Social adaptability, cognitive abilities, and other predictors for children's reactions to surgery

Study Objective: To examine the relationship between social adaptability, cognitive abilities, and other personality characteristics to perioperative anxiety. Study Design: Prospective cohort investigation. Patients: 60 children ASA physical status I and II, age 3 and 10 years. Setting: Tertiary care children's hospital. Measurements: Temperament (EASI), cognitive abilities (KABC), and adaptive behavior (Vineland) were evaluated in a group of children undergoing surgery. Parental coping style (MBBS) and parental state (STAI-S) and trait (STAI-T) anxiety were assessed as well. On the day of surgery, anxiety of the child was measured at the preoperative holding area and during induction of anesthesia (m-YPAS). Main Results: Univariate correlational analysis demonstrated that young age (r = -0.27), poor social adaptability (Vineland) (r = -0.38), shy and inhibited personality (EASI; temperament) (r = -0.33), higher intelligence (KABC) (r = 0.29), increased parental anxiety (r = 0.44), and parental high-monitoring coping style (r = -0.25) are all associated with higher levels of perioperative anxiety. Stepwise multivariate regression analysis has demonstrated that controlling for the variables above, parental anxiety (p = 0.004), child's social adaptive capabilities (p = 0.04), and child's temperament (sociability) (p = 0. 04) are independent predictors for increased perioperative anxiety (R-2 = 0.38, F= 5.5 p = 0.003). Conclusions: Anesthesiologists need to pay close attention to the families of pediatric surgical children who are socially maladjusted, shy and inhibited, and have anxious parents. (C) 2000 by Elsevier Science Inc.