Measurement tool for preoperative anxiety in young children: The yale preoperative anxiety scale

Abstract To develop a preoperative anxiety scale (YPAS) for children undergoing surgery, 21 specific behaviors indicating anxiety were defined within five domains (activity, emotional expressivity, state of arousal, vocalization, and use of adults). A reliability Kappa analysis revealed that inter-observer agreement ranged from .66 to .94, while intra-observer Kappa ranged from .66 to .91. Validity analysis between a Visual Analog Scale and the YPAS revealed an r of .59 for entering the operating room. Multiserial analysis comparing the YPAS to the Vernon Anxiety Scale ranged from .61 to .64. Showing good to excellent observer reliability and validity, the YPAS proves to be an appropriate tool for studying children's responses in preoperative settings. As such, the new assessment instrument should be of interest to clinical and research neuropsychologists who need to assess a child's anxiety level prior to the undertaking of a given surgical procedure.