PAEDIATRIC PRESURGICAL EDUCATION PROGRAM
IMPROVES KNOWLEDGE OF SURGICAL EVENTS AND OUTCOMES L Holzheimer, L Winkl*, F Henshelwood
and R Justo The Queensland Centre of Congenital Heart
Disease (QCCHD), The Prince Charles Hospital and the University of New England This study development and evaluated a
factual preparatory education program for young children undergoing surgery for
congenital heart abnormalities. Sarah's Story, a picture book explaining
the reasons for, and events associated with heart surgery was developed
following content analysis anf according to principles of health, developmental
and educational psychology. Thirty-six
children aged 3-12 years sequentially admitted to the QCCHD were allocated to
one of two groups to evaluate the program's effectiveness in increasing
knowledge of surgical events and outcomes, and cooperation, and decreasing
situational anxiety. On admission, Group 1 children (n=18, 55% male, mean age =
87 months) received the existing education program (photographic album with
oral narration). Group 2 children (n=18, 38%, mean age = 72 months) were read Sarah's
Story and viewed the photographic album. The Manifest Upset Scale,
Co-operation Scale, and Children's Self Report Anxiety Measure were
administered at critical points during hospitalisation (admission, education,
observations, blood test, ECG, pre-medication, return to ward and discharge) as
measures of situational anxiety and cooperation with procedures. The Children's
Heart Surgery Knowledge Test was administered on admission following education
and at discharge to determine changes in knowledge or surgical events and
outcomes. Mean knowledge scores for each group were similar at admissions
(p=0.08) and increased following education and at discharge. Analysis of changes
in knowledge between admission and discharge showed greater increases in
knowledge for Group 2 than Group 1 (p=0.008). While it was hypothesized that
knowledge increases would be associated with less anxiety and more cooperation
with events and procedures, no differences were found between the groups at
each critical period. It is concluded that young children can gain knowledge of
non-elective surgical events and outcomes via the use of well developed
educational resources in clinical settings. In the future, the book will be
distributed to children when the need for surgery is determined to allow for
greater comprehension of educational messages.
