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Published in: Indian Journal of Pediatrics 7/2018

01-07-2018 | Original Article

Predictors of Pre-operative Anxiety in Indian Children

Authors: Ritu Malik, Sandhya Yaddanpudi, Nidhi Bidyut Panda, Adarsh Kohli, Preethy J Mathew

Published in: Indian Journal of Pediatrics | Issue 7/2018

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Abstract

Objective

To identify the predictors of pre-operative anxiety in school-going children in India.

Methods

A prospective observational study was done at a tertiary care teaching hospital. Children aged 7–12 y scheduled for elective surgery and their parents were enrolled. Pre-operative anxiety in children and parents was assessed using STAI-C and STAI-P questionnaires respectively. The child’s anxiety in pre-op room, at the time of parental separation and induction of anesthesia were assessed using m-YPAS scale. Possible predictors of anxiety under ‘individual’, ‘social’ and ‘healthcare’ domains were analyzed using logistic regression. The quality of mask induction of anesthesia was assessed using Induction Compliance Checklist.

Results

Sixty children completed the study successfully. Receiver operating characteristic (ROC) curve indicted mYPAS score ≥ 30 (observed score) to identify children with high anxiety as identified by STAI-C ≥37 (self-reported score). The incidence of high anxiety escalated from pre-operative time (48%) to the time of parental separation (72%) and increased further at anesthetic induction (95%). Parental anxiety (p = 0.03) and socioeconomic background (p = 0.03) were significant predictors of the child’s pre-operative anxiety. The presence of >4 people at induction (p = 0.002), but not pre-operative anxiety, was found significantly more in children with poor quality of mask induction.

Conclusions

The incidence of peri-operative anxiety in Indian children is significant. Parental anxiety and socioeconomic background were found significant predictors of high pre-operative anxiety in our set-up.
Literature
1.
go back to reference Corman H, Hornick E, Kritchman M, Terestman N. Emotional reaction of surgical patients to hospitalization, anesthesia and surgery. Am J Surg. 1958;96:646–53.CrossRefPubMed Corman H, Hornick E, Kritchman M, Terestman N. Emotional reaction of surgical patients to hospitalization, anesthesia and surgery. Am J Surg. 1958;96:646–53.CrossRefPubMed
2.
go back to reference Vernon DT, Foley JM, Sipowiwcz R, Shutman J. The psychological responses of children to hospitalization and illness. Springfield: Thomas Books; 1965. p. 1–5. Vernon DT, Foley JM, Sipowiwcz R, Shutman J. The psychological responses of children to hospitalization and illness. Springfield: Thomas Books; 1965. p. 1–5.
3.
go back to reference Melamed BG, Siegel LG. Reduction of anxiety in children facing hospitalization and surgery by use of filmed modelling. J Consult Clin Psychol. 1975;43:511–21.CrossRefPubMed Melamed BG, Siegel LG. Reduction of anxiety in children facing hospitalization and surgery by use of filmed modelling. J Consult Clin Psychol. 1975;43:511–21.CrossRefPubMed
4.
go back to reference Golden L, Pagala M, Sukhavasi S, Nagpal D, Ahmad A, Mahanta A. Giving toys to children reduces their anxiety about receiving premedication for surgery. Anesth Analg. 2006;102:1070–2.CrossRefPubMed Golden L, Pagala M, Sukhavasi S, Nagpal D, Ahmad A, Mahanta A. Giving toys to children reduces their anxiety about receiving premedication for surgery. Anesth Analg. 2006;102:1070–2.CrossRefPubMed
5.
go back to reference Lee J, Lee J, Lim H, et al. Cartoon distraction alleviates anxiety in children during induction of anesthesia. Anesth Analg. 2012;115:1168–73.CrossRefPubMed Lee J, Lee J, Lim H, et al. Cartoon distraction alleviates anxiety in children during induction of anesthesia. Anesth Analg. 2012;115:1168–73.CrossRefPubMed
6.
go back to reference Bodas J, Ollendick TH. Test anxiety: a cross-cultural perspective. Clin Child Fam Psychol Rev. 2005;8:65–88.CrossRefPubMed Bodas J, Ollendick TH. Test anxiety: a cross-cultural perspective. Clin Child Fam Psychol Rev. 2005;8:65–88.CrossRefPubMed
7.
go back to reference Samaan RA. The influences of race, ethinicity, and poverty on the mental health of children. J Health Care Poor Underserved. 2000;11:100–10.CrossRefPubMed Samaan RA. The influences of race, ethinicity, and poverty on the mental health of children. J Health Care Poor Underserved. 2000;11:100–10.CrossRefPubMed
8.
go back to reference Spielberger CD, Gorsuch RL, Lushene RE, Vagg PR, Jacobs GA. Manual for state-trait anxiety inventory. California, USA: Consulting Psychologists press; 1983. Spielberger CD, Gorsuch RL, Lushene RE, Vagg PR, Jacobs GA. Manual for state-trait anxiety inventory. California, USA: Consulting Psychologists press; 1983.
9.
go back to reference Kain ZN, Mayes LC, Cicchetti DV. Measurement tool for pre-operative anxiety in young children: the Yale pre-operative anxiety scale. Child Neuropsychol. 1995;1:203–10.CrossRef Kain ZN, Mayes LC, Cicchetti DV. Measurement tool for pre-operative anxiety in young children: the Yale pre-operative anxiety scale. Child Neuropsychol. 1995;1:203–10.CrossRef
10.
go back to reference Keith RM. A frequent factor in the origins of primary nocturnal enuresis: anxiety in third year of life. Dev Med Child Neurol. 1968;10:465–70.CrossRef Keith RM. A frequent factor in the origins of primary nocturnal enuresis: anxiety in third year of life. Dev Med Child Neurol. 1968;10:465–70.CrossRef
11.
go back to reference Malhotra S, Randhawa A. A schedule for measuring temperament in children. Preliminary data on development and standardization. Indian J Clin Psychol. 1982;9:203–10. Malhotra S, Randhawa A. A schedule for measuring temperament in children. Preliminary data on development and standardization. Indian J Clin Psychol. 1982;9:203–10.
12.
go back to reference Aggarwal OP, Bhasin SK, Sharma AK, Chhabra P, Aggarwal K, Rajaura OP. A new instrument (scale) for measuring the socioeconomic status of a family: priliminary study. Indian J Comm Med. 2005;30:111–4.CrossRef Aggarwal OP, Bhasin SK, Sharma AK, Chhabra P, Aggarwal K, Rajaura OP. A new instrument (scale) for measuring the socioeconomic status of a family: priliminary study. Indian J Comm Med. 2005;30:111–4.CrossRef
13.
go back to reference Lerman J, Sampathi V, Watt S. Induction, maintenance and emergence from anesthesia. In: Gregory GA, Andropoulas DB, editors. Gregory’s Pediatric Anesthesia. 5th ed. West Sussex: Blackwell Publishing Ltd; 2012. p. 330–60. Lerman J, Sampathi V, Watt S. Induction, maintenance and emergence from anesthesia. In: Gregory GA, Andropoulas DB, editors. Gregory’s Pediatric Anesthesia. 5th ed. West Sussex: Blackwell Publishing Ltd; 2012. p. 330–60.
14.
go back to reference Kain ZN, Mayes L, O'Connor T, Cicchetti DV. Pre-operative anxiety in children. Predictors and outcomes. Arch Pediatr Adolesc Med. 1996;150:1238–45.CrossRefPubMed Kain ZN, Mayes L, O'Connor T, Cicchetti DV. Pre-operative anxiety in children. Predictors and outcomes. Arch Pediatr Adolesc Med. 1996;150:1238–45.CrossRefPubMed
15.
go back to reference Cui X, Zhu B, Zhao J, Huang Y, Luo A, Wei J. Parental state anxiety correlates with preoperative anxiety in Chinese preschool children. J Paediatr Child Health. 2016;52:649–55.CrossRefPubMed Cui X, Zhu B, Zhao J, Huang Y, Luo A, Wei J. Parental state anxiety correlates with preoperative anxiety in Chinese preschool children. J Paediatr Child Health. 2016;52:649–55.CrossRefPubMed
16.
go back to reference Davidson AJ, Shrivastava PP, Jamsen K, Haung GH, Czarnecki C, Gibson MA. Risk factors for anxiety at induction of anesthesia: a prospective cohort study. Pediatr Anaesth. 2006;16:919–27.CrossRef Davidson AJ, Shrivastava PP, Jamsen K, Haung GH, Czarnecki C, Gibson MA. Risk factors for anxiety at induction of anesthesia: a prospective cohort study. Pediatr Anaesth. 2006;16:919–27.CrossRef
17.
go back to reference Cagiran E, Sergin D, Deniz MN, Tanattı B, Emiroglu N, Alper I. Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children. J Int Med Res. 2014;42:572–80.CrossRefPubMed Cagiran E, Sergin D, Deniz MN, Tanattı B, Emiroglu N, Alper I. Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children. J Int Med Res. 2014;42:572–80.CrossRefPubMed
18.
go back to reference Wollin SR, Plummer JL, Owen H, Hawkins RM, Materazzo F. Predictors of preoperative anxiety in children. Anesth Intensive Care. 2003;31:69–74. Wollin SR, Plummer JL, Owen H, Hawkins RM, Materazzo F. Predictors of preoperative anxiety in children. Anesth Intensive Care. 2003;31:69–74.
20.
go back to reference Jain A, Runa P. Social sector and economic reforms (with special reference to public health). Int Res J Social Sci. 2014;3:38–42. Jain A, Runa P. Social sector and economic reforms (with special reference to public health). Int Res J Social Sci. 2014;3:38–42.
21.
go back to reference Kain ZN, Mayes LC, Cicchetti DV, Bagnall AL, Finley JD, Hofstadter MB. The Yale pre-operative anxiety scale: how does it compare with a “gold standard”? Anesth Analg. 1997;85:783–8.CrossRefPubMed Kain ZN, Mayes LC, Cicchetti DV, Bagnall AL, Finley JD, Hofstadter MB. The Yale pre-operative anxiety scale: how does it compare with a “gold standard”? Anesth Analg. 1997;85:783–8.CrossRefPubMed
22.
go back to reference Fourtier MA, Del Rosario AM, Martin SR, Kain ZN. Peri-operative anxiety in children. Pediatr Anaesth. 2010;20:318–22.CrossRef Fourtier MA, Del Rosario AM, Martin SR, Kain ZN. Peri-operative anxiety in children. Pediatr Anaesth. 2010;20:318–22.CrossRef
Metadata
Title
Predictors of Pre-operative Anxiety in Indian Children
Authors
Ritu Malik
Sandhya Yaddanpudi
Nidhi Bidyut Panda
Adarsh Kohli
Preethy J Mathew
Publication date
01-07-2018
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 7/2018
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-018-2606-3

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