Berghmans Johan M, Poley Marten J, van der Ende Jan, Weber Frank, Van de Velde Marc, Adriaenssens Peter, Himpe Dirk, Verhulst Frank C, Utens Elisabeth
Department of Anesthesia, ZNA Middelheim, Queen Paola Children's Hospital, Antwerp, Belgium.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Paediatr Anaesth. 2017 Sep;27(9):955-961. doi: 10.1111/pan.13206. Epub 2017 Jul 14.
The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time-consuming. A Visual Analog Scale, in contrast, requires no training, is easy-to-use and quickly completed.
The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut-offs to distinguish between anxious and nonanxious children.
Four hundred and one children (1.5-16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State-Trait Anxiety Inventory); (iii) cross-informant agreement using Bland-Altman analysis; (iv) cut-offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30).
Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high-anxious parents were higher than those of low-anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (-56.1 to 63.3). To classify anxious children, cut-offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established.
The present data provide preliminary data for the validity of a Visual Analog Scale to assess children's anxiety during induction.
改良耶鲁术前焦虑量表被广泛用于评估儿童在麻醉诱导期间的焦虑情况，但该量表需要培训且使用耗时。相比之下，视觉模拟量表无需培训，易于使用且能快速完成。
本研究旨在评估视觉模拟量表作为评估麻醉诱导期间焦虑的工具，并确定区分焦虑和非焦虑儿童的临界值。
纳入401名计划进行日间手术的儿童（1.5 - 16岁）。父母和麻醉医生使用视觉模拟量表对儿童诱导期间的焦虑进行评分，一名经过培训的观察者使用改良耶鲁术前焦虑量表进行评分。评估的心理测量学特性包括：（i）同时效度（父母和麻醉医生的视觉模拟量表与改良耶鲁术前焦虑量表得分之间的相关性）；（ii）结构效度（根据儿童年龄和父母焦虑情况（通过状态 - 特质焦虑量表评估）对亚组之间的差异）；（iii）使用布兰德 - 奥特曼分析的不同信息提供者之间的一致性；（iv）区分焦虑和非焦虑儿童的临界值（参考：改良耶鲁术前焦虑量表≥30）。
父母和麻醉医生的视觉模拟量表与改良耶鲁术前焦虑量表得分之间的相关性很强（分别为0.68和0.73）。与6岁及以上儿童相比，5岁及以下儿童的视觉模拟量表得分更高。高焦虑父母的孩子的视觉模拟量表得分高于低焦虑父母的孩子。父母和麻醉医生的视觉模拟量表得分的平均差异为3.6，一致性界限为95%（-56.1至63.3）。为了对焦虑儿童进行分类，确定了父母（≥37毫米）和麻醉医生（≥30毫米）的临界值。
目前的数据为视觉模拟量表评估儿童诱导期间焦虑的有效性提供了初步数据。
