{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:53:28Z","timestamp":1790906008728,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T00:00:00Z","timestamp":1594252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Moderate to severe postoperative pain complicates surgeries performed on children in upper\u2010income countries. The successful management of postoperative pain in children requires a biopsychosocial approach. Situational anxiety and anxiety disorders among caregivers influence a child's perioperative experience. This study aims to determine whether there is an association between caregiver's preoperative anxiety and children's postoperative pain in a lower\u2010middle\u2010income country (LMIC) setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional, descriptive study, we recruited 76 children aged 4\u201012\u00a0years, undergoing elective ambulatory tonsillectomy or adenotonsillectomy. Primary caregivers completed validated measures of anxiety (the Beck Anxiety Inventory [BAI] and the Kessler Psychological Distress Scale [K10]) prior to the children undergoing surgery. Postoperative pain was measured using the Wong\u2010Baker Faces Pain Rating Scale 4\u00a0hours after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Caregiver anxiety was found in 31.7% of participants using the K10 and in 42.1% using the BAI. Moderate to severe postoperative pain was reported by 51% of children. There was a statistically significant correlation of moderate strength between anxiety scores of caregivers and children's self\u2010reported postoperative pain scores (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.47 for K10, <jats:italic>r<\/jats:italic>\u00a0= .44 for BAI, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for both). Two median quantile regression models confirmed that K10 was positively associated with caregiver anxiety (WBFS) with slope\u00a0=\u00a00.16 and pseudo <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.25 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002, 95CI: 0.06\u20100.26) as was BAI with slope\u00a0=\u00a00.12 and pseudo <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.22 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.013 95CI: 0.03\u20100.22).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed that preoperative caregiver anxiety is significantly associated with postoperative pain in children undergoing elective, ambulatory surgery in a LMIC setting (correlation of moderate strength). Interventions aimed at reducing caregiver anxiety should become an important component of the biopsychosocial management of postoperative pain in children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13954","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T14:14:53Z","timestamp":1593267293000},"page":"990-997","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Caregiver anxiety and the association with acute postoperative pain in children undergoing elective ambulatory surgery in a lower\u2010middle\u2010income country setting"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9608-068X","authenticated-orcid":false,"given":"Reynard","family":"Knoetze","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care Faculty of Medicine and Health Sciences Stellenbosch University Cape Town South 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