COMET Initiative | Perspectives of Children, Parents, and Healthcare Providers on Outcomes after Anesthesia for Surgery: An International Mixed Methods Stakeholder Engagement Study from the Pediatric Perioperative Outcomes Group

Perspectives of Children, Parents, and Healthcare Providers on Outcomes after Anesthesia for Surgery: An International Mixed Methods Stakeholder Engagement Study from the Pediatric Perioperative Outcomes Group

Background:
The authors’ international collaboration of researchers and clinicians (the Pediatric Perioperative Outcomes Group) was established to develop core outcome sets for infants, children, and adolescents. Here, the authors report on a qualitative mixed methods study with semistructured interviews of parents/guardians and their children undergoing anesthesia for surgery along with perioperative healthcare providers (e.g., nurses, surgeons, and anesthesiologists).

Methods:
The authors compared and explored outcomes through a modified grounded theory analysis of interview transcripts to inform the establishment of an internationally recognized core outcome set for pediatric perioperative medicine. In total, 359 semistructured interviews were conducted between June 2021 and July 2022 across 10 study sites in eight countries: the United States, Canada, Australia, New Zealand, The Netherlands, South Africa, Colombia, and China.

Results:
The authors identified the themes of pain, complications, mental health and emotional state, and environment to be important for all stakeholder groups engaged. Differences were observed between the themes for healthcare providers and patients and parent/guardians. Emotional well-being, pain, and return to daily life may be undervalued in current research outcomes.

Conclusions:
The views elicited from these international stakeholder semistructured interviews complement the results of the outcome ratings surveys and provide a broad, objective, and foundational stakeholder perspective to support core outcome selection for pediatric perioperative research. These results may enhance relevance, inclusivity, and person-centeredness of the final outcomes measurement for pediatric perioperative care.

Contributors

Britta S von Ungern-Sternberg, Aine Sommerfield, Caroline O'Brien, Andrew J Davidson, Tania A Ramos, Susan M Goobie, Yun-Xia Zuo, Lei Yang, Heidi M Meyer, Elsa M Taylor, Simon D Whyte, Wallis T Muhly, Jurgen C de Graaff, Charlotte van Deuzen, Peidad C Echeverry, Paul A Stricker; Study Group of Pediatric Perioperative Outcomes Group (PPOG) Investigators

Publication

Journal: Anesthesiology
Volume: 144
Issue: 5
Pages: 1127 - 1138
Year: 2026
DOI: 10.1097/ALN.0000000000005947

Further Study Information

Current Stage: Completed
Date:
Funding source(s): A Foerderer Grant funded the activities of the Data Coordinating Center (Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania). A Society for Paediatric Anaesthesia in New Zealand and Australia (SPANZA) Grant and Starship Foundation Grant supported the participation of Starship Children’s Hospital (Auckland, New Zealand). BSvUS is funded in part by the Stan Perron Charitable Foundation and through a National Health and Medical Research Council Investigator Grant (No. 2009322). At Perth Children’s Hospital, the project was supported by a grant of the Perth Children’s Hospital Foundation and the Telethon Channel 7 (Perth, Australia). This study received financial support from the South African Society of Anaesthesiologists (Stellenbosch, South Africa) Jan Pretorius Research Fund for the South African site. Departmental funding supported the remainder of the project.

Health Area

Disease Category: Anaesthesia & pain control

Disease Name:

Target Population

Age Range: 0 - 17

Sex: Either

Nature of Intervention: Operative and non-operative management

Stakeholders Involved

- Clinical experts
- Consumers (caregivers)
- Consumers (patients)

Study Type

- Patient perspectives

Method(s)

- Interview
- Semi structured discussion