A Study for Structured Preoperative Preparation for Preschool Children Undergoing Ambulatory Surgery

It is generally accepted that hospitalization and surgery can be very traumatic for children. Based on accumulating evidence from research studies, psychological preparation is considered a necessity. A wide variety of preparation or teaching methods, including written materials, videotapes, and play therapy, have been developed. Only a few clinical studies of the influences of these preparation interventions on the child have included the increasing population of children undergoing a surgical procedure through an ambulatory surgery unit. In this clinical study, the postoperative recovery responses of preschool children to structured preoperative preparation were examined. A two- group experimental design was used. The sample consisted of 30 children between the ages of 3 years, 1 month and 6 years, 6 months. The children were scheduled for elective adenoidectomies with or without bilateral myringotomies with ear tube insertion and admitted to the ambulatory surgery unit. Children in the control group received the usual preoperative teaching protocol. Children in the experimental group received structured preoperative preparation by having the book Hike Goes to Surgery read to them and then were asked to play with r selected clinical equipment. The two groups were compared on the following postoperative variables: time to take oral fluids, time to first voiding, ease of fluid intake, ease of ambulation, incidence of vomiting, pulse rate, respiratory rate, systolic blood pressure and posthospital adjustment. The variables time to take oral fluids, time to first voiding, incidence of vomiting and vital signs were measured and recorded by the staff nurses. They also charted ease of fluid intake and ease of ambulation using a four point scale. The variable of posthospital adjustment was measured using the Posthospital Behavior Questionnaire completed by the parent one week after surgery. No significant statistical differences, with the exception of one question on the posthospital adjustment questionnaire, were found between the two groups. However, the anecdotal comments received one week postoperatively were more positive from parents of children in the experimental group than from the parents of children in the control group