The Effects of Preoperative Nursing Instruction on tile Physical and Emotional Recovery of Pediatric Surgical Patients - An Experimental Study-

소아의 수술전 환자교육이 신체 및 정서에 미치는 영향

Very few studies regarding the effects of preoperative nursing intervention on children's welfare after surgery have been conducted. The purpose of this study was 1) to evaluate the effects of preoperative nursing instructions on children's physical recovery and emotional state after surgery and 2) to analyse the relationship between the effects of preoperative nursing instructions and the age and general anxiety of child. The study was conducted flow: August 15th to October 30th at Severance Hospital, Seoul, Korea. A total of 41 Pediatric surgical Patients, between the age of 4 to 14, participated in the study. Twenty patients, randomly selected, were visited by the experimenter in the evening before, surgery and received specific preoperative nursing instructions. These instructions were designed to alleviate emotional stress and were adopted to the age of child. The postoperative recovery of these patients were then compared with a randomly selected control group of 21 patients who received only the routine preoperative care by the staff in the hospital Dependent variable were vomiting, pain medication, ability to void, elevation of temperature, infection, the between surgery and hospital discharge and postoperative emotional stress which was measured by the vital signs. Because of the limitation of the sample size it was difficult to obtain valid statistical results. However, the analysis of the raw data indicates that: 1) the preoperative nursing instructions appears to promote physical recovery and it seems especially effective in preventing elevation of temperature and shortening the length of the hospital stay, 2) the preoperative nursing instruction also seems to be effective in relieving the child's emotional stress(situational anxiety) after surgery, 3) the patient's general anxiety level preparatively seems to be a predictor of postoperative problems, 4) the preoperative nursing instructions were an effective means of promoting physical recovery in every age group as long as the child understood the instructions. The above data would seem to indicate that all preoperative pediatric patients four years of age or older, if they can understand, should have preoperative nursing instruction in order to alleviate postoperative stress and enhance physical recovery. The level of general anxiety preparatively deserves special attention since the amount of nursing instruction needed seems to vary with tile level of anxiety.