern for children undergoing dermatological surgery.J Dermatol Treat 2014;25:367-70.
• 3. Zuckerberg AL. Perioperative approach to children. Pediatric Clinics North Am 1994;41:15-29.
• 4. Kobayashi D, Turner DR, Forbes TJ, Aggarwal S. Parental anxiety among chil-dren undergoing cardiac catheterisation. Cardiol Young 2018;28:315e21.
• 5. Perdana A, Astuti SL, Ramlan AAW, Soenarto RF, Wiguna T. Preanestheticmaternal anxiety of 0-12 years old children who will undergo anesthesia andthe contributing factors. In: Journal of physics: conference series. IOP Pub-lishing; 2019.
• 6. Mitchell M. Influence of gender and anaesthesia type on day surgery anxiety. J Adv Nurs 2011;68:1014–25.
• 7. Uzger A, Baspinar O, Bulbul F, Yavuz S, Kilinc M. Evaluation of depression andanxiety in parents of children undergoing cardiac catheterization. Turk Kardiyol Dernegi Arsivi 2015;43:536-41.
• 8. Pomicino L, Maccacari E, Buchini S. Levels of anxiety in parents in the 24 hrbefore and after their child's surgery: a descriptive study. J Clin Nurs2018;27:278-87.
• 9. Scrimin S, Haynes M, Altoe G, Bornstein M, Axia G. Anxiety and stress inmothers and fathers in the 24 h after their child’s surgery. Child Care HealthDev 2009;35:227-33.
• 10. Charana A, Tripsianis G, Matziou V, Vaos G, Iatrou C, Chloropoulou P. Preop-erative anxiety in Greek children and their parents when presenting forroutine surgery. Anesthesiol Res Pract 2018;2018.https://doi.org/10.1155/2018/5135203.
• 11. Munafö MR, Stevenson J. Anxiety and surgical recovery. Reinterpreting the literature. J Psychosom Res 2001;51:589- 96.
• 12. Kassai B, Rabilloud M, Dantony E, Grousson S, Revol O, Malik S, et al. Intro-duction of a paediatric anaesthesia comic information leaflet reduced pre-operative anxiety in children. Br J Addiction: Br J Anaesth 2016;117:95-102.
• 13. Franck LS, Spencer C. Informing parents about anaesthesia for children'ssurgery: a critical literature review. Patient Educ Counsel 2005;59:117-25.
• 14. Rosenberg RE, Clark RA, Chibbaro P, Hambrick HR, Bruzzese J-M, Feudtner C,et al. Factors predicting parent anxiety around infant and toddler post-operative pain. Hosp Pediatr 2017;7:313-9.
• 15. Moerman N, van Dam FS, Muller MJ, Oosting H. The Amsterdam preoperative anxiety and information scale (APAIS). Anesth Analg 1996; 82: 445 – 51
• 16. Julian LJ. Measures of anxiety: state-trait anxiety inventory (STAI), beck anxiety inventory (BAI), and hospital anxiety and depression scale-anxiety (HADS-A). Arthritis Care Res 2011;63(Suppl 11):S467-72.
• 17. Fortier MA, De Rosario AM, Martin SR et al. Perioperative anxiety in children. Paediatr. Anaesth. 2010; 20: 318–22.
• 18. Yun OB, Kim SJ, Jung D. Effects of a clown-nurse educational intervention on the reduction of postoperative anxiety and pain among preschool children and their accompanying parents in South Korea. J. Pediatr. Nurs. 2015 pii: S0882-5963(15)00084-6. 10.1016/j.pedn.2015.03.003.
• 19. Kain ZN, Mayes LC, Weisman SJ, Hofstadter MB. Social adaptability, cognitive abilities, and other predictors for children’s reactions to surgery. J. Clin. Anesth. 2000; 12: 549–54
• 20. Cağıran E, Sergin D , Deniz MN, Tanattı B, Emiroglu N, Alper I. Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children. Journal of International Medical Research 2014;42:572–580
• 21. Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients - experience of a single unit. Acta Anaesthesiologica Taiwanica 2012;50:3-6
• 22. Aykent R, Kocamanoğlu İS, Üstün E, Tür A, Şahinoğlu H. Preoperatif anksiyete nedenleri ve değerlendirilmesi: APAIS ve STAI skorlarının karşılaştırılması. Türkiye Klinikleri Anesteziyoloji ve Reanimasyon Dergisi 2007;5:7-13.
• 23. Demir A, Akyurt D, Ergün B, Haytural C, Yiğit T, Taşoğlu İ, et al. Kalp cerrahisi geçirecek olgularda anksiyete sağaltımı. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2010;18:177-182.
• 24. Valenzuela Millán J, Barrera Serrano JR, Ornelas Aguirre JM. Anxiety in preoperative anesthetic procedures. Cir Cir 2010;78:147-51.
• 25. Çelik F, Edipoglu İS. Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. Eur J Med Res (2018) 23:41 https://doi.org/10.1186/s40001-018-0339-4
• 26. A. Boker, L. Brownell, N. Donen. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety. Can J Anaesth, 2002;49:792-798
• 27. Calvin RL, Lane PL. Perioperative uncertainty and state anxiety of orthopaedic surgical patients. Orthopaedic Nursing 1999;18:61-66.
• 28. Karadağ Arlı Ş. Evaluation of the Preoperative Anxiety With Apais and STAI-I Scales. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2017;4:38-47
• 29. Van Groenou MIB, Deeg DJ, Penninx BW. Income differentials in functional disability in old age: Relative risks of onset, recovery, decline, attrition and mortality. Aging Clin. Exp. Res. 2003;15:174–183.
• 30. Draisey J, Halldorsson B, Cooper P, Creswell C. Associations between family factors, childhood adversity, negative life events and child anxiety disorders: an exploratory study of diagnostic specificity. 2020;48:253-267
• 31. Stuart Parrigon KL, Kerns KA. Family Processes in Child Anxiety: the Long-Term Impact of Fathers and Mothers J Abnorm Child Psychol 2016;44:1253–1266 doı:10.1007/s10802-015-0118-4
• 32. Wetsch WA, Pircher I, Lederer W, Kinzl JF, Traweger C, Heinz-Erian P, et al. Preoperative stres and anxiety in day-care patients and inpatients undergoing fast-track surgery. British journal of anaesthesia 2009;103:199-205.
• 33. Perks A, Chakravarti S, Manninen P. Preoperative anxiety in neurosurgical patients. Journal of neurosurgical anesthesiology 2009;21:127-130.
• 34. Oğuzalp H, Pamuk A, Öcal T. Günübirlik Cerrahide Ebeveyn Anksiyetesinin ve Beklentilerinin Değerlendirilmesi. Türk Anest Rean Der 2010;38:208-16.
• 35. Bevan JC, Johnston C, Haig MJ, Tousignant G, Lucy S, Kirnon V,et al. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children. Can J Anaesth 1990;37:177-82.
• 36. Türk Anesteziyoloji Ve Reanimasyon Derneği (Tard) Anestezi Uygulama Kılavuzları Preoperatif Hazırlık 2005.
• 37. Tenenbaum G, Furst D, Weingarten G. A statistical reevaluation of the STAI anxiety questionnaire. J Clin Psychol 1985;41:239-44.
• 38. Cassady JF Jr, Wysocki TT, Miller KM, Cancel DD, Izenberg N. Use of preanesthetic video for facilitation of parental education and anxiolysis before pediatric ambulatory surgery. Anesth Analg l999;88:246-50.