Using a children's book to prepare children and parents for elective ENT surgery: results of a randomized clinical trial

Objective: We evaluated the effects of surgery preparation using a children's book on pre- and postoperative anxiety and distress in 2-10 years old children undergoing tonsillectomy and/or adenoidectomy and their mothers. Methods: Parents of the experimental group were given the preparation book during the preoperative visit at the hospital, whilst control subjects did not receive the book. Data collection was conducted on the evening prior to surgery (T1), and the evening post surgery (T2). At these two points in time, mothers completed a self-designed feeling states checklist and the state anxiety scale of the State and Trait Anxiety Inventory to assess their perceptions of the child's distress and their own level of anxiety. At T2, nurses were asked to give ratings of patient-caregiver variables, such as level of anxiety, cooperation with care or level of information. The sample under study consisted of 160 mother/child dyads in the experimental group and 240 controls. Results: We found that mothers who received the book exhibited less self-reported state anxiety prior to the operation compared to mothers who did not. Simultaneously, children of the experimental group showed less distress in 4 of 11 feeling states. Nurses assessed the mothers of the experimental group to participate more in the child's care than control mothers. Conclusions: The results demonstrated that our preparation book can provide educational and anxiety-reducing benefits. Given the relatively low production costs and its easy administration, it can be recommended as a popular, practical and cost-efficient tool to prepare children and parents for surgery and hospitalization. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.