JMIR Publications

ABSTRACT

Background:

Day surgery allows a family to return home quickly. Only a few approaches to preparing for day surgery have demonstrated how digital solutions can support families and children.

Objective:

To evaluate the effectiveness of a mobile application intervention on preschool children's fear and pain and parents' anxiety and stress in preparing children for day surgery.

Methods:

The study was conducted at the Pediatric Day Surgical Department of one University Hospital in Finland between 2018-2020. Parents of children (ages 2-6 years) who were in a queue for elective day surgery were randomized into intervention (IG, n=36) and control (CG, n=34) groups. The CG received routine preparation while the IG was prepared using a mobile application. Parents and children's outcomes were measured using validated scales at four different points: at home (T1, T4) and hospital (T2, T3), before and after surgery. Group differences were analyzed using statistical methods suitable for the material.

Results:

Before surgery, parents in both groups experienced mild anxiety and stress, which decreased after the surgery. Parental anxiety did not differ between the groups pre-operatively (P=.78) or post-operatively (P=.63). Pre-operatively at home, most parents in both groups experienced no stress or mild stress (P=.61). Pre-operatively in the hospital, the parents in both groups experienced mild stress (P=.02). Post-operatively in the hospital, most parents in both groups experienced no stress (P>.99). The child's pain before surgery was rated mild in both groups by parents and children and more intense after the surgery. According to a median of VAS, there were no statistically significant differences in p-values in children's pain between groups and measurement points pre-operatively at home (P=.25), pre-operatively in the hospital (P=.98) and post-operatively in the hospital (P=.72). The child's fear decreased more in the IG than in the CG. The median of FAS did not differ between the IG and CG pre-operatively (P=.20), in the hospital P=.59) or post-operatively in the hospital P=.62; at home (P=.81).

Conclusions:

Although the mobile application intervention did not significantly reduce parental anxiety and stress or children`s pain and fear compared to the established method, it proved non-inferior. The results are important for developing healthcare service chains and providing families with innovative and customer-oriented preparation methods. Clinical Trial: This study was registered at ClinicalTrials.gov (NCT03774303).