Parental Anxiety and Preoperative Anxiety in Children: A Dose-Response Association in the Perioperative Setting.

PURPOSE: This study aimed to examine the association between parental anxiety and preoperative anxiety in children and to clarify the role of parental anxiety in perioperative risk assessment.

DESIGN

This was a single-center cross-sectional observational study based on standardized postoperative telephone interviews with parents or legal guardians.

METHODS

Eligible children who underwent ophthalmologic or otolaryngologic surgery under general anesthesia between July and September 2025 and their parents or legal guardians were included. During standardized postoperative telephone interviews, parents or legal guardians rated their own anxiety and the child's anxiety during the preoperative waiting and preparation phase using a numeric rating scale (0-10). Child cooperation, perioperative supportive measures, and parental satisfaction were also recorded. Multivariable logistic regression and receiver operating characteristic analyses were used to examine the association between parental anxiety levels and child preoperative anxiety.

FINDINGS: Higher parental anxiety was independently associated with an increased likelihood of preoperative anxiety in children, demonstrating a clear dose-response relationship. Compared with minimal parental anxiety, moderate (score 4-6) and severe anxiety (score ≥7) were associated with progressively higher odds of child anxiety. Incorporation of parental anxiety into multivariable models improved discrimination for identifying children with preoperative anxiety. Children with higher anxiety were more likely to receive supportive preoperative care measures.

CONCLUSIONS

Parental anxiety is a practical and easily assessable correlate of preoperative anxiety in children. Incorporating parental anxiety assessment into routine perioperative nursing workflows may support early risk identification and facilitate targeted, family-centered nursing interventions.