A Preoperative Psychosocial Intervention for Youth Undergoing Pectus Repair: Development and Initial Patient/Caregiver Experiences

Abstract

Objective:

Pectus repair surgery for chest wall abnormalities is associated with postoperative pain and worry. Effective psychosocial interventions that equip patients and families for surgery and promote adaptive coping with surgery-related pain and worry are needed, but lacking. In this article, we outline a novel preoperative, psychosocial intervention for youth undergoing pectus repair surgery and their caregivers and evaluate initial patient and caregiver satisfaction, perceived benefit, and acceptability of the intervention using multiple method analysis.

Method:

A pain psychologist developed the intervention to provide patients with adaptive coping skills for pain and surgery-related worry. Adolescent patients undergoing pectus repair (n = 26; 83% male, 100% White, Mdn_age = 15) and their caregivers (n = 21) completed clinician-developed surveys to evaluate satisfaction, perceived benefit, and acceptability of the intervention.

Results:

Patients reported high satisfaction with learning strategies to manage pain (95%) and high overall acceptability (100%). Fewer patients (86%) than caregivers (95%) endorsed overall benefit. Caregivers reported a high degree of satisfaction with the intervention’s overall benefit (100%) and acceptability (99%), in addition to reporting observed benefit for managing pain (95%). Both caregivers (70%) and patients (47%) endorsed less perceived benefit for managing surgery-related worry. Themes from survey open-ended responses included intervention benefits, barriers to using skills learned, and suggestions for improvement.

Conclusions:

Providing psychosocial intervention during the preoperative period is highly satisfactory, beneficial, and acceptable to patients undergoing pectus repair and their caregivers. This newly developed, clinical intervention may guide the provision of preoperative psychosocial care in this population.

Implications for Impact Statement

Adolescents undergoing pectus repair surgery and their caregivers need coping tools in addition to medication to manage surgery-related pain and worry. This newly developed, education and skills-based psychosocial intervention addresses a current gap in preoperative surgical care by providing guidance for using psychosocial coping strategies during recovery.