Anxiety and stress in mothers and fathers in the 24 h after their child's surgery.

BACKGROUND AND OBJECTIVE: Surgery in a paediatric setting stresses children and their parents. Previous studies have focused on children and the preoperative period; however, the 24 h after child surgery are highly stressful for parents as their child is still physically recovering and physician-parent communication is vital. The aims of this study are to investigate the impact of three levels of severity of paediatric surgery on mothers' and fathers' anxiety and stress and to identify factors that contribute to parental anxiety and acute stress symptoms in the first 24 h after child surgery. PATIENTS AND METHODS: A total of 154 parents (91 mothers, 63 fathers) of children who had just undergone elective surgery for a major intervention (n = 41), minor intervention (n = 64) or day surgery (n = 49) completed questionnaires aimed at assessing levels of state anxiety and acute stress symptoms. Social network, socio-economic status and parental health locus of control were evaluated as contributors. RESULTS: Parents reported high levels of state anxiety (26% had scores on the state scale 2 standard deviations above the norm) and acute stress symptoms (28% in at least one of the four acute stress disorder symptom categories). Child's type of surgery is related to parental anxiety [F(2,134) = 38.12, P = 0.0001, eta(2) = 0.175] and acute stress symptoms [F(2,133) = 31.21, P = 0.0001, eta(2) = 0.133]. Parental state anxiety was predicted by parent's gender, trait anxiety and health external locus of control. Parent's number of acute stress symptoms was predicted by parental trait anxiety, health external locus of control, parent's level of education and the number of social contacts. CONCLUSIONS: There is a need to take into consideration parental anxiety and distress in the 24 h after child surgery. Parental well-being is related to several characteristics including the severity of child surgery; these aspects should be taken into consideration when interacting with parents in the aftermath of their child's surgery.

Attention and reaction to distress in infancy: a longitudinal study.

The primary aim of this study was to verify whether early individual differences in look duration are related to general mechanisms of the infant nervous system that draw together attention and emotion. Thirty-one infants were observed at 3, 5, and 11 months of age. Facial expressions of pain and distress were observed by means of C. Izard's (1979) Maximally Discriminative Facial Movement Coding System 90 s after routine pediatric vaccinations. Several measures of visual attention were taken experimentally in a separate testing session. Significant correlations between measures of attention and duration of facial expressions of pain and distress were found at each age level. Infants who showed pain or distress for a shorter time period also paid attention for a shorter time period and vice versa. The main conclusion is that individual differences combining control of both pain and attention can be identified from early infancy.

Pain in infancy: individual differences.

Two patterns of reactions to painful medical procedures were found in infancy, i.e., continuous and interval patterns. Also, infants often in a good mood in everyday life (as reported by their mothers) showed pain more briefly after blood sampling, while infants often in a bad mood in everyday life showed pain longer.

Development of language in 18-30-month-old HIV-1-infected but not ill children.

Thirty-six children (age range, 18-30 months) born to HIV-1-infected mothers were studied for speech development by matching 18 infected with 18 non-infected subjects for age, sex and socioeconomic status. All the children were in good health. Each child was given three comprehension and three production tasks. In addition, each child's mean length of utterance (MLU) was obtained by observation of natural child-parent interactions. The development quotients (DQ) were assessed by Brunet-Lézine's tests. Infection significantly affected children's MLU, the infected children being less advanced than those non-infected. Both infected and non-infected children progressed in language acquisition from the second to the third year of age, but infected children had significantly greater production difficulty than non-infected children in the second year of life. The matched subjects design adopted gives some strength to the conclusion that HIV-1 infection impairs the genesis rather than the later development of language in infected but not ill children.

Effects of spatial arrangement on 4- and 6-yr.-old children's memory.

This research is an investigation of the effects of different spatial arrangements of the same items on 4- and 6-yr.-old children's memory. The items were arranged in one of three ways, put in a random order, grouped into categories, or displayed in a configuration reproducing a real-world scene. Each subject was asked both to recall the items verbally and to remember their spatial locations. The results show that only 6-yr.-olds' memory for locations is enhanced by meaningful arrangements of objects in space. It is suggested that there is a developmental gap between memory for "raw" spatial relationships ("locational" cognitive mapping) and memory for spatial relationships which also takes into account the meaning of these relations ("relational" cognitive mapping). Furthermore, for 6-yr.-olds clustering of recall is categorically organized in all conditions. For 4-yr.-olds such clustering appears to reproduce the spatial arrangement of items in a scene, while recall is categorically organized in both categorical and random conditions.