The effect of psychoeducation on preoperative anxiety and parental self-efficacy in mothers of children undergoing surgery

Background Preoperative parental anxiety is a major clinical concern, affecting up to 74% of parents and serving as a primary predictor of adverse child outcomes, including increased postoperative pain and delirium. While information transfer is common, there is a critical gap in interventions that simultaneously target anxiety reduction and the enhancement of Parental Self-Efficacy (PSE). This study evaluated the effect of a dual-target psychoeducational program on preoperative anxiety and PSE in mothers of children undergoing surgery. Methods This parallel-group randomized controlled trial included 70 mothers (35 intervention, 35 control) of children aged < 7 years scheduled for first-time elective urological surgery at a specialized pediatric center in Iran. The intervention group received a three-session, CBT-based psychoeducation program integrating structured surgical information, cognitive restructuring, and progressive muscle relaxation. The control group received standard care plus a brief informational session. Outcomes were measured using the Spielberger State-Trait Anxiety Inventory (STAI) and the Dumka Parental Self-Efficacy Measure (PSAM) at baseline and immediately before surgery. Data were analyzed using ANCOVA, adjusting for baseline scores. Results The intervention group demonstrated significantly greater reductions in State Anxiety (adjusted mean difference = − 12.34, P < 0.001, Cohen’s d = 0.71) and Trait Anxiety (adjusted mean difference = − 11.26, P < 0.001, d = 0.72) compared to the control group. Furthermore, mothers in the intervention group showed a significantly greater increase in Parental Self-Efficacy (adjusted mean difference = + 7.80, P = 0.024, d = 0.48)1617. Within-group improvements were significant for both groups (all P < 0.001), though the structured program was statistically superior in all domains. Conclusion This study demonstrates that our brief, structured psychoeducational intervention—integrating cognitive restructuring, progressive muscle relaxation, and structured information—robustly addresses both negative emotional states and positive adaptive resources in mothers. The dual-target approach significantly enhances maternal psychological competence and self-efficacy. Given its efficacy, low cost, and non-pharmacological nature, we recommend its integration into routine family-centered preoperative care to improve maternal well-being and optimize pediatric surgical outcomes.