Qian Bi, Jinmei Ma, Xixia Liu, Haotian Fang, Miaomiao Xu, Yue Li, Kun Zhang
The WeChat-based preoperative program functioned as a practical screening and triage adjunct. Families characterized by high question frequency, older children, and major surgery were more likely to have higher anxiety scores and to report a need for targeted in-person consultation. These findings support a stratified approach to preoperative preparation and resource allocation.
PURPOSE: Preoperative anxiety is a common challenge in pediatric surgery. WeChat-based preoperative education offers a scalable solution, but a one-size-fits-all digital approach may not adequately meet the needs of all families. This study aimed to identify the characteristics of children and parents who still reported a need for an in-person preoperative consultation after completion of a standard WeChat-based program and to determine the independent factors associated with higher anxiety scores.
DESIGN: A cross-sectional, post-intervention observational study.
METHODS: The study involved 300 child-parent dyads from a tertiary pediatric hospital in China (October to December 2024). After the initial surgical consultation and confirmation of elective surgery, families were introduced to a standardized preoperative education program via a WeChat official account, typically at admission on the day before surgery. The platform included online communication, 3D operating room tours, educational videos, deep-sleep music, and interactive games. Child anxiety was assessed using the Chinese version of the Modified Yale Preoperative Anxiety Scale, and parental anxiety was evaluated using the Zung Self-rating Anxiety Scale. Univariate analyses and multiple linear regression were used to identify factors associated with anxiety scores.
FINDINGS: Among 293 participants (97.67% response rate), multivariate analysis revealed that for children, older age (7-12 years, B = 3.744, P = .001) and higher surgical grade (III/IV vs II, B = 10.343/14.311, P < .001) were associated with higher anxiety scores. For parents, asking greater than three questions on the platform (B = 3.775, P < .001) and expressing a higher perceived need for in-person consultation (B = 7.889/15.866, P < .001) were associated with higher anxiety scores, whereas the child's surgical grade was not retained in the final model. Parental anxiety scores increased progressively across consultation-demand levels (48.34 ± 4.19-67.62 ± 3.93, P < .001).
CONCLUSIONS: The WeChat-based preoperative program functioned as a practical screening and triage adjunct. Families characterized by high question frequency, older children, and major surgery were more likely to have higher anxiety scores and to report a need for targeted in-person consultation. These findings support a stratified approach to preoperative preparation and resource allocation.