Preoperative Education and Decreasing Preoperative Anxiety Among Children Aged 8 - 10 Years Old and Their Mothers The Effect of Performing Preoperative Preparation Program on School Age Children's Anxiety Preoperative Preparation Programs in Children: A Comparative Examination Family-centered Preparation for Surgery Improves Perioperative Outcomes in Children: A Randomized Controlled Trial Using a children's book to prepare children and parents for elective ENT surgery: results of a randomized clinical trial. Preoperative psychological preparation for children undergoing ENT operations: a comparison of two methods. Providing preoperative information for children undergoing surgery: a randomized study testing different types of educational material to reduce children's preoperative worries. Web-Based Tailored Intervention for Preparation of Parents and Children for Outpatient Surgery (WebTIPS): Formative Evaluation and Randomized Controlled Trial The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind randomised controlled trial. Paediatric preoperative teaching: effects at induction and postoperatively. 3-D Storybook: Effects on Surgical Knowledge and Anxiety Among Four- to Six-Year-Old Surgical Patients. The effectiveness of a storybook in lessening anxiety in children undergoing tonsillectomy and adenoidectomy in northern ireland A mixed-method study of effects of a therapeutic play intervention for children on parental anxiety and parents' perceptions of the intervention. Effect of Preoperative Education on Behaviour of Children during Induction of Anaesthesia: A Randomised Clinical Trial of Efficacy Therapeutic play intervention on children's perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial. Psychoeducational preparation of children for surgery: the importance of parental involvement. Parental presence during induction of anaesthesia. A randomized controlled trial of an at-home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery.
Background : Preoperative anxiety is associated with adverse clinical , behavioral , and psychological outcomes . Various effective interventions targeting preoperative anxiety in children exist . Objectives : The aim of this study was to evaluate the educational intervention by residents on children and maternal anxiety and their satisfaction from anxiety management . Patients and Methods : After obtaining the institutional ethics committee approval and written informed parental consent , 36 ASA-I , II children ( age range , 8 - 10 years ) underwent small operations were included in this prospect i ve r and omized study . The participants were allocated into the intervention ( n = 18 ) and control ( n = 18 ) groups . Children in the first group were prepared routinely . In the second group children and their mothers received data about anesthesia and operation by the booklet .  Children-maternal anxiety was assessed using the anxiety level form , at the night and in the morning before surgery . Few days after surgery mothers , residents , and children experiences and satisfaction from anxiety management were assessed in the focus group discussion . Results : Mean scores and st and ard deviations of state anxiety in the intervention group before and after training were 33.1 ± 5.5 and 30.8 ± 6 , respectively ( P = 0.06 ) . In the control group it was 32 ± 6.5 on the night and 34.1 ± 6.7 in the morning before surgery ( P = 0.00 ) . Comparison between groups was not significant ( P = 0.6 ) and ( P = 0.1 ) . The mean levels of anxiety in the control group mothers on the night before and in the morning of surgery were 39.2 ± 13.1 and 42.8 ± 14 ( P = 0.00 ) , respectively . In the intervention group , mothers ’ anxiety before education was 41 ± 12.7 and after education it was 35.6 ± 9.5 ( P = 0.04 ) . Comparison between groups was not significant ( P = 0.7 ) and ( P = 0.1 ) . According to the focus group discussion s , booklet study , provided education , sympathy of medical team , spiritual issues and beliefs reduced anxiety and fear of surgery . Anesthesia and lack of knowledge of what will happen , crying and restlessness of children increased preoperative anxiety . Conclusions : In this study , the preoperative anxiety was reduced by explaining anesthesia and surgery to the mothers and children ( in mothers it was significant P < 0.05 ) . Since there is a direct relation between mothers ’ and their children ’s anxiety , using an effective method to reduce anxiety in children and their mothers together at the same time would be very useful for children and their mothers Objective The purpose of this study was to examine effects of performing preoperative preparation program on  children 's anxiety .  Methods This study was performed in Amirkola Pediatrics Hospital , Maz and aran . A r and omized controlled trail was performed on 122 children ( 7–12 years of age ) admitted for elective surgery during 15 months . The research er r and omly assigned eligible participants in to the experimental and control groups , after pre-test baseline measurement had been taken . Analyzing was performed through independent t-test and χ2 test . P<0.005 was considered statistically significant . The experimental group received therapeutic play and the control group received routine preoperative information preparation . Findings The mean and st and ard deviation of the state anxiety scores of children in experimental and control groups before intervention were 35.52±6.99 and 34.98±6.78 , after intervention 31.44±5.87 and 38.31±7.44 respectively . The state anxiety score was lower significantly in the experimental group prior to preoperative surgery than in the control group ( P=0.000 ) . Conclusion Performing preoperative program with using therapeutic play intervention is effective for preparing children before surgery and decreases their anxiety We sought to determine whether an extensive behavioral preparation program for children undergoing surgery is more effective than a limited behavioral program . The primary end point was  child and parent anxiety during the preoperative period . Secondary end points included behavior of the child during the induction of anesthesia and the postoperative recovery period . Several days before surgery , children ( n = 75 ) aged 2 - 12 yr r and omly received either an information-based program ( OR tour ) , an information + modeling-based program ( OR tour + videotape ) , or an information + modeling + coping-based program ( OR tour + videotape + child-life preparation ) . Using behavioral and physiological measures of anxiety , we found that children who received the extensive program exhibited less anxiety immediately after the intervention , in the holding area on the day of surgery , and on separation to the operating room . These findings , however , achieved statistical significance only in the holding area on the day of surgery ( 44[10 - 72 ] vs 32[8 - 50 ] vs 9[6 - 33 ] ; P = 0.02 ) . Similarly , parents in the extensive program were significantly less anxious on the day of surgery in the preoperative holding area , as assessed by behavioral ( P = 0.015 ) and physiological measures ( P = 0.01 ) . In contrast , no differences were found among the groups during the induction of anesthesia , recovery room period , or 2 wk postoperatively . We conclude that children and parents who received the extensive preoperative preparation program exhibited lower levels of anxiety during the preoperative period , but not during the intraoperative or postoperative periods . Implication s : The extensive behavioral preoperative program that we undertook had limited anxiolytic effects . These effects were localized to the preoperative period and did not extended to the induction of anesthesia or the postoperative recovery period . ( Anesth Analg 1998;87:1249 - 55 Background : Children and parents experience significant anxiety and distress during the preoperative period . Currently available interventions are having limited efficacy . Based on an integration of the literature in both the anesthesia and psychological milieus , the authors developed a behaviorally oriented perioperative preparation program for children undergoing surgery that targets the family as a whole . Methods : Children and their parents ( n = 408 ) were r and omly assigned to one of four groups : ( 1 ) control : received st and ard of care ; ( 2 ) parental presence : received st and ard parental presence during induction of anesthesia ; ( 3 ) ADVANCE : received family-centered behavioral preparation ; and ( 4 ) oral midazolam . The authors assessed the effect of group assignment on preoperative anxiety levels and postoperative outcomes such as analgesic consumption and emergence delirium . Results : Parents and children in the ADVANCE group exhibited significantly lower anxiety in the holding area as compared with all three other groups ( 34.4 ± 16 vs. 39.7 ± 15 ; P = 0.007 ) and were less anxious during induction of anesthesia as compared with the control and parental presence groups ( 44.9 ± 22 vs. 51.6 ± 25 and 53.6 ± 25 , respectively ; P = 0.006 ) . Anxiety and compliance during induction of anesthesia was similar for children in both the ADVANCE and midazolam groups ( 44.9 ± 22 vs. 42.9 ± 24 ; P = 0.904 ) . Children in the ADVANCE group exhibited a lower incidence of emergence delirium after surgery ( P = 0.038 ) , required significantly less analgesia in the recovery room ( P = 0.016 ) , and were discharged from the recovery room earlier ( P = 0.04 ) as compared with children in the three other groups . Conclusion : The family-centered preoperative ADVANCE preparation program is effective in the reduction of preoperative anxiety and improvement in postoperative outcomes 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- design ed 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 A psychological preparation programme was developed for outpatient surgery in children . The purpose of this study was to determine if the programme could increase retrieval of information and reduce anxiety prior to ENT surgery . After ethical committee approval , 160 children and their parents were included . Eighty children ( group 1 ) received conventional verbal information from an ENT nurse , and another 80 children ( group 2 ) received specific information , including role-play , from a nurse anaesthetist at a preadmission visit . Children 's and parents ' experience of premedication , operation theatre ( OR ) , i.v.-needle insertion and induction of anaesthesia were evaluated from a self-rating question naire . The question naire included ratings for anxiety and satisfaction with information and care . The results indicate a clear improvement of the preoperative acquisition of knowledge in all age groups . When it comes to alleviation of fear , a positive effect of the preparation programme was noticed , especially among the younger children ( < 5 years ) , while preoperative anxiety overall was a significantly smaller problem among the older children . The effects of the programme were also related to previous experience of anaesthesia and most beneficial among young children with such experience . Overall , the most negative procedure reported by the children was the i.m . injection for premedication ( a routine which was ab and oned as a result of the study ) , followed by the insertion of the i.v . -needle . The parents experienced watching their child fall asleep during induction of anaesthesia as most negative , followed by the insertion of the i.v.-needle . Parents also reported more satisfaction and less anxiety after having received specific information and preparation preoperatively . It was concluded that this preoperative preparation programme is useful in all age groups with regard to information , while alleviation of anxiety and fear was seen mainly among the younger children with previous experience of anaesthesia This study developed three types of educational preoperative material s and examined their efficacy in preparing children for surgery by analysing children 's preoperative  worries and  parental anxiety .  The sample was recruited from three hospitals in Lisbon and consisted of 125 children , aged 8 - 12 years , scheduled to undergo outpatient surgery . The participants were r and omly assigned to one of the seven independent conditions that were combined into the following three main groups : an experimental group , which received educational material s with information about surgery and hospitalization ( a board game , a video or a booklet ) ; a comparison group , which received entertaining material with the same format type ; and a control group , which did not receive any material .  Children 's preoperative worries and parental anxiety were evaluated after the experimental manipulation . Children who received educational material s were significantly less worried about surgery and hospital procedures than children in the comparison and the control groups , although no statistically differences were found between the type of material s within the experimental group , and no significant effect occurred on parental state anxiety . These results do however support the hypothesis that providing preoperative material s with educational information reduce children 's preoperative worries BACKGROUND : The purpose of this 2-phase project was to conduct a formative evaluation and to test the preliminary efficacy of a newly developed Web-based Tailored Intervention for Preparation of parents and children undergoing Surgery  ( WebTIPS ) . METHODS : Phase 1 enrolled 13 children 2 to 7 years of age undergoing outpatient elective surgery and their parents for formative evaluation of WebTIPS .  Parent participation focus groups are common in qualitative research and are a method of asking research participants about their perceptions and attitudes regarding a product or concept . In phase 2 , children 2 to 7 years of age in 2 medical centers were assigned r and omly to receive the WebTIPS program ( n = 38 ) compared with children receiving the st and ard of care ( n = 44 ) . The primary outcome of phase II was child and parent preoperative anxiety . RESULTS : In phase 2 , parents reported WebTIPS to be both helpful ( P < 0.001 ) and easy to use ( P < 0.001 ) . In phase 2 , children in the WebTIPS group ( 36.2 ± 14.1 ) were less anxious than children in the st and ard of care group ( 46.0 ± 19.0 ) at entrance to the operating room ( P = 0.02 ; Cohen d = 0.59 ) and introduction of the anesthesia mask ( 43.5 ± 21.7 vs 57.0 ± 21.2 , respectively , P = 0.01 ; Cohen d = 0.63 ) . Parents in the WebTIPS group ( 32.1 ± 7.4 ) also experienced less anxiety compared with parents in the control group ( 36.8 ± 7.1 ) in the preoperative holding area ( P = 0.004 ; Cohen d = 0.65 ) . CONCLUSIONS : WebTIPS was well received by parents and children and led to reductions in preoperative anxiety AIMS To evaluate the effect of a structured preoperative preparation on  child and parent state anxiety , child behavioural change and parent satisfaction . BACKGROUND It is estimated that around 50 - 70 % of hospitalised children experience severe anxiety and distress prior to surgery . Children who are highly anxious and distressed preoperatively are likely to be distressed on awakening and have negative postoperative behaviour . Although education before surgery has been found to be useful mostly in North America , the effectiveness of preoperative preparation programme adapted to the Australian context remains to be tested . DESIGN This single-blind r and omised controlled study was conducted at a tertiary referral hospital for children in Western Australia . METHODS Following ethics approval and parental consent , 73 children and one of their carers ( usually a parent ) were r and omly assigned into two groups . The control group had st and ard practice with no specific preoperative education and the experimental group received a preoperative preparation , including a photo file , demonstration of equipment using a role-modelling approach and a tour . RESULTS The preoperative preparation  reduced parent state anxiety significantly ( -2·32 , CI -4·06 to -0·56 , p = 0·009 ) , but not child anxiety ( -0·59 , CI -1·23 to 0·06 , p = 0·07 ) . There was no significant difference in child postoperative behaviour or parent satisfaction between the groups . There was a significant two-point pain score reduction  in the preoperative preparation group , when compared with the control group median 2 ( IQR 5 ) and 4 ( IQR 4 ) , respectively ( p = 0·001 ) . CONCLUSIONS Preoperative preparation was more efficient on parent than child . Although the preoperative preparation had limited effect on child anxiety , it permitted to decrease pain experience in the postoperative period . RELEVANCE TO CLINICAL PRACTICE Parents should be actively involved in their child preoperative preparation In a r and omized controlled trial at Duke University and University of North Carolina Hospitals , 143 two to six year old children undergoing elective ambulatory surgery were r and omized into a control group who received routine preoperative teaching or an intervention group who received an interactive teaching book .  Changes in behaviour were measured by a Vernon behavioural question naire preoperatively and again two weeks postoperatively . A Global Mood Score was assessed in the preoperative holding area , at arrival into the operating room , and at the time of mask induction . The children in the control group were significantly more aggressive postoperatively than the intervention group ( P < 0.05 ) . Children who received the interactive teaching book exhibited higher levels of anxiety on the day of surgery , but fewer behavioural changes two weeks following surgery . Parents in the intervention group reported that preoperative teaching helped their child ( 87 % ) and themselves ( 83 % ) Inadequate surgical knowledge potentiates anxiety ; however , no methodology simultaneously addresses anxiety and surgical knowledge . Our quasi-experimental study determined the effectiveness of a three-dimensional ( 3-D ) storybook in increasing surgical knowledge and decreasing anxiety among young children scheduled for planned or required major surgeries . We studied 20 r and omly assigned participants who received either the 3-D storybook or traditional health teaching .  A presurgical knowledge question naire and modified Yale Preoperative Anxiety Scale assessed surgical knowledge and anxiety . Data were analyzed with one-way and repeated- measures multivariate analysis of variance . Results showed that both groups had higher knowledge scores ( F = 8.94 ; P = .008 ) and lower anxiety scores ( F = 5.13 ; P = .036 ) after the intervention . The children who received information from the 3-D storybook exhibited a significantly higher posttest knowledge score ( F = 11.71 ; P = .003 ) and lower anxiety score ( F = 10.05 ; P = .005 ) than the traditionally educated group of children . The 3-D storybook effectively increased surgical knowledge and decreased anxiety and could be used as an alternative method to prepare pediatric surgical patients Aim : This study aim ed to assess the effectiveness of a storybook , entitled , The Tale of Woody ’s Tonsils , written by Anne Marie Tunney , on reducing the level of anxiety of children aged 5–11 years who were undergoing tonsillectomy and adenoidectomy in one hospital in Northern Irel and . Background / Literature Review : Psychological preparation of children for surgery impacts coping . There is evidence , in both adult and pediatric studies , that effective psychological preparation for a surgical procedure has an impact on the individuals ’ coping ability with reduced levels of anxiety leading to better post-operative outcome , faster recovery and a reduction in long term sequelae associated with admission to hospital . A storybook , as a method of preparation , has been recommended by a number of research ers but the effectiveness of this in reducing anxiety has not yet been investigated in the UK . Previous studies have mainly used only one research instrument for anxiety measurement and child self-report is not a commonly used feature of such research . Design and Methodology : A quasi-experimental study involving 80 children was conducted using a repeated measures design . Children attending a pre- assessment clinic were r and omly allocated to either an experimental group ( received the storybook ) or a control group ( did not get the storybook ) . Anxiety was tested both pre- and post-intervention using a self-report Hospital Fears Rating Scale and Child Drawing : Hospital , a projective technique based on children ’s drawings . Findings : The storybook was found to be effective in reducing pre-operative anxiety and was found to be particularly effective for females and in the 7-year-old age group . Practice Implication s ; This study demonstrates the storybook ’s effectiveness for alleviating anxiety and advocates the use of child focused anxiety measurement tools . It reinforces the need for pre assessment to include exploration of anxiety triggers so that preoperative preparation and nursing care can be individualized for each child AIM To examine the effects of a therapeutic play intervention for children on parents ' perioperative anxiety  , the relationship between parents ' and their children 's anxiety  and to explore  parents ' perceptions of the intervention . BACKGROUND Therapeutic play intervention was found to reduce children 's perioperative anxiety .  Little is known about how such an intervention for children affects their parents ' anxiety . DESIGN A mixed method of r and omized controlled trial with qualitative process evaluation was used . METHODS Ninety-five pairs of parents and children were recruited between November 2011-August 2013 and r and omized into a control or an intervention group . The State Anxiety Scale for Children and the State Anxiety Scale for Adults were used to measure children 's and parents ' anxiety , respectively , at baseline , on surgery day and around 24 hours after surgery . Parents were interviewed about their perceptions of the intervention . Data were analysed using SPSS version 22·0 and thematic analysis . RESULTS There was no difference in parents ' anxiety after participating with their child in the intervention compared with usual care . There were significantly positive relationships between parents ' and their children 's baseline anxiety and parents ' postoperative anxiety and their children 's pre-operative anxiety . Four themes were identified : reducing anxiety , increasing knowledge and underst and ing about anaesthetic procedure , the worthiness of attending the intervention and suggestions for improvement of the intervention . CONCLUSIONS Therapeutic play intervention had no significant effect on  parents ' perioperative anxiety . Parents ' and their children 's perioperative anxiety are correlated . Parents perceived the intervention as helpful preparation for themselves and for their children undergoing elective surgery In this r and omised prospect i ve study we aim ed to evaluate whether preoperative anaesthetic education delivered to children on the day of surgery reduces anxiety behaviour during induction of anaesthesia . One hundred children , six to 15 years of age , undergoing general anaesthesia for ambulatory surgery were allocated at r and om to a preoperative education group ( n=50 ) or a control group ( n=50 ) . The main outcomes were behaviour score , self-reporting of satisfaction score and identification of the stage when children felt most fearful .  Data from all 100 participants were analysed . There was no difference in behaviour score at induction or satisfaction score between the groups . Eighteen percent in the intervention group reported no fear preoperatively vs 10 % in the control group . Intravenous induction failed in nine out of 38 children in the intervention group ( 23.7 % ) compared to five out of 40 in the control group ( 12.5 % ) . When intravenous induction failed , eight out of nine ( 89 % ) of the intervention group remained co-operative during gas induction compared to two out of five ( 40 % ) of the control group . Preoperative education delivered on the day of surgery did not reduce anxiety behaviour in children during intravenous induction of anaesthesia , but did reduce anxiety during subsequent inhalational induction AIM To examine if therapeutic play intervention could reduce perioperative anxiety , negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery . BACKGROUND Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations . Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children 's  perioperative anxiety , negative emotional manifestation and postoperative pain . DESIGN A r and omized controlled trial was used . METHODS Suitable children were recruited from November 2011-August 2013 . They were r and omized to receive either routine care ( control group , n = 47 ) or a 1-hour therapeutic play intervention ( experimental group , n = 48 ) . Children 's state anxiety , negative emotional manifestations and postoperative pain were measured at baseline , on the day of surgery and around 24 hours after surgery . Repeated measures analysis of covariance ( ancova ) and univariate ancova adjusting for all possible confounding factors were used in the data analysis . RESULTS The time effect of state anxiety was significant , but no group and interaction ( group x time ) effects between the control and experimental groups were found . Compared with the control group , children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain . CONCLUSIONS Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery . These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery OBJECTIVE To examine the effects of therapeutic play intervention on outcomes of children undergoing day surgery , and to highlight the importance of parental involvement in the psychoeducational preparation of children for surgery . METHODS A r and omized controlled trial , two group pre-test and repeated post-test , between subjects design was employed . Hong Kong Chinese children ( 7 - 12 years of age ; n=203 ) admitted for elective surgery in a day surgery unit , along with their parents during a 13-month period , were invited to participate in the study . By using a simple complete r and omization method , 97 of children with their parents were assigned to the experimental group receiving therapeutic play intervention , and 106 children with their parents were assigned to the control group receiving routine information preparation . RESULTS The results showed that both children and their parents in the experimental group reported lower state anxiety scores in pre- and post-operative periods . Children in the experimental group exhibited fewer instances of negative emotional behaviors and parents in the experimental group reported greater satisfaction . The results , however , find no differences in children 's post-operative pain between the two groups . CONCLUSION The study provides empirical evidence to support the effectiveness of using therapeutic play intervention and the importance of parental involvement in the psychoeducational preparation of children for surgery . PRACTICE IMPLICATION S The findings heighten the awareness of the importance of integrating therapeutic play and parental involvement as essential components of holistic and quality nursing care to prepare children for surgery Background To determine whether parental presence during induction of anesthesia is an effective preoperative behavioral intervention , a r and omized controlled trial with children undergoing outpatient surgery was conducted . Methods Eighty-four children were r and omly assigned to a parent-present or OBJECTIVES To determine whether the implementation of at-home psychological preparation programme for children and family prior to surgery can reduce anxiety for Japanese preschool children undergoing herniorrhaphy and their caregivers assessed as an appropriate outpatient care . METHODS Patients were r and omly assigned to either of two groups : the usual care group or the at-home preparation group . Both two groups viewed a patient-educational video for herniorrhaphy once as out patients with other patients prior to hospitalization . The control group later underwent surgery without any further preparation . The experimental group watched the same educational video at home again with an auxiliary booklet prior to hospitalization . Children 's anxiety was measured by the Wong-Baker FACES Rating Scale ( FACES Rating Scale ) , while caregivers ' anxiety was measured by the Spielberger 's State Trait Anxiety Inventory ( STAI ) . Both outcomes were measured repeatedly from pre-intervention to 1 month after surgery . RESULTS Of the eligible 161 patients participating , 158 ( 98.1 % ) were r and omly assigned to the control group ( n = 81 ) and the experimental group ( n = 77 ) , and 144 ( 89.4 % ) completed the study . The experimental group gained more information and knowledge about surgery from parents and showed significantly lower scores than the controls for FACES and STAI . CONCLUSION A specially design ed at-home preparation programme as an outpatient care is effective to encourage parent-child verbal interaction concerning surgery and reduce both children and caregivers ' anxiety associated with surgery
AIM To explore the effectiveness of preoperative psychological preparation programmes aim ed to reduce  paediatric preoperative anxiety  and the potential factors that could have an impact on parent and children 's acceptance of such interventions .
BACKGROUND Various preoperative psychological preparation programmes are available to address  paediatric preoperative anxiety .
No mixed- method review has been conducted to explore the effectiveness and acceptability of these programmes .