Risk factors for the development of medical stress syndrome following surgical intervention

Abstract

Amichai Ben Ari and Daniella Margalit

Pediatric surgical procedures involve traumatic stress that may cause psychological distress, leading to decreased adherence to
continued surgical follow-up and delayed physical recovery. Risk factors for pediatric medical trauma, however, have not been
studied enough. We aim to define the risk factors detectable during hospitalization in pediatric surgery and characterize children
at risk of developing PTSD, in order to focus preventive interventions on these children. The participants in this prospective study
were parents of 235 children aged one-thirteen years hospitalized in a pediatric surgical ward, who form a representative sample
of patients of this age in the ward. They completed questionnaires measuring symptoms of psychological distress, three-five
months after discharge. Higher parental stress, parental concerns regarding family social support, and parental concerns regarding
sibling problems had a significant positive correlation with the children’s emotional distress measured three-five months after
hospitalization. Among children aged one-five years, emergency (as opposed to elective) operation and a higher number of invasive
procedures were also positively correlated with the children’s PTSS. There is a need to develop measurements for identifying
children at high risk for developing posttraumatic stress following surgical intervention; guidelines for developing such a screening
instrument are outlined.

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