Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial

BACKGROUND

Reducing preoperative anxiety can help optimize surgical care.

AIM

To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents.

METHODS

We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups.

FINDINGS

The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups.

APPLICATION TO PRACTICE

Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.

COMPREENSÃO DE PACIENTES ÀS ORIENTAÇÕES DE ENFERMAGEM NO CATETERISMO CARDÍACO: UMA PESQUISA QUALITATIVA

Objetivo: compreender o conhecimento dos pacientes sobre o procedimento do cateterismo cardíaco a fim de elaborar orientações de enfermagem no pré-exame. Métodos: pesquisa qualitativa com 31 pacientes adultos de um hospital de ensino do interior do estado de São Paulo, realizada no primeiro semestre de 2015. Os dados foram coletados mediante entrevista semiestruturada e analisados pelo método de Análise de Conteúdo. Resultados: dos discursos emergiram três categorias: Compreensão dos sinais e sintomas que levaram à necessidade de realização do cateterismo cardíaco, Assimilação parcial das informações recebidas na forma escrita pelos pacientes, e Desconhecimento sobre o procedimento de cateterismo cardíaco realizado. Os resultados apontam para pacientes que recebem orientações insuficientes para a compreensão de procedimento tão complexo. Conclusão: o planejamento adequado de orientações em saúde, ao ser construído e colocado em prática, esclarece e fortalece os indivíduos para a promoção da saúde e promove o reconhecimento das ações de enfermagem.