Evaluar las características de la respuesta psicológica perioperatoria en niños sometidos a cirugía de corta estancia hospitalaria.
Pacientes y métodosSe analizan psicológicamente, antes y a los 7 días de la intervención, 100 niños de 6-14 años y sus familias, sometidos a cirugía electiva bajo anestesia general, en régimen de hospitalización de corta estancia. Evaluación preoperatoria del niño: STAIC, HFRS, EPQ-J, CDS y TAMAI, y de sus padres: FACES-III, SCRS y FILE. Evaluación postoperatoria del niño: STAIC y CDS. Agrupación de variables mediante análisis factorial: factor 1: estado clínico psicopatológico (CDS y STAIC-E); factor 2: personalidad (EPQ-J y STAIC-R) y capacidad de adaptación (TAMAI); factor 3: ansiedades y temores específicos (HFRS). Test de Student de muestras apareadas para la comparación variables clínicas.
ResultadosDe todos los pacientes (83 V/17 M), un 66% tenía 6-8 años de edad (X ± DE: 8,17 ± 2,10). En el varón, el diagnóstisco más frecuente fue fimosis y en la niña, la hernia inguinal. Presentaron ingresos hospitalarios previos 41 niños, 29 de ellos por cirugía. El análisis factorial de las variables explicó un 46,8% de la variancia. Existe disminución en STAIC-E y STAIC-R postoperatorios. Las niñas muestran mayor puntuación que los varones en el HFRS. Existe disminución en el STAIC-E en los niños con hospitalización previa. Los valores del FILE < 12 meses se correlacionan con elevaciones del STAIC-R.
ConclusionesLa cirugía de corta estancia hospitalaria provoca bajos niveles de ansiedad en niños, no observando valores del STAIC-R o STAIC-E sugestivos de alteraciones de ansiedad o neurosis. Las niñas presentan mayor ansiedad y temores específicos ante la cirugía. La hospitalización previa, con o sin cirugía, disminuye la ansiedad. Los conflictos familiares en el año anterior a la cirugía provocan mayor ansiedad y depresión en el niño.
To determine the psychological response in children undergoing short-stay ambulatory surgery.
Patients and methodsA prospective psychological analysis of 100 children, aged 6 to 14 years of age, who underwent general anesthesia, elective surgery and short-stay hospitalization. Children and their parents were analyzed before and 7 days after surgery. STAIC, HFRS, EPQ-J, CDS, and TAMAI were used in the preoperative evaluation of the children. FACES-III, SCRS, and FILE were used in the preoperative evaluation of their parents. Postoperative behavioral responses in children were evaluated at 7 days (STAIC and CDS questionnaires). Variables were studied by factorial analysis (varimax rotational). Factor 1: psychological responses (CDS, STAIC-E); factor 2: personality (EPQ-J and STAIC-R) and adaptability (TAMAI); factor 3: anxiety and hospital fears (HFRS). Student's paired t-test was used to compare clinical variables.
ResultsSixty-six percent of the children (83 males and 17 females) were aged 6 to 8 years (XX ± SD: 8.17 ± 2.10). The most frequent diagnosis in boys was phymosis and that in girls was inguinal hernia. Forty-one children had previously been hospitalized, of which 29 had undergone surgery. Factorial analysis of the variables explained 46.8% of variance. STAIC-E and STAIC-R scores significantly decreased in the postoperative period. Girls had higher HFRS scores than boys. STAIC-R scores were lower in previously hospitalized children. FILE values in the previous 12 months correlated with increased STAIC-R scores.
ConclusionsElective ambulatory surgery in children minimizes emotional disruption to the child. In this study no differences were observed in the STIC-R and STAIC-E scores before and after surgery. Girls had higher levels of anxiety and fear of surgery. Previously hospitalized children, with or without surgery, had lower anxiety levels. Family problems during the 12 months prior to surgery increased the children's anxiety and depression.
