Guest post by Claudia Thomas & Anne Schirrmeister
A large body of evidence indicates that dealing with pediatric patients’ anxiety
prior to surgical interventions is not optimal, and that this is true worldwide.
Literature shows that preoperative anxiety results in increased pain after surgery, a
higher incidence of postoperative delirium and longer hospital stays. In addition,
behavioral disorders like enuresis nocturna and separation anxiety as well as sleep
disorders and nightmares often occur.
Developing easy-to-use and standardized tools for reducing preoperative anxiety in
children could be an approach to address this problem. Using the ability of
imagination and magic thinking can help gain confidence. That’s why we developed
– in cooperation with the illustrator sandruschka – a comic for anesthesiological
patient education that is tailored to the needs of children between 3 and 12 years.
The comic strip’s setting looks like our hospital, its main character is a small
monkey called Manchu who accompanies the children during anesthesia and
In order to assess the effect of this intervention, we measure preoperative anxiety
by using the mYPAS-SF (modified Yale Preoperative Anxiety Score Short form) and
postoperative pain by using QUIPSi (Quality Improvement of Postoperative Pain
Management infant). First results indicate that children in the control group (i.e.
without comic) are not optimally prepared for coping with the challenges they have
to face in hospital. This shows that improvement concepts are needed. Our comic
is a first step in this direction. Results will be published once the study is finished
end of 2018.
Claudia Thomas & Anne Schirrmeister & Winfried Meißner (Physicians of the
Departement of Anesthesia and Intensive Care Medicine – University Friedrich-
Schiller-Jena, Germany – Sandra Bach (Sandruschka) – Illustator, Rebecca Rädel
(Student of Medicine –University Friedrich Schiller Jena, Germany), Antje
Göttermann (Pain Nurse, University Hospital, Jena, Germany), Claudia Weinmann
(Projectmanagement PAIN and QUIPS)