Analysing a family-centred preoperative intervention programme: a dismantling approach

The goal of this project was to identify key effective components of ADVANCE, a family-centred preoperative intervention programme, through the use of a dismantling approach. ADVANCE was previously demonstrated to be more effective than parental presence and just as effective as midazolam in reducin...

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Veröffentlicht in:British journal of anaesthesia : BJA 2011-05, Vol.106 (5), p.713-718
Hauptverfasser: Fortier, M.A., Blount, R.L., Wang, S.-M., Mayes, L.C., Kain, Z.N.
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container_issue 5
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container_title British journal of anaesthesia : BJA
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creator Fortier, M.A.
Blount, R.L.
Wang, S.-M.
Mayes, L.C.
Kain, Z.N.
description The goal of this project was to identify key effective components of ADVANCE, a family-centred preoperative intervention programme, through the use of a dismantling approach. ADVANCE was previously demonstrated to be more effective than parental presence and just as effective as midazolam in reducing children’s preoperative anxiety. The total programme, however, may be difficult to implement in hospitals across the country. Subjects in this follow-up dismantling report were 96 children aged 2–10 who were part of the original study and who underwent anaesthesia and surgery. Baseline characteristics, parental adherence to the components of ADVANCE, and child and parent anxiety were assessed. We found that greater parental adherence to the ADVANCE intervention was associated with lower child anxiety before surgery. The two components of ADVANCE that emerged as having a significant impact on children’s anxiety were practising with the anaesthesia mask at home and parental planning and use of distraction in the preoperative holding area. In fact, not only did children experience significantly less preoperative anxiety when their parents were adherent to mask practise and use of distraction, their anxiety tended to remain stable and relatively low throughout the preoperative period. Shaping and exposure (i.e. practise with the anaesthesia mask) and parental use of distraction in the surgical setting are two beneficial components that could be included in preoperative preparation programmes that will be designed in the future.
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subjects Adult
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anxiety - etiology
Anxiety - prevention & control
Attention
Biological and medical sciences
Child
Child, Preschool
children
Cooperative Behavior
Female
Habituation, Psychophysiologic
Health Education - methods
Humans
Male
Masks
Medical sciences
Paediatrics
Parents - psychology
Preoperative Care - methods
surgery, paediatric
surgery, preoperative period
Surgical Procedures, Operative - psychology
title Analysing a family-centred preoperative intervention programme: a dismantling approach
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