Impact of Parental Proxy-Reported Pre-Operative Fear on Sleep Quality in Paediatric Day Surgery: A Comparative Analysis of Elective and Acute Procedures

Background Pre-operative fear may negatively affect sleep quality and perioperative adaptation in preschool-aged children undergoing paediatric day surgery. Aims This study aimed to examine the impact of pre-operative fear on sleep quality in children aged 3 to 6 years scheduled for paediatric day surgery, and to compare fear and sleep quality outcomes between those undergoing elective and acute procedures. Methods This descriptive, cross-sectional and correlational study was conducted using parental proxy reports with 178 parents of preschool children scheduled for surgery in a paediatric surgery department between March and December 2024. In collecting research data, Introductory Information Form, Child Fear Scale, and Children's Sleep Habits Questionnaire were used. Results The mean age of the children in the study was 4.29 ± 1.38 years (minimum: 3 years; maximum: 6 years); and the parents were 32.89 ± 6.13 years (minimum: 23 years; maximum: 49 years). The mean total score on the Child Fear Scale was 2.09 ± 1.38; the mean total score on the Children's Sleep Habits Questionnaire was 54.72 ± 4.40. A weak but statistically significant positive correlation was found between the Child Fear Scale and the Children's Sleep Habits Questionnaire ( r = 0.240; p = .001). When children were stratified by procedure type, no significant difference was found in pre-operative fear scores between the elective group ( n = 90; mean: 2.05 ± 1.36) and the acute group ( n = 88; mean: 1.97 ± 0.82) ( Z = 0.574; p = .557). Sleep quality scores differed significantly between procedure groups ( Z = 4.224; p < .001), with acute-surgery children showing better sleep quality than their elective counterparts. Conclusions/Implications Nursing Parental proxy-reported pre-operative fear was significantly associated with poorer sleep quality in preschool-aged children undergoing paediatric day surgery. These findings suggest that anticipatory stress related to planned surgery may adversely affect perioperative sleep behaviours in young children.