Validity of the modified-Distraction-Short-Scale and Verbal-Numeric-Anxiety-Fear-Rating-Scale for children in a preoperative setting

Health Benefits in a Cohort of Children 6 Months After Tonsil Surgery in Relation to the Perioperative Period: An Observational Prospective Cohort Study

Background and Aim

Tonsil-surgery is a common treatment for tonsillitis and upper-airway obstruction. Health benefits are a key point of clinical concern. Aim: To evaluate health benefits 6-months after pediatric tonsil-surgery and to examine the influence of the perioperative period on health-related quality of life (HRQoL).

Method

Participants, 198 children (4-17 years) who underwent tonsillectomy ± adenoidectomy on infection-related indications (TE ± A infec , n = 46), tonsillectomy ± adenoidectomy due to upper-airway-obstruction (TE ± A obstr , n = 44), or tonsillotomy ± adenoidectomy due to upper-airway-obstruction (TT ± A obstr , n = 108). Data were collected via a postoperative pain-diary, and 6-month-questionnaires. The Glasgow Children's Benefit Inventory (GCBI) evaluated HRQoL. An additional questionnaire assessed disease-specific benefits, including open-ended-questions to capture what the children wanted to convey to other children scheduled for surgery.

Results

QoL-score after surgery was positive in all indication/surgical-method groups. The highest GCBI-scores were seen in the subscale-scores for physical health and vitality. Comparing TE ± A obstr and TT ± A obstr , no significant differences were noted in the total-score or in the subscores. No differences in GCBI-scores were seen between subgroups of patients divided by postoperative pain intensity and duration. No differences in frequency or loudness of snoring or ENT-infections were seen between the groups, and satisfaction rates were high. The information that the children considered essential to share with others covered details of the day of surgery, including the anesthesia, nutrition, pain and pain relief, and well-being after surgery.

Conclusions

All indication/surgical-method groups reported improvements regarding the health benefits of surgery, with the most pronounced effect being seen for physical health and vitality. TE ± A and TT ± A showed similar benefits in cases of obstructive and infection problems. Postoperative pain had no impact on QoL at the 6-month follow-up. Children's memories of the surgery can provide direction for management and improvements in children's care. Pain management needs to be optimized to improve recovery.

'Preoperative information helps my child and I experience less anxiety and fear': A grounded study examining parents' opinions and expectations

PURPOSE

This study aimed to investigate the opinions and experiences of parents whose children are hospitalized in a pediatric surgery clinic in Turkey regarding care practices.

DESIGN AND METHODS

Sixteen in-depth interviews with parents whose children were hospitalized in a pediatric surgery clinic were conducted and analyzed between October and December 2023, by grounded theory methodology. The COREQ guidelines guided the reporting of this study.

RESULTS

A core category was identified, 'Preoperative information helps my child and I experience less anxiety and fear' demonstrating that parents are aware of their situation. Analyzing resulted in an interpretive theory of two interrelated categories: 'Quality Nursing Care' and 'Patient and Parent Satisfaction'.

CONCLUSION

Children and parents who received accurate, sufficient, and timely information experienced less anxiety and fear in the preoperative. Quality nursing care significantly affects the well-being of parents and pediatric patients. As a result of all these, high patient and parent satisfaction is an important care outcome.

PRACTICE IMPLICATIONS

Reducing the anxiety and fears of pediatric patients and parents in the preoperative is an important goal. Quality nursing care is one of the most important perceived factors in achieving this goal. Providing in-service training on this subject can increase awareness, especially for nurses new to the pediatric surgery clinic.

State of the Art in Pediatric Anesthesia: A Narrative Review about the Use of Preoperative Time

This review delves into the challenge of pediatric anesthesia, underscoring the necessity for tailored perioperative approaches due to children's distinctive anatomical and physiological characteristics. Because of the vulnerability of pediatric patients to critical incidents during anesthesia, provider skills are of primary importance. Yet, almost equal importance must be granted to the adoption of a careful preanesthetic mindset toward patients and their families that recognizes the interwoven relationship between children and parents. In this paper, the preoperative evaluation process is thoroughly examined, from the first interaction with the child to the operating day. This evaluation process includes a detailed exploration of the medical history of the patient, physical examination, optimization of preoperative therapy, and adherence to updated fasting management guidelines. This process extends to considering pharmacological or drug-free premedication, focusing on the importance of preanesthesia re-evaluation. Structural resources play a critical role in pediatric anesthesia; components of this role include emphasizing the creation of child-friendly environments and ensuring appropriate support facilities. The results of this paper support the need for standardized protocols and guidelines and encourage the centralization of practices to enhance clinical efficacy.