Perioperative Family-Centered Care: Effectiveness of Parental Presence during Induction of Anesthesia and Parental Visitation in the Post-Anesthesia Care Unit
Buell, Caesy L.
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Family-centered care is a health care model based on participation and collaboration of patients, families and health care providers. Family-centered care developed as an alternative to paternalistic medicine in response to the discovery of the damaging effects of mother-child separation anxiety in children during hospitalization. The perioperative environment is the area of medicine that deals with the medical care prior to, during and after surgical procedures. The perioperative period is a stressful experience during the hospitalization of a child and preoperative anxiety has been linked to both operative complications, such as turbulent anesthesia induction and postoperative complications, such as increased pain levels, increased anxiety levels and emergence delirium. Family-centered practices, such as parental presence during the induction of anesthesia (PPIA) and PACU (Post-Anesthesia Care Unit) visitation, have been developed in an attempt to decrease anxiety and its consequences in both the pediatric patient and their family. Current research has not concretely shown that either program reduces the anxiety levels of pediatric patients, although PPIA and PACU visitation both significantly increase parent's self-reported satisfaction with care and decrease self-reported anxiety levels. Family-centered perioperative preparation is needed in conjunction with PPIA and PACU visitation to develop family-centered programs that maximize anxiety management and satisfaction with care to the benefit of the child, family and medical institution.
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