Service Delivery

The Effectiveness of Preoperative Preparation for Improving Perioperative Outcomes in Children and Caregivers.

Lin et al. (2019) · Behavior modification 2019
★ The Verdict

A 20-minute tour plus cartoon and toy equipment keeps kids calm before surgery.

✓ Read this if BCBAs working with children in hospital or day-surgery settings.
✗ Skip if Clinicians who only serve adult or outpatient-clinic populations.

01Research in Context

01

What this study did

The team invited families whose children needed same-day surgery. Kids were neurotypical and ranged from toddlers to early elementary age.

Half the families got the usual paper handout. The other half also toured the ward, watched a cartoon about the big day, and let the child handle real masks and tubes.

The visit lasted about 20 minutes. Staff then tracked each child’s fear and cooperation on surgery day.

02

What they found

Children who received the prep stayed calm as surgery neared. Their fear scores stayed low.

Kids in the control group grew more upset the closer they got to the operating room. Parents in the prep group also reported less stress.

03

How this fits with other research

Winett et al. (1991) and Neef et al. (1986) showed that short videos and manuals can teach respite staff new skills. Chia-Jung et al. (2019) moved the same idea to families facing hospital care.

Schnell‐Peskin et al. (2023) used only a video to teach safe infant sleep. The surgery prep added a live tour and toy equipment, giving kids real practice.

Carter et al. (2017) built a toolkit for autistic adults in the hospital. Their materials could be merged with the child package to cover the whole lifespan.

04

Why it matters

You can copy this package in any pediatric ward. One staff member can run the tour during a lunch break. The cartoon keeps kids still while they learn. Letting them touch the mask removes the scary unknown. Try it next time you prepare a family for a procedure.

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Add a five-minute mask-play station to your current pre-op tour.

02At a glance

Intervention
other
Design
randomized controlled trial
Population
neurotypical
Finding
positive
Magnitude
medium

03Original abstract

Most children experience significant anxiety during the preoperative period. Greater preoperative anxiety may be related to a higher incidence of negative behaviors. This study aimed to develop a family-centered preoperative preparation program and to evaluate the effects of this program on children's preoperative emotional behaviors, postoperative behavior, and posthospital behavior, and on caregiver anxiety. A prospective, randomized controlled study was conducted. The population consisted of children who underwent minor surgery and their caregivers. The control group received standard care, and the experimental group received standard care plus preoperative preparation, which included a tour, a cartoon video depicting a boy's surgical journey, and familiarization with medical equipment. Children's emotional behaviors and caregiver anxiety were measured at the preoperative visit, in the preoperative holding area, and at induction of anesthesia. Postoperative behavior was measured when children were in the recovery room, and the researcher also contacted caregivers 2 weeks after the surgery to assess the children's behavior at home. A linear mixed-effects model results showed that as the surgery approached, the experimental group had fewer and more stable preoperative emotional behaviors (least squares means of preoperative emotional behaviors from preoperative visit to induction of anesthesia = 10.01-10.95). However, the control group exhibited significantly increased preoperative emotional behaviors as the surgery approached (least squares means of preoperative emotional behaviors from the preoperative visit to induction of anesthesia = 7.87-12.23). Family-centered preoperative preparation can effectively improve children's negative emotional behaviors from their time in the preoperative holding area to the induction of anesthesia.

Behavior modification, 2019 · doi:10.1177/0145445517751879