Surgery on children may cause chronic trauma, say Israeli researchers

New study reveals that children who undergo surgery are at risk of developing pediatric medical traumatic stress.

By JUDY SIEGEL-ITZKOVICH
Updated: DECEMBER 14, 2017 01:41
A worried mother and her child talking to a doctor. (Illustrative) (photo credit: INGIMAGE)
A worried mother and her child talking to a doctor. (Illustrative)
(photo credit: INGIMAGE)
One-third of children who undergo operations develop pediatric medical traumatic stress, or PMTS, according to newly published study by researchers at the Ariel University Department of Behavioral Sciences.
While the psychological distress disappears spontaneously for many, a significant portion of youngsters might develop chronic mental distress and dysfunction including post-traumatic stress disorder (PTSD).
PMTS refers to a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures and invasive or frightening treatment experiences.
These responses can include symptoms of arousal, re-experiencing the trauma and avoidance.
PTSD is a mental health condition that is triggered by a terrifying event – either by experiencing or witnessing that event.
Symptoms can include flashbacks, nightmares, severe anxiety, as well as uncontrollable thoughts about the event.
PMTS causes reluctance to follow doctor’s instructions, fear of medical staffers and injections, sleep difficulties, restlessness, repeated bad dreams – even nervousness at seeing white uniforms.
Tens of thousands of Israeli children undergo surgery each year. As part of their treatment, many of them are exposed to pain, uncertainty, helplessness, fear of disability and life-threatening situations.
The study was carried out on children who underwent operations in the pediatric surgery department of Hadassah-University Medical Center, in Jerusalem’s Ein Kerem, in cooperation with Ariel University researchers.
Children’s emotional reactions to surgery had not been studied before, said doctoral student Amihai Ben-Ari, who worked under the direction of Prof. Dana Margalit and Dr. Porto Ben-Harosh.
A total of 230 children who underwent surgery – 79 girls and 151 boys – were included in the study. The majority of operations had been planned in advanced, while one-quarter of the procedures were emergency surgeries.
The average length of hospitalization was 4.5 days. During the course of the study, two tests were performed – the first was done close to the time of surgery and the other, after about three months.
The findings showed that a significant proportion of the children in the study reported persistent mental distress, with 31.7% of developing PMTS and 11.3% reporting PTSD. Risk factors include: parental anxiety, duration of hospitalization, number of invasive medical procedures and the family’s socioeconomic status.
Today, many children with chronic post-surgical PTSD remain undiagnosed and untreated due to lack of awareness about the subject and insufficient allocation of resources for treatment, the authors wrote.
Identifying children at high risk for the condition can bring about effective intervention, despite limited resources. There appears to be a need for a future screening tool to identify children at risk of developing a medical-stress syndrome, they concluded.