101
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Rodrigues JRG, de Avila MAG, Jamas MT, Siqueira FPC, Daniel LG, Nilsson S. Transcultural adaptation of the children's anxiety questionnaire in Brazil. Nurs Open 2021; 8:1652-1659. [PMID: 33611862 PMCID: PMC8186675 DOI: 10.1002/nop2.794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/17/2020] [Accepted: 01/29/2021] [Indexed: 12/19/2022] Open
Abstract
Aim To describe the transcultural adaptation process of the Children's Anxiety Questionnaire (CAQ) for the Brazilian culture. Design This is a methodological study of cross‐cultural adaptation. Methods Study conducted in Brazil and Sweden involved the following steps: preparation, translation, synthesis of translations, back‐translation and review, and harmonization of the translations by a committee of 13 healthcare professionals using the content validity index (CVI). Cognitive debriefing, using children between 4–10 years old, was completed by 15 children to determine if the images corresponded with their meanings and 17 children to determine if they could understand the Global CAQ after listening. Results Convergences and discrepancies between the original instrument in Swedish, the English version and the Brazilian translation were compared. The process of culturally adapting the CAQ to Brazilian Portuguese was validated, as demonstrated by a satisfactory S‐CVI (0.94) among professionals and an agreement of 95% and above by children.
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Affiliation(s)
| | | | | | | | | | - Stefan Nilsson
- Institute of Health and Care Sciences, and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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102
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Maharjan P, Murdock D, Tielemans N, Goodall N, Temple B, Askin N, Wittmeier K. Interventions to Improve the Cast Removal Experience for Children and Their Families: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:130. [PMID: 33578958 PMCID: PMC7916681 DOI: 10.3390/children8020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cast removal can be a distressing experience for a child. This scoping review aims to provide a comprehensive review of interventions designed to reduce anxiety and improve the child's and family's experience of pediatric cast removal. METHODS A scoping review was conducted (Medline, Embase, PsycINFO, CINAHL, Scopus, grey literature sources). INCLUSION CRITERIA studies published January 1975-October 2019 with a primary focus on pediatric patients undergoing cast removal/cast room procedures. Screening, full text review, data extraction, and quality appraisal were conducted in duplicate. RESULTS 974 unique articles and 1 video were screened. Nine articles (eight unique studies) with a total of 763 participants were included. Interventions included the following, alone or in combination: noise reduction, electronic device use, preparatory information, music therapy, play therapy, and child life specialist-directed intervention. Heart rate was used as a primary (88%) or secondary (12%) outcome measure across studies. Each study reported some positive effect of the intervention, however effects varied by age, outcome measure, and measurement timing. Studies scored low on outcome measure validity and blinding as assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials. CONCLUSION Various methods have been tested to improve the pediatric cast removal experience. Results are promising, however the variation in observed effectiveness suggests a need for the use of consistent and valid outcome measures. In addition, future research and quality improvement projects should evaluate interventions that are tailored to a child's age and child/family preference.
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Affiliation(s)
- Pramila Maharjan
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Orthopedic Technology Services, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada
| | - Dustin Murdock
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R33 0T6, Canada; (D.M.); (N.T.)
| | - Nicholas Tielemans
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R33 0T6, Canada; (D.M.); (N.T.)
| | - Nancy Goodall
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Orthopedic Technology Services, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada
| | - Beverley Temple
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2M6, Canada;
| | - Nicole Askin
- WRHA Virtual Library, University of Manitoba, Winnipeg, MB R3E 3P5, Canada;
| | - Kristy Wittmeier
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
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103
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Rashid AA, Cheong AT, Hisham R, Shamsuddin NH, Roslan D. Effectiveness of pretend medical play in improving children's health outcomes and well-being: a systematic review. BMJ Open 2021; 11:e041506. [PMID: 33472781 PMCID: PMC7818823 DOI: 10.1136/bmjopen-2020-041506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The healthcare setting is stressful for many people, especially children. Efforts are needed to mitigate children's healthcare-related anxiety. Medical play using the Teddy Bear Hospital (TBH) concept can expose children to healthcare settings and help them develop positive experiences in these settings. In this role-playing game, children bring their soft toys and act as parents to the 'sick' teddies in a pretend hospital or clinic play setting. The objective of this systematic review is to evaluate the effectiveness of the TBH in improving children's health outcomes and well-being. METHODS We searched the reference lists of included studies from four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) from inception until November 2020. We included pre-post, quasiexperimental and case-control studies, as well as randomised controlled trials (RCTs) that discussed medical play using the TBH concept as an intervention. Studies that involved sick patients and used interventions unlike the TBH were excluded. We assessed the quality of the included studies using the Cochrane Collaboration's 'Risk of bias' tool. RESULTS Ten studies were included in this systematic review. Five specifically investigated the TBH method, while the others involved the same concept of medical play. Only three studies were RCTs. All of the studies report more than one outcome-mostly positive outcomes. Two report lower anxiety levels after intervention. Two found better healthcare knowledge, with one reporting increased feelings of happiness regarding visiting a doctor. Two studies found no change in anxiety or feelings, while another two found increased levels of fear and lowered mood after the medical play (which involved real medical equipment). CONCLUSIONS The practice of TBH has mostly positive outcomes, with lower anxiety levels and improved healthcare knowledge. Its effectiveness should be verified in future studies using a more robust methodology. PROSPERO REGISTRATION NUMBER CRD42019106355.
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Affiliation(s)
- Aneesa Abdul Rashid
- Department of Family Medicine, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Selangor, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Selangor, Malaysia
| | - Ranita Hisham
- T J Danaraj Medical Library, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Nurainul Hana Shamsuddin
- Department of Family Medicine, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Selangor, Malaysia
| | - Dalila Roslan
- Global Health Unit, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
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104
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Honeyman C. Planning surgery for young people with learning disabilities. Nurs Child Young People 2021; 33:26-31. [PMID: 32954703 DOI: 10.7748/ncyp.2020.e1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 11/09/2022]
Abstract
Surgery for spinal deformity is complex and preparation involves a wide multidisciplinary team. For young people with learning disabilities, especially those who have behaviour that challenges, there are further considerations to ensure that their hospital stay is a positive experience and all their additional needs are met. Staff and carers need to be well informed and there must be effective communication. Evaluation of one patient's journey through pre-assessment, surgery and rehabilitation has identified the need for more input from learning disability liaison nurses in acute children's services.
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Affiliation(s)
- Cheryl Honeyman
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, England
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105
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Liu MC, Chou FH. Play Effects on Hospitalized Children With Acute Respiratory Infection: An Experimental Design Study. Biol Res Nurs 2020; 23:430-441. [PMID: 33334144 DOI: 10.1177/1099800420977699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Acute respiratory infection is a major health issue and a primary cause of morbidity and mortality among preschool-aged children worldwide. Disease and hospitalization are chief stressors for children during their development. Therapeutic play has been used in pediatric care processes and has been demonstrated to be effective by most studies that have targeted children undergoing surgeries or invasive medical treatments. Currently, few published studies have focused on children receiving acute inpatient care. Additionally, not all types of therapeutic play produce significant results, and few studies have elaborated on the purposes, principles, and concrete measures of therapeutic play. Therefore, this study aimed to design therapeutic play that would reduce the stress responses of preschool-aged children hospitalized with acute respiratory infection. An experimental design with a pretest/posttest was conducted with 105 preschool children recruited from a regional teaching hospital in southern Taiwan. The children in the experimental group received the therapeutic play, while those in the control group received routine nursing care. Children in the experimental group showed significantly greater reductions in their physiological, psychological, and behavioral stress responses than those in the control group. Future studies could apply therapeutic play to children from different age groups with diverse health issues before recommending it be used in pediatric health settings.
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Affiliation(s)
- Mei-Chun Liu
- 63408Chung-Jen College of Nursing, Health Sciences and Management, Chia-Yi.,210832College of Nursing, Kaohsiung Medical University, Kaohsiung
| | - Fan-Hao Chou
- 210832College of Nursing, Kaohsiung Medical University, Kaohsiung
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106
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Fronk E, Billick SB. Pre-operative Anxiety in Pediatric Surgery Patients: Multiple Case Study Analysis with Literature Review. Psychiatr Q 2020; 91:1439-1451. [PMID: 32424544 DOI: 10.1007/s11126-020-09780-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Pre-operative anxiety affects millions of pediatric surgery patients each year and can have both short and long-term adverse effects in the post-operative period. As a result, it is particularly important for healthcare providers and others involved in the child's care, such as the parents, to be aware of interventions that can be used to reduce the onset of pre-operative anxiety and, thus, the likelihood of negative post-operative changes. The purpose of this paper is to familiarize the reader with the issue of pre-operative anxiety through a review of the literature and analysis of case studies. First, the paper looks at the causes of pre-operative anxiety and its effect on the development of maladaptive behavioral, emotional, and physiological changes. It then discusses the ways pre-operative anxiety can be measured and current methods for reducing the post-operative adverse outcomes associated with it. After doing so, it proposes the need for additional research and the use of precision medicine by physicians.
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Affiliation(s)
- Emily Fronk
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, One Park Avenue, 7th Floor, New York, NY, 10016, USA.
| | - Stephen Bates Billick
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, One Park Avenue, 7th Floor, New York, NY, 10016, USA
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107
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Houston AD, Coppack RJ, Bennett AN. Effectiveness of virtual reality-based gait education in enhancing the rehabilitation outcomes of injured military personnel. BMJ Mil Health 2020; 168:308-313. [PMID: 33087538 DOI: 10.1136/bmjmilitary-2020-001581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/06/2020] [Accepted: 08/14/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Correcting adverse biomechanics is key in rehabilitating musculoskeletal injuries. Verbal instruction remains the primary method for correcting biomechanics and therefore a patient's understanding of these instructions is believed to directly influence treatment outcomes. The aim of this study was to establish the patients' perceptions of virtual reality-based gait education (VR-GEd) and to assess its influence on the standard military rehabilitation outcomes. METHODS A retrospective analysis using routinely collected data was performed. Twenty patients with lower-limb musculoskeletal injuries undertook a VR-GEd session on the commencement of a 3-week, multidisciplinary, inpatient course of rehabilitation. Patient outcomes were compared with a group of matched controls, completing the same standardised course of inpatient treatment. RESULTS The VR-GEd group exhibited greater reductions the interference pain had on their mood (p=0.022). Improvements in generalised anxiety (p=0.029) were greater in the VR-GEd group but were not large enough to be clinically meaningful. VR-GEd did not influence functional outcomes. Patients rated the sessions highly in terms of enjoyment and perceived value. Patient feedback highlighted that they understood their injury better and felt the session could positively influence their recovery. CONCLUSION VR-GEd was proven to be an enjoyable and valued means of educating military inpatients about their injury mechanics. This study found no contraindications for the inclusion of VR-GEd in current rehabilitation programmes. However, current evidence suggests a single VR-GEd session cannot act as a replacement for biofeedback interventions, due to the lack of enhanced improvement across rehabilitation outcomes.
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Affiliation(s)
- Andrew David Houston
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK
| | - R J Coppack
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK.,Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Bath, Bath, Somerset, UK
| | - A N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
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108
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Aufegger L, Bùi KH, Bicknell C, Darzi A. Designing a paediatric hospital information tool with children, parents, and healthcare staff: a UX study. BMC Pediatr 2020; 20:469. [PMID: 33032549 PMCID: PMC7542856 DOI: 10.1186/s12887-020-02361-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The hospital patient pathway for having treatment procedures can be daunting for younger patients and their family members, especially when they are about to undergo a complex intervention. Opportunities to mentally prepare young patients for their hospital treatments, e.g. for surgical procedures, include tools such as therapeutic clowns, medical dolls, or books and board games. However, while promising in reducing pre-operative anxiety and negative behaviours, they may be resource intensive, costly, and not always readily available. In this study, we co-designed a digital hospital information system with children, parents and clinicians, in order to prepare children undergoing medical treatment. METHOD The study took place in the UK and consisted of two parts: In part 1, we purposively sampled 37 participants (n=22 parents, and n=15 clinicians) to understand perceptions and concerns of an hospital information platform specifically design for and addressed to children. In part 2, 14 children and 11 parents attended an audio and video recorded co-design workshop alongside a graphic designer and the research team to have their ideas explored and reflected on for the design of such information technology. Consequently, we used collected data to conduct thematic analysis and narrative synthesis. RESULTS Findings from the survey were categorised into four themes: (1) the prospect of a hospital information system (parents' inputs); (2) content-specific information needed for the information system (parents' and clinicians' inputs); (3) using the virtual information system to connect young patients and parents (parents' inputs); and (4) how to use the virtual hospital information system from a clinician's perspective (clinicians' inputs). In contrast, the workshop highlighted points in times children were most distressed/relaxed, and derived the ideal hospital visit in both their and their parents' perspectives. CONCLUSIONS The findings support the use of virtual information systems for children, in particular to explore and learn about the hospital, its facilities, and the responsibilities of healthcare professionals. Our findings call for further investigations and experiments in developing safer and more adequate delivery of care for specific age groups of healthcare users. Practical and theoretical implications for improving the quality and safety in healthcare delivery are discussed.
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Affiliation(s)
- Lisa Aufegger
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK.
| | - Khánh Hà Bùi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Colin Bicknell
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Ara Darzi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
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109
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Cox N. Critically appraised paper: A virtual reality education intervention prior to chest radiology for children reduces child distress related to the procedure and improves parent satisfaction [commentary]. J Physiother 2020; 66:266. [PMID: 32847764 DOI: 10.1016/j.jphys.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Narelle Cox
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia
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110
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Harper HE, Hirt PA, Lev-Tov H. The use of virtual reality in non-burn dermatological care - a review of the literature. J DERMATOL TREAT 2020; 33:48-53. [PMID: 32174192 DOI: 10.1080/09546634.2020.1743812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: Virtual Reality (VR) is the artificial depiction of a three-dimensional (3D) environment using computer-generated technology which allows users to interact with a simulated setting. VR has been used in a variety of clinical scenarios due to its efficacy as a distraction intervention, reducing anxiety and pain associated with medical procedures. The aim of this review is to provide clinicians with an overview of VR use in clinical dermatology.Methods: A search on VR use in clinical dermatology was conducted using PubMed Medline, Embase, Cochrane, Google Scholar and ClinicalTrials.Gov in July 2019. Results related to burn care were excluded.Results: This review identifies studies that utilized VR in the management of skin diseases and discusses considerations for its future use.Conclusion: The findings of these studies indicate that VR has beneficial effects as a complementary tool in the treatment of dermatological conditions.
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Affiliation(s)
| | - Penelope A Hirt
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hadar Lev-Tov
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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111
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Effects of intravenous and mask induction on post-operative emergence delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy. Ir J Med Sci 2020; 189:1061-1068. [PMID: 32048203 DOI: 10.1007/s11845-020-02197-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Emergence delirium occurs in children during recovery from general anesthesia. The aim of the study was to examine the effects of mask and intravenous sevoflurane anesthesia induction on emergence delirium in children undergoing tonsillectomy with or without adenoidectomy. METHODS This single-blinded, prospective, randomized clinical trial was conducted in the operating room and the post-operative recovery area at a university hospital. Sixty-seven children (aged 3-12 years) were randomly assigned to receive either mask induction (group M) or intravenous induction (group IV). Vascular access was provided in group M after 8% sevoflurane and 60% nitrous oxide in oxygen were given through a mask. In the IV cohort, an intravenous cannula was inserted prior to induction. The incidence of emergence delirium was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale after arrival in the post-anesthesia care unit. Post-operative pain was assessed using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. RESULTS PAED scores were significantly higher in group M at 5 min (group M = 12.2 ± 4.215, group IV = 9.1 ± 4.0; mean difference = 3.094, 95% CI [1.108; 5.081]; P = 0.003), at 15 min (group M = 8.0 ± 2.6, group IV = 5.1 ± 2.3; mean difference = 2.942, 95% CI [1.586-4.301]; P < 0.001), and at 30 min (group M = 5.1 ± 2.8, group IV = 2.5 ± 1.8; mean difference = 2.620, 95% CI [1.457; 3.783]; P < 0.001) than in group IV. The FLACC scale scores were similar between the two groups. CONCLUSION Mask induction for pediatric patients undergoing tonsillectomy with or without adenoidectomy increased Pediatric Anesthesia Emergence Delirium scores more than intravenous induction. TRIAL REGISTRATION NCT03252405.
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112
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Jiang S. Positive Distractions and Play in the Public Spaces of Pediatric Healthcare Environments: A Literature Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 13:171-197. [DOI: 10.1177/1937586720901707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: A positive distraction is a significant environmental feature that introduces positive feelings by diverting attention from stress or anxious thoughts. Existing research has deemed the application of positive distractions in pediatric environments to be significant. This study investigated the essential positive distractions and the associated health benefits. Aims: The aims of this study were to validate and extend evidence on positive distractions and play opportunities in the design of the public spaces in pediatric healthcare environments, translate existing evidence into design suggestions, and identify research gaps in this realm. Methods: A four-phased literature review method was employed in the study, including literature search, literature screening and selection, literature appraisal, and thematic analysis and in-depth discussion. Eventually, 27 peer-reviewed publications were reviewed and discussed in detail. Results/Conclusions: The gathered materials were grouped into six themes of positive distractions: (1) art and environmental aesthetics, (2) spatial arrangement and atrium, (3) considerations of socialization patterns, (4) play and interactive technologies, (5) sound and lighting interventions, and (6) access to nature. The research indicated that positive distractions in the pediatric healthcare environment provide a series of health benefits for patients, including improved behavioral and emotional well-being, reduced stress and anxiety, enhanced healthcare experience and satisfaction, and facilitated medical procedures and recovery. Yet significant research gaps emerged between positive distractions and play in garden spaces and spatial design to accommodate interactive technology and socialization in the public areas of pediatric healthcare environments. This study organized the understanding on the components of supportive environments and its outcomes for pediatric healthcare design.
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Affiliation(s)
- Shan Jiang
- School of Design and Community Development, West Virginia University, Morgantown, WV, USA
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113
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Caruso TJ, George A, Menendez M, De Souza E, Khoury M, Kist MN, Rodriguez ST. Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial. Paediatr Anaesth 2020; 30:116-123. [PMID: 31785015 DOI: 10.1111/pan.13778] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Vascular access is a minor procedure that is associated with reported pain and fear in pediatric patients, often resulting in procedural incompliance. Virtual reality has been shown to be effective in adult populations for reducing pain and anxiety in various medical settings, although large studies are lacking in pediatrics. AIMS The primary aim was to determine whether pain would be reduced in pediatric patients using virtual reality undergoing vascular access. The four secondary aims measured patient fear, procedural compliance, satisfaction, and adverse events. METHODS A prospective, randomized, controlled trial was completed at a pediatric hospital, enrolling children 7-18 years old undergoing vascular access in a variety of clinical settings, randomized to virtual reality or standard of care. Pain scores were measured using a numeric pain faces scale. The secondary outcomes of patient fear, procedural compliance, satisfaction, and adverse events were measured with the Child Fear Scale, modified Induction Compliance Checklist, and satisfaction surveys, respectively. Chi-squared, t tests, and regression models were used to analyze the results. RESULTS The analysis included 106 patients in the virtual reality group and 114 in the control. There were no significant differences in postprocedure pain (VR group estimated 0.11 points lower, 95% confidence interval: 0.50 points lower to 0.28 points greater, P = .59), postprocedure fear (VR group estimated 0.05 points lower, 95% confidence interval: 0.23 points lower to 0.13 points greater), or compliance (adjusted odds ratio 2.31, 95% confidence interval: 0.96-5.56). Children in the virtual reality group were satisfied with the intervention. There were no adverse events. CONCLUSION This study demonstrates no reduction in pain while using Virtual reality (VR) across a heterogeneous pediatric inpatient population undergoing vascular access.
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Affiliation(s)
- Thomas J Caruso
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexandria George
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Maria Menendez
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth De Souza
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Khoury
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Madison N Kist
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Samuel T Rodriguez
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
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Canga M, Malagnino I, Malagnino G, Malagnino VA. Evaluating different stressors among parents with hospitalized children. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:9. [PMID: 32154304 PMCID: PMC7032031 DOI: 10.4103/jehp.jehp_529_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The pediatric hospital is an environment with a high level of stress for most parents. Parents experience high levels of stress if their children are hospitalized due to the fear for the loss of their child's life. OBJECTIVE The objective of this study was to evaluate stress factors in parents of hospitalized children. MATERIALS AND METHODS This study was conducted from January to July 2019 at the General Pediatrics Department of Fieri Regional Hospital. The study sample was composed of 200 parents, of which 86 (43.3%) were males and 114 (56.7%) were females. The parents chosen as our sample had their children hospitalized for at least 5 days. RESULTS Our results showed that 80% of the sample was stressed out by waiting at the hospital, whereas 42% of them felt stressed also by their child's oral problems. Parents of hospitalized children (83%) felt stressed about the painful techniques applied to their children. Nearly 65% of them were stressed out by the hospital environment; child's sleep bruxism was considered another stressor by 39% of the sample. CONCLUSION This study claims that parents of hospitalized children experience stress from different stressors such as dental visits, waiting for the diagnosis, and sleep bruxism. There are other factors which do not influence parental stress including residence, divorced parents, and hospital conditions.
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Affiliation(s)
- Mimoza Canga
- Department of Nursing, Faculty of Public Health, University “Ismail Qemali,” Vlora, Albania
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Mutambo C, Shumba K, Hlongwana KW. User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa. BMC Public Health 2020; 20:91. [PMID: 31964361 PMCID: PMC6975036 DOI: 10.1186/s12889-019-7712-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/30/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND KidzAlive is a child-centred intervention aimed at improving the quality of HIV care for children in South Africa. Through this intervention, 10 child-friendly spaces were created in 10 primary healthcare centres (PHCs) in KwaZulu-Natal to enhance child-centred HIV care. However, the user-provider experiences of these child-friendly spaces in these facilities have not been explored. This paper addresses this gap. METHODS We conducted qualitative interviews with children (n = 30), their primary caregivers (PCGs) (n = 30), and KidzAlive trained healthcare workers (HCWs) (n = 20) using and providing child-friendly spaces, respectively. Data were generated, using a semi-structured interview guide printed in both English and IsiZulu. The interviews were audio-recorded transcribed and translated to English by a research team member competent in both languages. Data were imported to NVivo 10 for thematic analysis. The COREQ checklist was used to ensure that the study adheres to quality standards for reporting qualitative research. RESULTS Child-friendly spaces contributed to the centredness of care for children in PHCs. This was evidenced by the increased involvement and participation of children, increased PCGs' participation in the care of their children and a positive transformation of the PHC to a therapeutic environment for children. Several barriers impeding the success of child-friendly spaces were reported including space challenges; clashing health facility priorities; inadequate management support; inadequate training on how to maximise the child-friendly spaces and lastly the inappropriateness of existing child-friendly spaces for much older children. CONCLUSION Child-friendly spaces promote HIV positive children's right to participation and agency in accessing care. However, more rigorous quantitative evaluation is required to determine their impact on children's HIV-related health outcomes.
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Affiliation(s)
- Chipo Mutambo
- The Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, King George Avenue, Durban, 4041 South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, King George Avenue, Durban, 4041 South Africa
- Department of Public Health Medicine, University of KwaZulu-Natal, George Campbell Building, Room 217, 2nd Floor, King George V Avenue, Glenwood, Durban, KwaZulu-Natal 4041 South Africa
| | - Kemist Shumba
- The Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Office IX06 TB Davies Ext, Howard College Campus, Durban, 4041 South Africa
| | - Khumbulani W. Hlongwana
- Department of Public Health Medicine, University of KwaZulu-Natal, George Campbell Building, Room 217, 2nd Floor, King George V Avenue, Glenwood, Durban, KwaZulu-Natal 4041 South Africa
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Exploring Non-Pharmacological Management among Anesthesia Providers to Reduce Preoperative Distress in Children. J Pediatr Nurs 2020; 50:105-112. [PMID: 31805493 DOI: 10.1016/j.pedn.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022]
Abstract
Preparation for surgery with the induction of general anesthesia is one of the most stressful events that a child can experience. It produces several threats to the child, including physical harm, parent separation, and fear of the unknown. Anesthesia providers utilize non-pharmacological and pharmacological interventions to decrease this preoperatively. However, little is known about the non-pharmacological interventions utilized by anesthesia providers in practice. The purpose of this study was to explore non-pharmacological interventions utilized by anesthesia providers before and during the induction of general anesthesia to reduce preoperative distress in children ages one to six years old. A qualitative descriptive approach was used in this study. Twenty anesthesia providers, fourteen registered nurse anesthetists and six anesthesiologists, participated in face to face, in-depth interviews in South Florida. Content analysis was used to identify and define the major themes that emerged from the interviews. A total of seven main themes were identified. Only the three themes directly related to parent-provider-child relationship are discussed in this paper: (I) Communication, (II) Observational Skills, and (III) Parental Presence. The anesthesia providers who participated in this study offered an opportunity to better understand the non-pharmacological interventions used to impact the management of preoperative distress among children. Study findings provide evidence about non-pharmacological anesthesia providers' clinical work not found elsewhere in the literature. Non-pharmacological interventions are effective in reducing preoperative distress in children.
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Castelo-Soccio L. Stripping Away Barriers to Find Relevant Skin Biomarkers for Pediatric Atopic Dermatitis. JAMA Dermatol 2019; 155:1342-1343. [PMID: 31596425 DOI: 10.1001/jamadermatol.2019.2792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Leslie Castelo-Soccio
- Department of Dermatology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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118
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Mutambo C, Shumba K, Hlongwana KW. Child-Centred Care in HIV Service Provision for Children in Resource Constrained Settings: A Narrative Review of Literature. AIDS Res Treat 2019; 2019:5139486. [PMID: 31885911 PMCID: PMC6899315 DOI: 10.1155/2019/5139486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Child-centred care approaches are increasingly gaining traction in healthcare; and are being applied in the delivery of HIV care for children in resource constrained settings. However, very little is known about their potential benefits. METHODS We synthesised literature from primary and secondary publications exploring the philosophical underpinnings of the concept of child-centred care, and its application to HIV service delivery for children in resource constrained settings. We concluded the review by suggesting a conceptual framework for mainstreaming and integrating child-centred care approaches in the management of HIV in resource constrained settings. RESULTS The philosophical underpinnings of child-centred care stem from human rights (child-rights), holism, the ecological model, and life-cycle approaches. Although there is no standard definition of child-centred care in the context of HIV, the literature review highlighted several phrases used to describe the "child-centredness" of HIV care for children. These phrases include: (i) Respect for child-healthcare rights. (ii) Using the lifecycle approach to accommodate children of different ages. (iii) Provision of age-appropriate HIV services. (iv) Meaningful participation and inclusion of the child in the healthcare consultation process. (v) Using age-appropriate language to increase the child's understanding during healthcare consultations. (vi) Age-appropriate disclosure. (vii) Primary caregiver (PCG) participation and preparation (equipping the PCGs with information on how to support their children). (viii) Creation of a child-friendly healthcare environment. (ix) Consideration of the child ecological systems to have a holistic understanding of the child. (x) Partnership and collaborative approach between children, PCGs, and healthcare workers (HCWs). CONCLUSION Child-centred care approaches can potentially increase child-participation, promote positive health outcomes and resilience in children living with a communicable, highly stigmatised and chronic condition such as HIV. More evidence from controlled studies is required to provide concrete results to support the application of child-centred care approaches in HIV care services.
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Affiliation(s)
- Chipo Mutambo
- The Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Kemist Shumba
- The Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Khumbulani W. Hlongwana
- The Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Lapp V. The Patient's Voice: Development of an Adolescent Hospital Quality of Care Survey (AHQOCS). J Pediatr Nurs 2019; 49:43-50. [PMID: 31476679 DOI: 10.1016/j.pedn.2019.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To develop an adolescent determined hospital quality of care survey. BACKGROUND Adolescents do not currently evaluate their quality of hospital care. Hospital satisfaction surveys are mailed following discharge to parents, and parental input may not reflect adolescent perception. DESIGN AND METHODS This exploratory, descriptive study utilizing Q-sort methodology, investigated 60 adolescents/young adults' (ages 12-21) perception of hospital care. A comprehensive, peer-reviewed journal search conducted 1998-2017 explored adolescent perception of hospital care. Themes emerging from adolescent's perception of care were developed into 56 statements for relevance sorting. RESULTS Excellent content validity of the care domains was established at 0.982 (utilizing the universal agreement). After placement of all 56 cards, items were correlated in order to reveal similarities in perspectives. Items of greatest importance to adolescents included 'able to tell the doctor what was wrong with you', 'having family stay', 'trust in nurse to take care of you', 'able to ask the doctor to explain what they said', 'nurse clearly told you what would happen to you', and 'a clean room'. Little variation in response occurred across the variables of age, gender, length of stay, or diagnosis. CONCLUSIONS Given the opportunity to relate autonomously to health services, adolescents are able to determine quality preferences and should be contributory in determining hospital care. PRACTICE IMPLICATIONS Based on adolescent preferences demonstrated in this study, satisfaction with pediatric care delivery should be improved with attention tailored to adolescent wishes.
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Affiliation(s)
- Valerie Lapp
- Arnold Palmer Hospital for Children, FL, United States of America.
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120
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Delvecchio E, Salcuni S, Lis A, Germani A, Di Riso D. Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play. Front Public Health 2019; 7:250. [PMID: 31555632 PMCID: PMC6743064 DOI: 10.3389/fpubh.2019.00250] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 08/20/2019] [Indexed: 12/27/2022] Open
Abstract
The aim of this paper was to assess strengths and fragilities in children aged 6 to 10 who suffered one or more hospitalizations. State and trait anxiety, coping abilities, and cognitive and affective functioning through play were assessed using a triangulation approach. Fifty hospitalized children aged 6-10 were compared to 50 non-hospitalized children, and children at first admission were compared with children with more than one hospitalization experience. The State-Trait Anxiety Scales Inventory for Children was administered for assessing trait and state anxiety, and the Children's Coping Strategies Checklist (Revision 1) was administered to assess coping dimensions. The Affect in Play Scale - Preschool - Brief (Extended version) was used to assess cognitive and affective dimensions of play. No significant differences were found for trait anxiety between hospitalized vs. non-hospitalized children. Instead, as expected, state anxiety was significantly higher in hospitalized childen than in the non-hospitalized children. Hospitalized children reported higher scores than non-hospitalized children in support-seeking strategies. As for pretend play, hospitalized children showed significantly higher cognitive scores than non-hospitalized children. However, hospitalized children appeared significantly more restricted in their affect expressions. No significant differences were found for play and anxiety scores between children admitted for the first time in the hospital ward and children with more than one admission. However, children at first admission scored higher in coping and positive cognitive restructuring and in avoidance-coping strategies than children with more than one admission. The initial assessment of the interplay of key variables such as anxiety, coping and play can inform healthcare professionals by serving as a guide in order to determine a child's risk for negative psychological outcomes due to hospitalization, to plan appropriate interventions and to provide substantial assistance to hospitalized children in the future.
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Affiliation(s)
- Elisa Delvecchio
- Dipartimento di Filosofia, Scienze Sociali, Umane e della Formazione, Università di Perugia, Perugia, Italy
| | - Silvia Salcuni
- DPSS - Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, Italy
| | - Adriana Lis
- DPSS - Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, Italy
| | - Alessandro Germani
- Dipartimento di Filosofia, Scienze Sociali, Umane e della Formazione, Università di Perugia, Perugia, Italy
| | - Daniela Di Riso
- DPSS - Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, Italy
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Gabriel MG, Wakefield CE, Vetsch J, Karpelowsky JS, Darlington ASE, Cohn RJ, Signorelli C. Paediatric surgery for childhood cancer: Lasting experiences and needs of children and parents. Eur J Cancer Care (Engl) 2019; 28:e13116. [PMID: 31184790 DOI: 10.1111/ecc.13116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 03/19/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Surgery for paediatric cancer presents many stresses on patients and families. The authors aimed to understand the long-term impact of childhood cancer surgery on survivors and parents. METHODS The study recruited participants from 11 Australia/New Zealand hospitals for telephone interviews. The authors used descriptive statistics to analyse participants' quantitative distress ratings and conducted thematic analysis of shared surgical experiences and needs. RESULTS Of 32 participants (n = 17 survivors, n = 15 parents), survivors' mean age at surgery was 6.9 (SD = 5.17) and parents' children were 2.1 years old (SD = 1.41) at time of surgery. Survivors had surgery on average 15.2 years ago (SD = 6.72) and parents' children 11.5 years ago (SD = 3.94). Parents and survivors rated surgery as highly distressing. Pre-operatively, survivors recalled experiencing fear and pain mainly associated with pre-operative procedures. Post-operatively, survivors reported immobility and some lasting behavioural disturbances. Parents described pre- and intra-operative anxiety and stress and some lasting post-operative psychological disturbances. Experiences appeared to improve with clear/consistent communication from hospital staff, proximity to hospital, and with support for parents and children post-operatively. CONCLUSIONS Surgical treatment for childhood cancer can have a lasting impact for survivors and parents. Better information provision may improve families' surgical experience whilst reducing anxiety, distress and physical discomfort.
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Affiliation(s)
- Mark G Gabriel
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Janine Vetsch
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Jonathan S Karpelowsky
- Department of Paediatric Surgery, Children's Hospital Westmead, Sydney, New South Wales, Australia.,Children's Cancer Research Unit, Kids Research Institute, Sydney, New South Wales, Australia.,Division of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Richard J Cohn
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Christina Signorelli
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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123
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Isokääntä S, Koivula K, Honkalampi K, Kokki H. Resilience in children and their parents enduring pediatric medical traumatic stress. Paediatr Anaesth 2019; 29:218-225. [PMID: 30592109 DOI: 10.1111/pan.13573] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 12/05/2018] [Accepted: 12/24/2018] [Indexed: 01/25/2023]
Abstract
Due to the general lack of familiarity with the concept in the medical field, resilience is rarely considered in pediatric medical traumas. Resilience is an ability that enables recovery after adversities such as traumas, surgeries, serious health problems, or social issues. Stress from medical traumas encompasses both the psychological and physical responses of children and their families. Lack of resilience in children with medical traumatic stress may contribute to poor adjustment, slow recovery, disruptive behaviors, and psychiatric disorders. Furthermore, persistent parental distress increases the child's risk of low resilience. Consequently, these patients and their parents require early identification. This is achievable using a common stress measure such as the Perceived Stress Scale. Moreover, health care providers can screen patients' risks for low resilience, which include few social contacts, poor family functioning, and low cohesion among family members. Findings from the stress scale and screened risks could indicate the need for additional psychosocial support at the time of diagnosis of a serious illness, soon after injuries, and before and after operations. Such interventions can include decreasing distress, counseling children and their parents, and enabling strong connections to health care providers. Health care providers can help parents to minimize distress and adjust to their child's illness, thereby supporting the child's resilience, adjustment, and recovery.
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Affiliation(s)
- Siiri Isokääntä
- Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland.,Faculty of Health Sciences, Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Krista Koivula
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Hannu Kokki
- Faculty of Health Sciences, Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
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124
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Nilsson S, Holstensson J, Johansson C, Thunberg G. Children's Perceptions of Pictures Intended to Measure Anxiety During Hospitalization. J Pediatr Nurs 2019; 44:63-73. [PMID: 30683283 DOI: 10.1016/j.pedn.2018.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 10/17/2018] [Accepted: 10/21/2018] [Indexed: 12/19/2022]
Abstract
Many children experience anxiety during a hospital stay, which can have an adverse impact on their recovery and response to future hospital care. To facilitate assessment of anxiety in young children and children with communicative disabilities, the short S-STAI (short version of the State scale of the State-Trait Anxiety Inventory), has previously been adapted to a visual format. The aims of the present study were (a) to validate the pictures used to represent emotions and the steps of a quantitative scale ('a lot' - 'some' - 'a little'), including to determine whether any of them should be replaced, and (b) to assess different pictures to be used for a qualitative scale ('good/like' - 'in between/so-so' -'bad/dislike') in the same instrument. A total of 103 children aged 5-8 years were asked to choose verbal labels for pictures of facial expressions intended to represent emotions, match those pictures with the emotional categories used in the short S-STAI (Tense/Nervous, Worried/Afraid, Calm/Relaxed, and Happy/Content) and indicate their preferences for pictures intended to represent the steps of a quantitative scale and a qualitative one. The children understood both scales and the differences between positive and negative emotions in the short S-STAI. The older children (aged 7 and 8) significantly more often chose a picture for each step of the scales that was intended to represent that particular step. The article discusses implications for the choice of pictures representing emotional states in the short S-STAI and presents recommended pictures.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | | | | | - Gunilla Thunberg
- DART center for AAC and AT, Sahlgrenska University Hospital, Gothenburg, Sweden
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125
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Przybylska MA, Burke N, Harris C, Kazmierczyk M, Kenton E, Yu O, Coleman H, Joseph S. Delivery of the UN Convention on the Rights of the Child in an acute paediatric setting: an audit of information available and service gap analysis. BMJ Paediatr Open 2019; 3:e000445. [PMID: 31423467 PMCID: PMC6688700 DOI: 10.1136/bmjpo-2019-000445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/29/2019] [Accepted: 05/09/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The United Nations Convention on Children's Rights stresses the importance of providing children with information relating to their health and well-being, yet reports suggest children are offered insufficient support in healthcare environments. We audited the information provided to children and families requiring planned surgical admission in comparison to those admitted acutely to medical paediatrics. Additionally, we identified examples of child-specific information resources in national and international hospitals. METHODS Three approaches were taken to gain insight into practice locally, nationally and internationally.(1) Information resources provided to paediatric inpatients admitted to the acute receiving unit were audited in comparison to information given to children with planned admissions via process observations.(2) Qualitative feedback was gained from play specialists (n=2), families (n=30) and children (n=9; aged 3-15 years) via interviews.(3) A review, including UK, Australian and US hospitals, was conducted to assess child-specific information resources (n=36 hospitals) and to systematically compare the information available on websites (n=9 hospitals). RESULTS At the study site, no child-specific information resources were available for acute admissions, whereas planned admissions were offered significant information face-to-face with supplemental resources. Child, parent and play specialist interviews highlighted gaps in information provision regarding hospital practicalities and processes. Twelve external child-specific resources were identified, for 4-14 year olds, explaining key care information: medical procedures, equipment and staff. These resources could positively respond to the topics cited as lacking by the interviewed patients and families at the study site. International hospital websites provided considerably more in-depth information compared with UK hospitals. CONCLUSIONS The hospital experience of children and families can be improved by ensuring they are provided with adequate information relating to their hospital stay. It is essential that suitable high-quality resources are consistently available and that feedback from children informs the process of resource development.
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Affiliation(s)
| | - Niall Burke
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Clare Harris
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Marcel Kazmierczyk
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Ellie Kenton
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Olivia Yu
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Harriet Coleman
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
| | - Sonia Joseph
- Department of General Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK
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Psychosocial Outcomes of Children and Adolescents With Severe Congenital Heart Defect: A Systematic Review and Meta-Analysis. J Pediatr Psychol 2018; 44:463-477. [DOI: 10.1093/jpepsy/jsy085] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/18/2018] [Accepted: 09/28/2018] [Indexed: 12/29/2022] Open
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127
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Kada S, Satinovic M, Booth L, Miller PK. Managing discomfort and developing participation in non-emergency MRI: Children's coping strategies during their first procedure. Radiography (Lond) 2018; 25:10-15. [PMID: 30599823 DOI: 10.1016/j.radi.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/22/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Building on existing work, this paper aims to develop a detailed analysis of the practical coping strategies developed by children who had not previously experienced an MRI, regarding a non-emergency examination of the brain. METHODS Semi-structured interviews with 22 children, aged between eight and sixteen years, were conducted immediately post-procedure. Emergent data were thematically analysed in line with the core precepts of Grounded Theory, and triangulated against interview data with their parents where pertinent. RESULTS The primary concern among interviewees related to how they had coped with the discomfort of an unfamiliar medical procedure; this was recurrently managed through a process herein termed Participation Development. This comprised three phases. The first, preparative participation, describes the children's reported attempts to ready themselves for the examination (with parents) ahead of arriving in hospital. The second, enabling participation, describes how the children (with input from parents and radiographers) endeavoured to understand what was to come, and select viable distraction techniques. Finally, sustaining participation describes the children's reports of actualizing their preparations during the examination itself. Where the overall process of participation development was successful, the children reported a sense of mastery, growth and even joy. CONCLUSION While much work in the domain portrays children as relatively 'passive' agents during an MRI procedure, the findings herein point to how they can (with varying degrees of success) actively and constructively work with others. This, it is contended, has direct import for the improvement of support, both prior to and within a procedure itself.
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Affiliation(s)
- S Kada
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway.
| | - M Satinovic
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway.
| | - L Booth
- Department of Medical and Sport Sciences, University of Cumbria, Bowerham Road, Lancaster, LA1 3JD, UK.
| | - P K Miller
- Department of Medical and Sport Sciences, University of Cumbria, Bowerham Road, Lancaster, LA1 3JD, UK.
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Kossoff EH, Sutter L, Doerrer SC, Haney CA, Turner Z. Impact of Child Life Services on Children and Families Admitted to Start the Ketogenic Diet. J Child Neurol 2017; 32:828-833. [PMID: 28482736 DOI: 10.1177/0883073817709179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Traditionally the ketogenic diet is started as an inpatient admission to the hospital. Starting in January 2015, child life services were made formally available during ketogenic diet admissions to help families cope. One-page surveys were then provided to 15 parents on the day of discharge and again after 3 months. Every family believed that the child life services were helpful. Children who were developmentally appropriate/mildly delayed had higher parent-reported anxiety scores than those who were moderate to severely delayed (4.4 vs 1.0, P = .02). At 3 months, child life services were deemed very helpful for the parents (mean score: 8.9, range: 5-10), and were more helpful for the parent than the child (mean 6.2, range 1-10, P = .047). One of the most helpful services was a prior phone call to parents 1 week prior. In this small pilot study, child life involvement during the start of the ketogenic diet was highly useful.
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Affiliation(s)
- Eric H Kossoff
- 1 Departments of Neurology and Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Lindsay Sutter
- 2 Division of Child Life, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Sarah C Doerrer
- 1 Departments of Neurology and Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Courtney A Haney
- 3 Division of Nutrition, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Zahava Turner
- 3 Division of Nutrition, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
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