Ethnicity and Language Said to Influence Negative Postoperative Behavioral Change in Children

A study presented at the ANESTHESIOLOGY 2012™ annual meeting found children’s negative behavioral change after surgery differs among Spanish- and English-speaking White and Hispanic families.

Previous studies show 80 percent of children exhibit some form of negative behavioral change (i.e. anxiety, separation anxiety, sleep disturbance, aggression toward authority, temper tantrums, apathy/withdrawal and eating problems) on the first day home after surgery, and for one-third of these children, change persists over the course of two weeks. 

The severity and duration of negative behavioral change can vary according to individual characteristics such as temperament, age, postoperative pain and prior health care experience. The study aimed to determine whether ethnicity also plays a role in postoperative behavioral change among Hispanic and White children.

“It is known Hispanic children may under report pain and also are potentially at risk for suboptimal pain management,” said study author Suzanne Strom, M.D., Assistant Clinical Professor, Department of Anesthesiology and Perioperative Care School of Medicine, University of California, Irvine. “Therefore, it is reasonable to assume the incidence of behavioral change after surgery may also vary according to ethnicity.”

About the Study
The study analyzed 288 parents of healthy children undergoing outpatient elective surgery at Children’s Hospital of Orange County, Calif. Demographic information was collected from the parents on the day of surgery and recorded pain and behavioral change the first, third and seventh day after surgery. The results were grouped into English-speaking Hispanic (92 parents), Spanish-speaking Hispanic (72 parents) and English-speaking White (42 parents).

The findings revealed group differences in behavioral change, including general anxiety, apathy-withdrawal and eating disturbances, among Hispanic and White ethnicities. Lower overall negative behavioral change was found in 51 percent of Spanish-speaking Hispanic parents, 71 percent of English-speaking Hispanic parents and 83 percent of English-speaking White parents.

“The results suggest parent perceptions of children’s behavioral change after surgery are influenced by ethnicity and language, even after considering potential differences in pain severity and socioeconomic status,” said Zeev N. Kain, M.D., Chair and Professor, Department of Anesthesiology and Perioperative Care School of Medicine, University of California, Irvine. “The results may imply cultural values, such as stoicism in Hispanic families, may affect reports of pain.”

The researchers believe the results will add to a growing body of research that highlights the need for culturally sensitive assessment and care of families in health care.