Parental anxiety in pediatric day surgery: Identifying high-risk families for targeted preoperative support

Abstract

Aim Preoperative parental anxiety is an important yet often overlooked factor that may adversely affect perioperative outcomes and compromise the quality of informed consent. This study aimed to evaluate parental anxiety levels in pediatric day surgery patients using the validated Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI). Methods This prospective cross-sectional study enrolled parents of children undergoing elective day surgery at a tertiary pediatric surgery center over a six-month period. Parents completed APAIS and STAI questionnaires preoperatively. Demographic data, surgical details, and past medical/surgical history were recorded. Multivariate logistic regression analysis was performed to identify independent predictors of anxiety. Results A total of 125 parents were included. According to APAIS scores, 80.8 % were classified as anxious. Mean STAI-Y1 and STAI-Y2 scores were 41.4 and 46.2, respectively, and were positively correlated. In univariate analysis, parents of children undergoing circumcision reported significantly lower APAIS scores compared with those undergoing other elective day surgeries (mean 14.8 vs 17, p = 0.033); mothers also reported significantly higher APAIS scores than fathers (16.9 vs 13.5, p = 0.001), and younger parental age (p = 0.035) and younger child age (r = −0.18, p = 0.044) were associated with higher anxiety. In multivariate analysis, no demographic variable remained independently significant after adjustment for confounders. Conclusion Preoperative parental anxiety is highly prevalent in pediatric day surgery, affecting over 80 % of families and is influenced by both the type of procedure and demographic factors. In univariate analysis, mothers, parents of children undergoing non-circumcision procedures, younger parents, and parents of younger children demonstrated higher procedure-specific anxiety. Although no variable remained independently significant in multivariate analysis, these univariate risk markers provide actionable screening criteria. These findings support routine anxiety screening using brief validated instruments such as APAIS, combined with targeted preoperative support for identified high-risk families to optimize family-centered surgical care.