Sequential analysis of mothers' and fathers' reassurance and children's postoperative distress.

OBJECTIVE Children experience distress after surgery. Associations exist between parent reassurance (e.g., "It's OK") and child distress, but little is known about the causal direction of these interactions. This study examined sequential relations between mothers' and fathers' reassurance and children's distress. METHODS 146 families with 2- to 11-year-olds undergoing elective surgery participated. Time-event coding and time-window sequential analysis examined whether reassurance preceded or followed child distress. Secondary analyses examined the relation of child sex and parent anxiety with the reassurance/distress contingency. RESULTS Reassurance was positively correlated with distress; however, nonverbal distress was less likely to start following reassurance and was also more likely to continue following reassurance. Mothers were more likely to reassure following boys' verbal distress, and mothers with higher anxiety were more likely to reassure following nonverbal distress. CONCLUSIONS Whereas parental reassurance may prevent the start of child distress, it might maintain ongoing child distress.