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Purpose: To describe the current practice of how children and their parents are informed and prepared for medical procedures at Swedish pediatric units, and to follow up on practices reported previously in 17 units.

Design and Methods: A cross-sectional survey using a semi-structured questionnaire was performed in 2000, defined as Trial 1 (T1), with 58 responses, and repeated from 2017 to 2018, defined as Trial 2 (T2), with 26 responses. Potential differences between T1 and T2 were calculated with Pearson's Chi-square, and open-ended question responses were subjected to content analysis.

Results:  In T1, 95% of respondents reported regular preparation services and 65% reported this in T2; most practices were equal between T1 and T2. However, prior to admission, conversations with nurses (p < 0.05) and video shows on the Internet or web-based programs (p < 0.001) were more frequently reported in T2 than in T1. Additionally, written information about psychological needs at discharge (p < 0.001) and communication with nurses and physicians increased in the present study (p < 0.01). Checking the child's level of understanding was reported less in T2 (p < 0.01). Open-ended responses gave the impression that the units had ambition to inform and prepare children properly but were hindered because of time constraints, a strained staff situation, and lack of routines.

Conclusions: In Swedish Pediatric Care, preparation services are emphasized; however, increased outpatient care and decreased hospital stays challenged the practice of preparation and information. The child's perspective of preparation and information needs further illumination.