Prehospital Psychological Preparation for Tonsillectomy Patients: Effects on Children's and Parents' Adjustment

Abstract

This experiment tested the stress-reducing effects of written and illustrated materials which were designed to prepare children for hospitalization for minor surgery. The preparatory materials incorporated information and procedures used successfully in previous studies to prepare children and parents in the hospital. One hundred sixty-three children 3 to 12 years of age and hospitalized for tonsillectomies were randomly assigned to one of five experimental groups or a control group. The experimental groups consisted of combinations of home preparation with different types of in-hospital preparation and supportive care. Children's hospital adjustment was measured by blind ratings of behavioral upset and cooperation during the blood test, medication injection, transport to surgery, induction and postoperative fluid intake. Recovery room medications and time to first voiding were also used as indications of upset. Posthospital adjustment was assessed by the Vernon et al Posthospital Adjustment Inventory. Parent outcome measures included self-ratings for anxiety and satisfaction with information and care. The results indicated that children who used the home-preparatory materials alone or in combination with in-hospital preparation showed better adjustment than children in the control group. In-hospital preparation was as effective as home preparation alone or in combination with hospital preparation. Parents reported more satisfaction and less anxiety when they received some in-hospital preparation than with home preparation alone. Differences in children and parents who chose to use the preparatory materials at home from those who did not use them were noted. The overall results provide further replication for the stress-reducing effects of systematic psychological preparation for hospitalization and surgery.