Children's pre-operative anxiety could be reduced by flexible approaches

A survey of nurses anaesthetists in Sweden identified difficulties in preparing children for surgery but also found that when the hospital and the staff were flexible in their approaches, the children's anxiety could be reduced. These approaches included varying the operation schedule, provided it do not create risk to the child, and pre-surgical visits with operating staff.

Swedish researchers have found that reducing the anxiety of a child before an operation requires flexible approaches, which could have implications for all stressful hospital procedures involving children.

The study of nurse anaesthetists' experiences and actions when administering and caring for children requiring anesthesia is reported in the February issue of Nursing Children and Young People.

The study concentrated on critical incidents in relation to the induction of anesthesia.

Among the findings were that:

• The absence of sufficient advance information about the child made it difficult for the nurse anaesthetists to make the necessary preparations.
• Some respondents described having no alternative but to physically restrain the child, although they knew this was not good practice. Those situations usually arose in emergencies.
• Arranging a visit to the operating theatre for the child to meet the nurse anaesthetists several times before surgery increased the child's confidence. Another technique involved sending a photo of the nurses to a child with special needs so the child could see a familiar face at the hospital.
• Deviating from organisational and personal routines, for example diverting from the operating schedule, without risking the patient's safety, could lessen a child's anxiety.

'Being sensitive to the child, acting according to the situation and being flexible in altering actions to suit the needs of the child are important strategies to reduce pre-operative anxiety and avoid physical restraint of a child,' the researchers said.

'Furthermore, making the child and parents active participants in the pre-operative process is another successful strategy.'