Abstract
BACKGROUND: Informed consent (IC) is essential in medical decision-making, ensuring that patients and their families fully understand the consequences of treatment options. In pediatric surgery, however, the process is often inadequate due to limited consultation time, high parental anxiety, and widespread misinformation. This study evaluates the effectiveness of the "ChPedBo" smartphone application in improving parental understanding and reducing preoperative anxiety. METHODS: A prospective observational study was conducted at the Department of Pediatric Surgery, IRCCS Sant'Orsola-Malpighi University Hospital of Bologna. A total of 150 questionnaires were distributed to parents of children scheduled for elective surgery; 100 completed questionnaires were included in the final analysis. Parents completed a structured 9-item questionnaire assessing knowledge, anxiety, usefulness, and satisfaction before and after using the "ChPedBo" app. Statistical analysis included the Wilcoxon signed-rank test, with a significance threshold set at p < 0.05. RESULTS: Parental knowledge of their child's condition significantly improved after using the app, with mean scores increasing from 2.39 to 3.14 (p = 3.88 × 10(-6)). Similarly, comprehension of the surgical procedure improved from 2.27 to 3.20 (p = 1.71 × 10(-6)). Preoperative anxiety levels decreased from 1.64 to 1.36 (p = 0.0073). The app was rated highly useful (mean score 2.64) and received a high overall satisfaction rating (mean score 2.70). CONCLUSIONS: The "ChPedBo" app significantly enhanced parental understanding and reduced preoperative anxiety, demonstrating its potential as a valuable digital tool in the IC process for pediatric surgery. Future studies should explore its application in emergency settings and its long-term impact.