Reduction of anxiety in children facing hospitalization and surgery by use of filmed modeling.

Abstract

Sixty children about to undergo elective surgery for hernias, tonsillectomies, or urinary-genit al tract difficulties were shown on hospital admission either a relevant peer modeling film of a child being hospitalized and receiving surgery or an unrelated control film. Both groups received extensive preparation by the hospital staff. State measures of anxiety, including self-report, behavioral observation, and Palmar Sweat Index, revealed a significant reduction of preoperative (night before) and postoperative (3-4 week postsurgery examination) fear arousal in the experimental as compared to the control film group. The parents reported a significant posthospital increment in the frequency of behavior problems in the children who had not seen the modeling film. Trait measures of anxiety did not reflect the group differences due to the hospital experience. The literature on hospitalized children suggests that there is a consensus that all children need some kind of psychological preparation for the hospital experience, particularly when accompanied by surgery. The need for such preparation is predicted on the belief that hospitalization and surgery are stressful and anxiety-producing experiences that can lead to transient or long-term psychological disturbances in most children. A number of behavior problems have been observed in children who have been hospitalized for surgery (Chapman, Loeb, & Gibbons, 19S6; Gellert, 19S8) with estimates for the incidence of these problems ranging from 10% to 35% (Jessner, Blom, & Waldfogel, 1952; Prugh, Staub, Sands, Kirschbaum, & Lenihan, 1953; Schaffer & Callender, 1959). Cassell (1965) reported slight psychological upset in as many as 92% of the hospitalized children studied.