Title

A Study of Psychological Preparation for Pediatric Surgery (Symbolic Modeling, Anxiety, Treatment)

Date of Award

1985

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

James G. Hollandsworth

Advisor Department

Psychology

Abstract

The relative effectiveness of two types of videotape models developed to prepare pediatric patients for surgery and administered under two different conditions was investigated using a 2 x 3 design. Forty-two children undergoing their first surgical experience were randomly assigned to one of three groups. Two of the three groups involved having the child view a videotape model with a child narrator as compared to the same videotape narrated by an adult. The third group served as a no-treatment control. Within the two treatment groups, the subjects were randomly assigned to one of two conditions--viewing the model alone or viewing the model with his or her parent present. A battery of adjustment measures were administered to the children at three intervals--before viewing the videotape model, after viewing the model, and just prior to the operation. In addition, the nursing staff completed a set of measures related to post-surgical recovery. These measures were combined to generate a single recovery index. Parents also completed a pre- and post-hospitalization behavior checklist. The data were analyzed using a multiple linear regression technique with covariance set at p < .05. Results indicated that all four treatment groups became more anxious than the control group after viewing the videotape model as determined by the behavioral observation measure. All treatment groups, however, were significantly less anxious than the control group just prior to the operation as determined by self-report, behavioral and physiological (palmar sweat index) measures. Patients viewing the videotape model with their parents were significantly less anxious than patients viewing the model alone, according to the behavioral and self-report measures obtained prior to surgery. However, the palmar sweat index generated the opposite finding, with patients viewing the model alone demonstrating less of a response prior to surgery than those viewing the model with their parents. All treatment groups yielded significantly better recovery index scores than the control group. Again, differential effects based on screening conditions were noted. The treatment groups exhibited significantly fewer behavioral problems at home, post-surgery, than the control group.