Parental presence during anaesthetic induction: Investigations of the effects of parent and child traits and parent -child interactions on child anxiety levels

This dissertation examined a number of important issues regarding the impact of parental presence on child anxiety in the pediatric surgery context. A series of four investigations addressed: (1) the utility of a self-report measure of child anxiety in capturing the impact of parental presence in the preoperative context, (2) the main effects of child temperament and interactions with parental presence on preoperative child anxiety, (3) the influence of parental trait anxiety on child preoperative anxiety given parental presence, and (4) the influence of parent-child interactions on child anxiety given parental presence in the operating room (OR). These four investigations were conducted with two separate day surgery samples of children ages 3-6 years. Sample 1 (used in Studies 1 and 2) was from the IWK Health Centre in Halifax, Nova Scotia and was comprised of 63 children undergoing various day surgery procedures. Sample 2 (used in Studies 3 and 4) was from the Department of Dentistry, Royal University Hospital in Saskatoon, Saskatchewan and was comprised of 32 children undergoing dental surgery. Results suggested: (1) The Child Anxiety Pain Scale-Anxiety Scale measure was unable to appropriately measure child anxiety in the day surgery context; (2) Regardless of parental presence, parent-rated anxious/shy child temperament as measured by the Conners' Parent Rating Scales predicted increased observer-rated anxiety just prior to entering the OR and at anaesthetic induction; (3) Parental trait anxiety on the State-Trait Anxiety Inventory was associated with increased observer-rated child anxiety just prior to entering the OR; (4) Sequential analyses revealed that, at anaesthetic induction, there was a sequential relationship between child distress and parental provision of reassurance and child distress and parental provision of physical comfort. Practical and theoretical implications of the present results are discussed.