Psihološka priprava kot dejavnik zmanjševanja predoperativne anksioznosti pri pediatričnih pacientih
narativni pregled literature
DOI:
https://doi.org/10.14528/snr.2026.60.Suppl.1.3331Ključne besede:
operativni poseg, strah, otroci; psihična priprava, operacijaPovzetek
Uvod: Psihološka priprava otroka pred operativnim posegom pomembno zmanjšuje predoperativno anksioznost. Pristop mora biti prilagojen individualnim značilnostim otroka. Namen pregleda literature je raziskati pomen ustrezne psihološke priprave otroka na operativni poseg v splošni anesteziji ter njen vpliv na zmanjševanje predoperativne anksioznosti pri otrocih.
Metode: Izveden je bil narativni pregled literature v bazah PubMed, CINAHL Ultimate in ScienceDirect ter v iskalniku COBISS. Uporabljeni so bili iskalni niz v angleščini in ključne besede v slovenščini. Z iskanjem je bilo pridobljenih 113 zadetkov, od katerih je bilo v končno analizo vključenih sedem randomiziranih kontroliranih raziskav.
Rezultati: V šestih raziskavah so nefarmakološki pristopi (slikanice, virtualna resničnost, igre na pametnih telefonih, prevoz z otroškim avtomobilom, informativne brošure) statistično značilno zmanjšali predoperativno anksioznost in/ali izboljšali kooperativnost pri indukciji anestezije, medtem ko ena intervencija s tabličnim računalnikom ni dosegla statistične značilnosti. V eni raziskavi je bila psihološka priprava enako učinkovita kot peroralni midazolam, virtualna resničnost pa je učinkovito preprečila povečanje anksioznosti med indukcijo anestezije; ugotovljeno je bilo tudi zmanjšanje anksioznosti staršev.
Diskusija in zaključek: Enotne smernice za najprimernejši pristop še niso oblikovane, zato je ključnega pomena prilagajanje individualnim potrebam otroka. Učinkoviti ukrepi vključujejo izobraževalne in vedenjske intervencije, tehnike odvračanja pozornosti, prisotnost staršev ter ustrezno komunikacijo zdravstvenega osebja, ki pomembno zmanjšujejo predoperativno anksioznost.
Prenosi
Literatura
Hedén, L., von Essen, L., & Ljungman, G. (2016). The relationship between fear and pain levels during needle procedures in children from the parents’ perspective. European Journal of Pain, 20(2), 223–230. https://doi.org/10.1002/ejp.711 PMid:25845466
Jung, M. J., Libaw, J. S., Ma, K., Whitlock, E. L., Feiner, J. R., & Sinskey, J. L. (2021). Pediatric distraction on induction of anesthesia with virtual reality and perioperative anxiolysis: A randomized controlled trial. Anesthesia & Analgesia, 132(3), 798–806. https://doi.org/10.1213/ANE.0000000000005004 PMid:32618627; PMCid:PMC9387568
Kassai, B., Rabilloud, M., Dantony, E., Grousson, S., Revol, O., Malik, S., Ginhoux, T., Touil, N., Chassard, D., & Pereira de Souza Neto, E. (2016). Introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety in children. British Journal of Anaesthesia, 117(1), 95–102. https://doi.org/10.1093/bja/aew154 PMid:27317708; PMCid:PMC4913405
Kleye, I., Sundler, A. J., Karlsson, K., Darcy, L., & Hedén, L. (2023). Positive effects of a child-centered intervention on children’s fear and pain during needle procedures. Paediatric and Neonatal Pain, 5(1), 23–30. https://doi.org/10.1002/pne2.12095 PMid:36911787; PMCid:PMC9997124
Lestari, A. W., Lee, C.-K., & Hayati, H. (2023). The impact of parental psychological distress on child behavior issues in hospitalized children. Pediatric Medicine and Surgery, 45(1), Article 311. https://doi.org/10.4081/pmc.2023.311 PMid:37306607
Li, H., Chiu, P. L., Efendi, D., Huang, H., Ko, K. Y., & Wong, C. L. (2025). Effects of virtual reality–based interventions on preoperative anxiety in patients undergoing elective surgery with anesthesia: Systematic review and meta-analysis. Journal of Medical Internet Research, 27, Article e55291. https://doi.org/10.2196/55291 PMid:40305092; PMCid:PMC12079079
Liu, P. P., Sun, Y., Wu, C., Xu, W. H., Zhang, R. D., Zheng, J. J., Huang, Y., Chen, Y. Q., Zhang, M. Z., & Wu, J. Z. (2018). The effectiveness of transport in a toy car for reducing preoperative anxiety in preschool children: A randomised controlled prospective trial. British Journal of Anaesthesia, 121(2), 438–444. https://doi.org/10.1016/j.bja.2018.02.067 PMid:30032883
Luo, Z., Zhou, R., Nong, K., Peng, X., Chen, L., Li, P., Deng, S., Ou, M., Hao, X., Ye, L., Wang, Y., Chen, G., Li, S., & Zhu, T. (2025). Digital health interventions in pediatric perioperative care: A network meta-analysis. JAMA Pediatrics, 179(11), 1153–1161. https://doi.org/10.1001/jamapediatrics.2025.3099 PMCid:PMC12439185
Manyande, A., Cyna, A. M., Yip, P., Chooi, C., & Middleton, P. (2015). Non-pharmacological interventions for assisting the induction of anaesthesia in children. Cochrane Database of Systematic Reviews, 2015(7), Article CD006447. https://doi.org/10.1002/14651858.CD006447.pub3 PMid:26171895; PMCid:PMC8935979
Meletti, D. P., Meletti, J. F. A., Camargo, R. P. S., Silva, L. M., & Módolo, N. S. P. (2019). Psychological preparation reduces preoperative anxiety in children: Randomized and double-blind trial. Jornal de Pediatria, 95(5), 545–551. https://doi.org/10.1016/j.jped.2018.05.009 PMid:31340899
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Novak Jankovič, V. (2019). Anestezija starostnika. https://www.ukc-mb.si/media/files/uploads/zborniki/ZBORNIK_4.modul_2019.pdf
Oak, S., Dave, N., Garasia, M., & Parelkar, S. (2015). Surgical checklist application and its impact on patient safety in pediatric surgery. Journal of Postgraduate Medicine, 61(2), 92–94. https://doi.org/10.4103/0022-3859.150450 PMid:25766340; PMCid:PMC4943428
Oktaviani, J. R., Widjaja, V., Singgih, N. A., & Secodiningrat, R. H. P. S. (2024). Audiovisual technology intervention for reducing preoperative anxiety in children undergoing general anesthesia: A systematic review and meta-analysis. Journal of Education and Health Promotion, 13(1), Article 222. https://doi.org/10.4103/jehp.jehp_1344_23 PMid:39297100 PMCID:PMC11410179
Osei Appiah, E., Appiah, S., Kontoh, S., Mensah, S., Baffour Awuah, D., Menlah, A., & Baidoo, M. (2022). Pediatric nurse-patient communication practices at Pentecost Hospital, Madina: A qualitative study. International Journal of Nursing Sciences, 9(4), 481–489. https://doi.org/10.1016/j.ijnss.2022.09.009 PMid:36285089; PMCid:PMC9587402
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Ryu, J.-H., Park, J.-W., Nahm, F. S., Jeon, Y.-T., Oh, A.-Y., Lee, H. J., Kim, J.-H., & Han, S.-H. (2018). The effect of gamification through a virtual reality on preoperative anxiety in pediatric patients undergoing general anesthesia: A prospective, randomized, and controlled trial. Journal of Clinical Medicine, 7(9), Article 284. https://doi.org/10.3390/jcm7090284 PMid:30227602
Santapuram, P., Stone, A. L., Walden, R. L., & Alexander, L. (2021). Interventions for parental anxiety in preparation for pediatric surgery: A narrative review. Children, 8(11), Article 1069. https://doi.org/10.3390/children8111069 PMid:34828782; PMCid:PMC8623601
Sellers, C., & Woodman, N. (2023). Inhalational induction in paediatric anaesthesia. BJA Education, 23(1), 32–38. https://doi.org/10.1016/j.bjae.2022.10.002 PMid:36601023; PMCid:PMC9805937
Seyedhejazi, M., Sharabiani, B. A., Davari, A., & Taghizadieh, N. (2020). A comparison of preoperative psychological preparation with midazolam premedication to reduce anxiety in children undergoing adenotonsillectomy. African Journal of Paediatric Surgery, 17(1), 10–14. https://doi.org/10.4103/ajps.AJPS_62_17 PMid:33106446; PMCid:PMC7818662
Suleiman-Martos, N., García-Lara, R. A., Membrive-Jiménez, M. J., Pradas-Hernández, L., Romero-Béjar, J. L., Dominguez-Vías, G., & Gómez-Urquiza, J. L. (2022). Effect of a game-based intervention on preoperative pain and anxiety in children: A systematic review and meta-analysis. Journal of Clinical Nursing, 31(23/24), 3350–3367. https://doi.org/10.1111/jocn.16227 PMid:35075716; PMCid:PMC9787560
Vagnoli, L., Bettini, A., Amore, E., De Masi, S., & Messeri, A. (2019). Relaxation-guided imagery reduces perioperative anxiety and pain in children: A randomized study. European Journal of Pediatrics, 178(6), 913–921. https://doi.org/10.1007/s00431-019-03376-x PMid:30944985
Vakili, R., Feizi, R., Salimi, Y., Mottahedi, M., & Rizevandi, P. (2025). Play dough or balloon blowing: A clinical trial comparing creative interventions for reducing preoperative anxiety in children aged 4–8 years. BMC Pediatrics, 25(1), Article 384. https://doi.org/10.1186/s12887-025-05718-1 PMid:40375092; PMCid:PMC12080033
Vičič, M. (2022). Predoperativna priprava otroka. In M. Senica Verbič (Ed.), Osnove otroške kirurgije: zbornik predavanj. Maribor, 26. maj 2022 (pp. 9–22). Univerzitetni klinični center Maribor.
Yang, C.-Q., Yu, K.-H., Huang, R.-R., Qu, S.-S., Zhang, J.-M., & Li, Y.-L. (2022a). Comparison of different sedatives in children before general anaesthesia for selective surgery: A network meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 47(10), 1495–1505. https://doi.org/10.1111/jcpt.13763 PMid:36029118
Yang, Y., Li, L., Wang, Y., Zhang, Y., & Liu, X. (2022b). Effects of advance exposure to an animated surgery-related picture book on preoperative anxiety and anesthesia induction in preschool children: A randomized controlled trial. BMC Pediatrics, 22(1), 1–8. https://doi.org/10.1186/s12887-022-03123-4 PMid:35164741; PMCid:PMC8843029
Yucedağ, F., Sezgin, A., Bilge, A., & Başaran, B. (2024). The effect on perioperative anxiety and emergence delirium of the child or parent’s preference for parental accompaniment during anesthesia induction in children undergoing adenotonsillectomy surgery. Paediatric Anaesthesia, 34(8), 792–799. https://doi.org/10.1111/pan.14912 PMid:28240692
Prenosi
Objavljeno
Kako citirati
Številka
Rubrike
Licenca
Avtorske pravice (c) 2026 Obzornik zdravstvene nege
To delo je licencirano pod Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 mednarodno licenco.
Na Obzornik zdravstvene nege, Ob železnici 30A, 1000 Ljubljana, prenašam naslednje materialne avtorske pravice: pravico reproduciranja v neomejeni količini, in sicer v vseh poznanih oblikah reproduciranja, kar obsega tudi pravico shranitve in reproduciranja v kakršnikoli elektronski obliki (23. čl. Zakona o avtorski in sorodnih pravicah – v nadaljevanju ZASP); pravico distribuiranja (24. čl. ZASP); pravico dajanja na voljo javnosti vključno z dajanjem na voljo javnosti prek svetovnega spleta oz. računalniške mreže (32.a čl. ZASP); pravico predelave, zlasti za namen prevoda (33. čl. ZASP). Prenos pravic velja za članek v celoti (vključno s slikami, razpredelnicami in morebitnimi prilogami). Prenos je izključen ter prostorsko in časovno neomejen.
