Impact of pediatric surgery on anxiety in children and their families and coping strategies: a narrative review.

Background and Objective: During surgical procedures, children often experience significant anxiety, which affects their mental health and may have adverse effects on surgical outcomes and postoperative recovery. Additionally, pediatric emergency surgery, as a high-risk medical intervention, heightens anxiety in both children and their families. Therefore, understanding and addressing anxiety experienced by children and their families during surgery is particularly important. This study aimed to systematically review the relevant literature, analyze the primary factors influencing anxiety in children and their families during surgery, and discuss effective coping strategies to help healthcare providers reduce the anxiety levels of patients and their families, thereby promoting the safety of surgeries and postoperative recovery outcomes. Methods: Recent literature was identified using the PubMed database with combinations of keywords "pediatric surgery", "anxiety", "children or families", and "coping strategies", focusing on studies published between 2010 and 2024. Eligible studies were identified through predefined inclusion and exclusion criteria. Data were synthesized using qualitative and quantitative methods to provide an overview of current evidence and identify research gaps. Key Content and Findings: The review revealed a significant association between a child's age and preoperative anxiety levels. Key risk factors for preoperative anxiety included prior medical experiences, the family environment, and the nature of the surgical procedure. Family members' anxiety levels were positively correlated with those of the children. Notably, children who received preoperative education via virtual reality technology exhibited significantly lower anxiety scores compared to those who received traditional education methods. Additionally, interventions such as parental presence, music therapy, and psychological support were found to be effective in mitigating anxiety. Conclusions: Managing anxiety during children's surgeries requires various approaches, and future research and clinical practice should complement each other to improve surgical experiences and mental health in children. By continuously optimizing the relevant strategies, we can create a safer and more supportive environment for children and their families during surgery.