Parental stress in paediatric day-case surgery

Day-case surgery involves a considerable amount of stress not only for the children who undergo surgery but also for their parents. In a prospective survey analysis performed in 1995/1996, we identified the following main factors influencing the amount of stress experienced by parents: feelings of insufficient preparation and problems with postoperative pain at home. As a consequence, measures were taken regarding information and pain management, including the creation of an interactive CD-ROM. We then analysed the consequences of our interventions regarding parental stress. In this study we collected the data of all patients who underwent day-case surgery during two additional 13-month periods in 1997/1998 and 1999/2000. The methods of data collection remained unchanged for all three periods and included a questionnaire for the parents. In total, 1,490 questionnaires were analysed. Comparing the three time periods, parents feelings of being well-informed improved significantly (91% vs. 98% vs. 97%, P<0.0001). However, the percentage of those experiencing moderate to severe stress did not change substantially (16% vs. 9% vs. 19%, not significant). Analgaesics were given more frequently over the years in a general as well as a prophylactic manner (20% vs. 35% vs. 43%, P<0.0001). Nevertheless, problems with pain control at home remained unchanged (33% vs. 23% vs. 29%, not significant). Despite considerable efforts to improve information, parental stress did not significantly decrease. It cannot be assessed yet whether wrong information was given or whether a certain degree of stress cannot be prevented. There is some evidence that improvements in coping with pain-related problems might be a promising next step.