[Emotional states of mothers and behavior of the child during minor surgery].
The objectives of this descriptive correlational study were to measure the degree of fear-anxiety in mothers and in their children who were having minor surgery, and then to verify if there was a relationship between these two variables. Other variables examined were: child's age, rooming-in, premedication and child's experience with surgery. Fifty (50) mothers described their emotional states both on the day before and during the surgery. Fifty (50) children between the ages of two (2) and ten (10) years old were observed at five different times (one hour preoperatively, leaving for the OR, pre-induction, coming back to the room and one hour post-operatively). Their behaviours were noted on a new scale, the ECEO: Echelle des comportement de l'enfant opéré. This scale was developed to describe the behaviour of children experiencing fear, anxiety and pain. Results show that the mother's fear-anxiety score was significantly higher during the surgery than before it (t df.49 = 3.77, p < 0.001). Rooming-in significantly affected mothers' emotional states (F = 4.07, p < 0.05). Younger children were more affected than older ones; they also showed more distress when the mother was present (t df.49 = 5.31, p < 0.001). Rooming-in contributed significantly to the child's stress score; children whose mother roomed-in at least one night showed more distress behaviours than children whose mothers did not room-in (t df.48 = 2.03, p < 0.05). A correlation was found between the degree of mothers' fear-anxiety and the children's fear-anxiety-pain score or distress behaviours (r = .28, p < 0.05). A strong relationship was established between the total distress score of the child and his or her score when the mother was present (r = .81, p < 0.01). These results support the theory of social referencing: the child is influenced greatly by the mother's emotional state and he refers to her for the interpretation of events provoking anxiety. Therefore, nurses should inform and support mothers, especially those who are rooming-in; they should also make more use of parents in the preparation and the management of the child for surgery. The development and validation of an instrument measuring fear-anxiety-pain in younger children will facilitate evaluation of the effect of surgery or other procedures on the child, and the planning adequate interventions.