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Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis

IMPORTANCE: Preoperative anxiety is associated with poor behavioral adherence during anesthetic induction and adverse postoperative outcomes. Research suggests that temperament can affect preoperative anxiety and influence its short- and long-term effects, but these associations have not been system...

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Autores principales: Chow, Cheryl H. T., Rizwan, Ayesha, Xu, Richard, Poulin, Lauren, Bhardwaj, Varun, Van Lieshout, Ryan J., Buckley, Norman, Schmidt, Louis A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563582/
https://www.ncbi.nlm.nih.gov/pubmed/31173131
http://dx.doi.org/10.1001/jamanetworkopen.2019.5614
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author Chow, Cheryl H. T.
Rizwan, Ayesha
Xu, Richard
Poulin, Lauren
Bhardwaj, Varun
Van Lieshout, Ryan J.
Buckley, Norman
Schmidt, Louis A.
author_facet Chow, Cheryl H. T.
Rizwan, Ayesha
Xu, Richard
Poulin, Lauren
Bhardwaj, Varun
Van Lieshout, Ryan J.
Buckley, Norman
Schmidt, Louis A.
author_sort Chow, Cheryl H. T.
collection PubMed
description IMPORTANCE: Preoperative anxiety is associated with poor behavioral adherence during anesthetic induction and adverse postoperative outcomes. Research suggests that temperament can affect preoperative anxiety and influence its short- and long-term effects, but these associations have not been systematically examined. OBJECTIVE: To examine the associations of temperament with preoperative anxiety in young patients undergoing surgery. DATA SOURCES: Studies from MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched from database inception to June 2018. STUDY SELECTION: All prospective studies reporting associations of temperament with preoperative anxiety were included. Overall, 43 of 5451 identified studies met selection criteria. DATA EXTRACTION AND SYNTHESIS: Using the PRISMA guidelines, reviewers independently read 43 full-text articles, extracted data on eligible studies, and assessed the quality of each study. Data were pooled using the Lipsey and Wilson random-effects model. MAIN OUTCOMES AND MEASURES: Primary outcome was the association of temperament with preoperative anxiety in patients undergoing surgery. RESULTS: A total of 23 studies, with 4527 participants aged 1 to 18 years, were included in this review. Meta-analysis of 12 studies including 1064 participants revealed that emotionality (r = 0.11; 95% CI, 0.04 to 0.19), intensity of reaction (r = 0.29; 95% CI, 0.11 to 0.46), and withdrawal (r = 0.40; 95% CI, 0.23 to 0.55) were positively associated with preoperative anxiety, whereas activity level (r = −0.23; 95% CI, −0.31 to −0.16) was negatively correlated with preoperative anxiety. Impulsivity was not significantly associated with preoperative anxiety. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provided evidence suggesting that temperament may help identify pediatric patients at risk of preoperative anxiety and guide the design of prevention and intervention strategies. Future studies should continue to explore temperament and other factors influencing preoperative anxiety and their transactional effects to guide the development of precision treatment approaches and to optimize perioperative care.
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spelling pubmed-65635822019-06-28 Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis Chow, Cheryl H. T. Rizwan, Ayesha Xu, Richard Poulin, Lauren Bhardwaj, Varun Van Lieshout, Ryan J. Buckley, Norman Schmidt, Louis A. JAMA Netw Open Original Investigation IMPORTANCE: Preoperative anxiety is associated with poor behavioral adherence during anesthetic induction and adverse postoperative outcomes. Research suggests that temperament can affect preoperative anxiety and influence its short- and long-term effects, but these associations have not been systematically examined. OBJECTIVE: To examine the associations of temperament with preoperative anxiety in young patients undergoing surgery. DATA SOURCES: Studies from MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched from database inception to June 2018. STUDY SELECTION: All prospective studies reporting associations of temperament with preoperative anxiety were included. Overall, 43 of 5451 identified studies met selection criteria. DATA EXTRACTION AND SYNTHESIS: Using the PRISMA guidelines, reviewers independently read 43 full-text articles, extracted data on eligible studies, and assessed the quality of each study. Data were pooled using the Lipsey and Wilson random-effects model. MAIN OUTCOMES AND MEASURES: Primary outcome was the association of temperament with preoperative anxiety in patients undergoing surgery. RESULTS: A total of 23 studies, with 4527 participants aged 1 to 18 years, were included in this review. Meta-analysis of 12 studies including 1064 participants revealed that emotionality (r = 0.11; 95% CI, 0.04 to 0.19), intensity of reaction (r = 0.29; 95% CI, 0.11 to 0.46), and withdrawal (r = 0.40; 95% CI, 0.23 to 0.55) were positively associated with preoperative anxiety, whereas activity level (r = −0.23; 95% CI, −0.31 to −0.16) was negatively correlated with preoperative anxiety. Impulsivity was not significantly associated with preoperative anxiety. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provided evidence suggesting that temperament may help identify pediatric patients at risk of preoperative anxiety and guide the design of prevention and intervention strategies. Future studies should continue to explore temperament and other factors influencing preoperative anxiety and their transactional effects to guide the development of precision treatment approaches and to optimize perioperative care. American Medical Association 2019-06-07 /pmc/articles/PMC6563582/ /pubmed/31173131 http://dx.doi.org/10.1001/jamanetworkopen.2019.5614 Text en Copyright 2019 Chow CHT et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Chow, Cheryl H. T.
Rizwan, Ayesha
Xu, Richard
Poulin, Lauren
Bhardwaj, Varun
Van Lieshout, Ryan J.
Buckley, Norman
Schmidt, Louis A.
Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title_full Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title_fullStr Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title_full_unstemmed Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title_short Association of Temperament With Preoperative Anxiety in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis
title_sort association of temperament with preoperative anxiety in pediatric patients undergoing surgery: a systematic review and meta-analysis
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563582/
https://www.ncbi.nlm.nih.gov/pubmed/31173131
http://dx.doi.org/10.1001/jamanetworkopen.2019.5614
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