Child Life Intervention to Decrease Anxiety in Patients and Caregivers for Outpatient Surgical Intervention

This is a prospective, interventional study with two groups of patients scheduled for
outpatient surgery at Ann and Robert H. Lurie Children's Hospital of Chicago. Participants
eligible for enrollment will be identified and screened upon diagnosis and/or at the time of
referral for surgery until patient enrollment is completed. Based on a power analysis, using
average scores and norms for the validated tool with a projected difference of four points
difference between groups, minimum enrollment is 22 per group, 44 patients total to detect a
statistically significant difference based on established parameters.

Potential participants will be identified in the outpatient clinic setting once a physician
and family has agreed to pursue surgical invention. The research team will consent either
during clinical evaluation or following surgical consent obtainment. All questions will be
answered prior to obtaining signed study consent. Once consent is received, Child Life will
be paged to observe the patient and caregiver along with the physician provider in order to
observe and assess behavior required to complete the PRAP assessment form. Additionally, the
patient and parent/guardian will be asked to complete the STAI-CH and STAI-AD assessments as
appropriate per age. After the completion of the assessments the patient and family will be
randomly assigned to intervention or control group. Only the Child Life Specialist and
research staff facilitating the intervention will be unblinded as to which patients are in
which group, which is necessary for conducting the study. All other study staff will remain
blinded. For patients randomized to the intervention group, the Child Life specialist will
reach out via telephone to offer support and expertise in helping prepare their child and
themselves for outpatient surgery to help decrease anxiety and increase coping. Concepts
covered will include: developmentally appropriate language for explaining surgery and related
procedures, potential coping skills to ease separation for caregivers and pediatric patients.
Additionally, written materials (attached) covering the same information will be sent via
mail or email covering the same information discussed in the phone conversation to serve as a
refresher and resource before the day of surgery. On the day of surgery, the patient will
receive standard of care (SOC) Child Life Services available to all patients. Patients
randomized to the control group will not receive the preoperative phone call or written
materials and will only receive SOC Child Life services on the day of surgery.

After the surgical induction or day of the procedure, the Child Life Specialist will complete
the PRAP and document in EPIC per SOC procedures. The Child Life Specialist will also attend
the postoperative and complete the third PRAP based on feedback from the patient,
family/caregiver and providing surgeon. At this postoperative time the patient and
parent/guardian will be asked to complete the STAI-CH and STAI-AD assessments as appropriate
per age for the second time. Once data is collected, analysis will compare PRAP, STAI-CH, and
STAI-AD scores between groups at all three points on the timeline. Information gained may be
used to help direct and develop interventions to help decrease patient and family anxiety and
increase coping related to surgical intervention

Inclusion Criteria:

- Participants will be patients ages 6 - 17 and their families/caregivers that are
scheduled for outpatient surgical intervention in the division of pediatric surgery of
Ann and Robert H. Lurie Children's Hospital of Chicago. Patients receiving low acute,
lower risk procedures will be enrolled

Exclusion Criteria:

- Patients who may turn 18 during the course of the study will not be eligible for
enrollment and will be excluded.