Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2013.04.001
Brazilian Journal of Anesthesiology
Scientific Article

Impacto do tipo de informação pré-anestésica sobre a ansiedade dos pais e das crianças

Impact of preanesthetic information on anxiety of parents and children

Débora de Oliveira Cumino; Guilherme Cagno; Vinícius Francisco Zacarias Gonçalves; Denis Schapira Wajman; Lígia Andrade da Silva Telles Mathias

http://dx.doi.org/10.1016/j.bjan.2013.04.001 Braz J Anesthesiol, vol.63, n6, p.473-482, 2013
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Resumo

JUSTIFICATIVA E OBJETIVOS: Ansiedade pré-operatória é um fator negativo na experiência anestésico-cirúrgica. Dentre as estratégias para redução da ansiedade em crianças, as não farmacológicas são tão importantes quanto as farmacológicas, porém sua validade ainda é controversa. Verificar se a informação oferecida aos responsáveis interfere na ansiedade da criança. MÉTODOS: 72 crianças de 4 a 8 anos, ASA I e II, submetidas a procedimentos cirúrgicos eletivos e seus responsáveis, divididos aleatoriamente em: Grupo Controle (GC) = responsável recebeu informação anestésica convencional; e Grupo Informativo (GI) = responsável recebeu folheto sobre a anestesia. Foi avaliada ansiedade das crianças pela escala de ansiedade pré-operatória de Yale modificada (EAPY-m), em dois momentos, na sala de espera do centro cirúrgico (SE) e na sala de operação (SO), e dos pais, pela Escala de ansiedade de Hamilton (HAM-A) em SE. RESULTADOS: Não houve diferença nos dados sociodemográficos entre os grupos. O nível de ansiedade nas crianças não apresentou diferença entre os grupos nos dois momentos. Houve diferença estatística significativa nos níveis de ansiedade entre SE e SO nos dois grupos, p = 0,0019 no GC e p < 0,0001 no GI, assim como na prevalência de ansiedade em GC (SE 38,9% e SO 69,4%, p = 0,0174) e em GI (SE 19,4% e SO 83,3%, p< 0,0001). O nível de ansiedade dos responsáveis não apresentou diferença entre os grupos. CONCLUSÃO: Independentemente da qualidade de informação oferecida aos responsáveis, o nível e a prevalência de ansiedade das crianças foram baixos no momento SE e aumentaram significativamente no momento SO.

Palavras-chave

Ansiedade, Anestesia, Avaliação, Cuidados pré-operatórios, Criança

Abstract

BACKGROUND AND OBJECTIVES: Preoperative Anxiety is a negative factor in anesthetic and surgical experience. Among the strategies for reducing children's anxiety, non-pharmacological strategies are as important as the pharmacological ones, but its validity is still controversial. OBJECTIVES: The aim of this study was to verify if the information provided to guardians interferes with child anxiety. METHODS: 72 children, 4-8 years old, ASA I and II, undergoing elective surgical procedures and their guardians were randomly divided into two groups: control group (CG) = guardian received conventional information about anesthesia; informative group (IG) = guardian received an information leaflet about anesthesia. Children's anxiety was assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS) on two occasions: at the surgical theater waiting room (WR) and at the operating room (OR). Parents' anxiety was assessed using the Hamilton Anxiety Scale (HAM-A) at the CT. RESULTS: There was no difference in demographic data between groups. The level of anxiety in children showed no difference between groups at two measured times. There was statistically significant difference in anxiety levels between WR and OR in both groups, p = 0.0019 for CG and p < 0.0001 for GI, as well as the prevalence of anxiety for CG (38.9% WR and 69.4 % OR, p = 0.0174) and GI (19.4% WR and 83.3% OR, p < 0.0001). The anxiety level of guardians did not differ between groups. CONCLUSION: Regardless of the quality of information provided to the guardians, the level and prevalence of anxiety in children were low at WR time and significantly increased at OR time.

Keywords

Anxiety, Anesthesia, Evaluation, Preoperative care, Child

References

Lumley MA, Melamed BG, Abeles LA. Predicting children's presurgical anxiety and subsequent behavior changes. J Pediatr Psychol. 1993;18:481-97.

Kain ZN, Mayes LC, O'Connor TZ. Preoperative anxiety in children: Predictors and outcomes. Arch Pediatr Adolesc Med. 1996;150:1238-45.

Kain ZN, Mayes LC, Caramico LA. Preoperative preparation in children: a cross-sectional study. J Clin Anesth. 1996;8:508-14.

Wollin SR, Plummer JL, Owen H. Predictors of preoperative anxiety in children. Anaesth Intensive Care. 2003;31:69-74.

Davidson AJ, Shrivastava PP, Jamsen K. Risk factors for anxiety at induction of anesthesia in children: a prospective cohort study. Paediatr Anaesth. 2006;16:919-27.

Kain ZN, Mayes LC, Weisman SJ. Social adaptability, cognitive abilities, and other predictors for children's reactions to surgery. J Clin Anesth. 2000;12:549-54.

Kain ZN, Caldwell-Andrews AA, Maranets I. Predicting which child-parent pair will benefit from parental presence during induction of anesthesia: a decision-making approach. Anesth Analg. 2006;102:81-4.

Bevan JC, Johnston C, Haig MJ. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children. Can J Anaesth. 1990;37:177-82.

Watson AT, Visram A. Children's preoperative anxiety and postoperative behaviour. Paediatr Anaesth. 2003;13:188-204.

Kain ZN, Caldwell-Andrews AA, Mayes LC. Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial. Anesthesiology. 2007;106:65-74.

Astuto M, Rosano G, Rizzo G. Preoperative parenteral information and parentes presence at induction of anaesthesia. Minerva Anestesiol. 2006;72:461-5.

Wright KD, Stewart SH, Finley GA. Prevention and intervention strategies to alleviate preoperative anxiety in children: a critical review. Behav Modif. 2007;31:52-79.

Chundamala J, Wright JG, Kemp SM. An evidence-based review of parental presence during anesthesia induction and parent/child anxiety. Can J Anaesth. 2009;56:57-70.

Kain ZN, Mayes LC, Cicchetti DV. The Yale preoperative anxiety scale: how does it compare with a "gold standard"?. Anesth Analg. 1997;85:783-8.

Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:50-5.

Andrade L, Gorenstein C. Aspectos gerais das escalas de avaliação de ansiedade. Escalas de avaliação clínica em psiquiatria e psicofarmacologia. 2000:139-44.

Nardi AE. Comentários do debatedor: escalas de avaliação de ansiedade. Rev Psiquiatr Clín. 1998;25:331-3.

Caumo W, Broenstrub JC, Fialho L. Risk factors for postoperative anxiety in children. Acta Anaesthesiol Scand. 2000;44:782-9.

Moro ET, Módolo NSP. Ansiedade, a criança e os pais. Rev Bras Anestesiol. 2004;54:728-38.

Guaratini AA, Marcolino JAM, Teixeira AB. Estudo transversal de ansiedade pré-operatória em crianças: utilização da escala de Yale modificada. Rev Bras Anestesiol. 2006;56:591-601.

Kain ZN, Mayes LC, Cicchetti DV. Measurement tool for preoperative anxiety in young children: the Yale Preoperative Anxiety Scale. Child Neuropsychol. 1995;1:203-10.

Kain ZN, Mayes LC, Wang SM. Parental presence and a sedative premedicant for children undergoing surgery: a hierarchical study. Anesthesiology. 2000;92:939-46.

Schiff JH, Russ N, Ihringer K. Paediatric Perianesthesia Questionnaire: development and data from eight hospitals across Germany. Br J Anaesth. 2011;106:88-95.

Padda GS, Moore J, DeNeal D. Parental expectations management by preoperative education. Anesthesiology. 1998;89.

Chan CSM, Molassiotis A. The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanaesthesia care unit. Paediatr Anaesth. 2002;12:131-9.

Bellew M, Atkinson KR, Dixon G. The introduction of a paediatric anaesthesia information leaflet: an audit of its impact on parental anxiety and satisfaction. Paediatr Anaesth. 2002;12:124-30.

Lee A, Chui PO, Gin T. Educating patients about anesthesia: a systematic review of randomized controlled trials of media-based interventions. Anesth Analg. 2003;96:1424-31.

Spencer C, Franck LS. Giving parents written information about children's anesthesia: are setting and timing important?. Paediatr Anaesth. 2005;15:547-53.

Martin SR, Fortier MA, Kain DI. Desire for perioperative information and parental ethnicity. Paediatr Anaesth. 2011;21:1046-51.

White PF, Amos Q, Zhang Y. Anesthetic considerations for magnetic seizure therapy: a novel therapy for severe depression. Anesth Analg. 2006;103:76-80.

Rangel Avila F, Haro Haro JM, Garcia Mendes N. La ansiedad de los padres incrementa la ansiedad preoperatoria en el paciente pediátrico cuando este va a someterse a cirugía ambulatoria. Rev Esp Anestesiol Reanim. 2012;59:83-90.

Kain ZN, Mayes LC, Wang SM. Distress during the induction of anesthesia and postoperative behavioral outcomes. Anesth Analg. 1999;88:1042-7.

Kain ZN, Shu-Ming W, Mayes LC. Sensory stimuli and anxiety in children undergoing surgery: a randomized, controlled trial. Anesth Analg. 2001;92:897-903.

Vagnoli L, Caprilli S, Messeri A. Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?. Paediatr Anaesth. 2010;20:937-43.

Messeri A, Caprilli S, Busoni P. Anaesthesia induction in children: a psychological evaluation of the efficiency of parents' presence. Paediatr Anaesth. 2004;14:551-6.

Caldwell-Andrews AA, Kain ZN, Mayes LC. Motivation and maternal presence during induction of anesthesia. Anesthesiology. 2005;103:478-83.

Golden L, Pagala M, Sukhavasi S. Giving toys to children reduces their anxiety about receiving premedication for surgery. Anesth Analg. 2006;102:1070-2.

Sadhasivam S, Cohen LL, Szabova A. Real-time assessment of perioperative behaviors and prediction of perioperative outcomes. Anesth Analg. 2009;108:822-6.

Wright KD, Stewart SH, Finley GA. When are parents helpful?: A randomized clinical trial of the efficacy of parental presence for pediatric anesthesia. Can J Anesth. 2010;57:751-8.

Tiedman ME. Anxiety responses of parents during and after the hospitalization of their 5-to-11-year-old children. J Pediatr Nurs. 1997;12:110-9.

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