Paediatric Surgery: A Comprehensive Text For Africa [Chapter 14]

The last few decades have been marked by tremendous improvement in the successful performance of most paediatric surgical procedures. This improvement is in terms of both increased knowledge and skills of attending physicians and updated surgical equipment now available for a variety of procedures. This has resulted in a higher survival rate as well as a reduction in the associated risk. Despite these improvements, however, many children and parents still experience high levels of distress when children are awaiting an invasive surgical procedure.1–4 This chapter looks at issues in paediatric surgical practice that make it stressful not only for the child awaiting surgery but also for the child’s parents. We first look briefly at the classifications of surgical procedures and the sources of stress for the child and parents. We then look at the commonly reported stress-related emotional experience, first for the child and then for the parents, and how this relates to prognosis. This discussion is followed by elaborating more on the conditions in sub-Saharan African countries that contribute to possible heightened levels of stress, and we draw this chapter to its conclusion by looking at some evidence-based efforts to reduce surgery-related stress and how effective or feasible the application of these may be in the sub-Saharan health care environment.