1
|
Mete İzci S, Çetinkaya B. The impact of digital storytelling for children during paediatric day surgery on anxiety and negative emotional behaviors: Randomized controlled trial. J Pediatr Nurs 2024; 77:e231-e241. [PMID: 38658306 DOI: 10.1016/j.pedn.2024.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE The aim of the study was to examine the effectiveness of digital storytelling as a therapeutic care intervention in paediatric day surgery. DESIGN AND METHODS his study was conducted in a randomized controlled experimental design. Seventy-two voluntary children who were scheduled for day surgery and met the inclusion criteria for the study were included. Research data were collected using the Child's Descriptive Information Form, the Children's Emotional Manifestation Scale, and the State Anxiety Inventory for Children. The study group used digital storytelling to prepare for day surgery. RESULTS State anxiety scores decreased over time in the study group. The digital storytelling intervention was found to be effective in reducing anxiety scores. In the control group, state anxiety scores were highest on the day of the surgery. Children in the control group experienced higher levels of anxiety on the day of the surgery compared to those in the study group. The high anxiety levels in the control group continued at a higher level even two weeks after surgery. Children in the control group exhibited more negative emotional behaviors on the day of the surgery. CONCLUSION The digital storytelling intervention implemented in this research was found to be effective in reducing children's anxiety and negative emotional behaviors. PRACTICE IMPLICATIONS Digital storytelling should be applied and adapted to various other areas of paediatric surgery. Its utilization is significant for nurses working in the field of day surgery.
Collapse
Affiliation(s)
- Selver Mete İzci
- Pediatric Nursing, Institute for Health Sciences, Pamukkale University, Denizli,Turkey.
| | - Bengü Çetinkaya
- Faculty of Health Sciences, Department of Pediatric Nursing, Pamukkale University, Denizli,Turkey.
| |
Collapse
|
2
|
Matava CT, Bordini M, Sullivan BO, Garcia-Tejedor GA, Gai N, Petroz G, Donnell CM, Alam F, Brazel K, Caldeira-Kulbakas M. Virtual parental presence with coaching for reducing preoperative anxiety in children: a feasibility and pilot randomized controlled trial. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:844533. [PMID: 38942079 DOI: 10.1016/j.bjane.2024.844533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/03/2024] [Accepted: 06/08/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety; nevertheless, it is not always possible or effective, namely when parents are overly anxious. Parental presence via video has been demonstrated to be useful in other contexts (divorce, criminal court). This study reports the feasibility of a randomized controlled trial to investigate the effect of video parental presence and parental coaching at induction on preoperative anxiety. METHODS The study was a randomized, 2 × 2 factorial design trial examining parental presence (virtual vs. physical) and coaching (provided vs. not provided). Feasibility was assessed by enrollment rate, attrition rate, compliance, and staff satisfaction with virtual method with the NASA-Task Load Index (NASA-TLX) and System Usability Scale (SUS). For the children's anxiety and postoperative outcomes, the modified Yale Preoperative Anxiety Scale (mYPAS) and Post-Hospitalization Behavioral Questionnaire (PHBQ) were used. Parental anxiety was evaluated with the State-Trait Anxiety Inventory (STAI) questionnaire. RESULTS A total of 41 parent/patient dyads were recruited. The enrollment rate was 32.2%, the attrition rate 25.5%. Compliance was 87.8% for parents and 85% for staff. The SUS was 67.5/100 and 63.5/100 and NASA-TLX was 29.2 (21.5-36.8) and 27.6 (8.2-3.7) for the anesthesiologists and induction nurses, respectively. No statistically significant difference was found in mYPAS, PHBQ and STAI. CONCLUSION A randomized controlled trial to explore virtual parental presence effect on preoperative anxiety is feasible. Further studies are needed to investigate its role and the role of parent coaching in reducing preoperative anxiety.
Collapse
Affiliation(s)
- Clyde T Matava
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada; University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
| | - Martina Bordini
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada; University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada; University of Bologna, Department of Medical and Surgical Sciences (DIMEC), Bologna, Italy
| | - Ben O' Sullivan
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada
| | | | - Nan Gai
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada; University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada
| | - Guy Petroz
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada
| | - Conor Mc Donnell
- The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada
| | - Fahad Alam
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Department of Anesthesia, Toronto, Ontario, Canada
| | - Katie Brazel
- Hospital for Sick Children, Child Life Department, Toronto, Ontario, Canada
| | | |
Collapse
|
3
|
Williamson KA. Nurse-led Preoperative Education With Home-based Internet Resources for Pediatric Patients and Their Parents. J Perianesth Nurs 2024; 39:6-9. [PMID: 37656107 DOI: 10.1016/j.jopan.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/18/2022] [Accepted: 05/02/2023] [Indexed: 09/02/2023]
Abstract
The majority of pediatric patients and their parents experience fear and anxiety related to their surgical experience. Traditionally, anesthesia providers addressed this anxiety with pharmacologic therapy, such as benzodiazepines, to provide amnesia and anxiolysis. However, this approach has been questioned due to the potential for developmental neurotoxicity, among other drawbacks. Further, the pharmacological approach does not remove preexisting anxiety that the child and parent experience before arrival and during check-in. Pediatric and parental preparation before surgery is an important step that continues to be inconsistently addressed, particularly in lower-resource community hospitals where the majority of routine pediatric outpatient procedures occur. This care gap provides an opportunity for preanesthesia nurses to intervene with valid, evidence-based preoperative education tools aimed at pediatric patients and their parents. Providing these resources before the day of surgery allows time for child-directed, at-home practice as often as the parent(s) and patient choose. Use of available resources from a leading children's hospital, nurses can create a tailored, developmentally appropriate preoperative education plan for pediatric patients and their parents, providing families with the power to create a positive surgical experience.
Collapse
|
4
|
Godbole NB, Paliwoda ED, Gajjar AA, Gupta N, Nguyen A, Nguyen A, Alexander R. Patient and Caregiver Perception of Adenoidectomies: A Non-Real-World Social Media Analysis. OTO Open 2024; 8:e100. [PMID: 38274440 PMCID: PMC10809292 DOI: 10.1002/oto2.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/27/2024] Open
Abstract
Objective To survey the social media outlets Twitter and Instagram for public posts related to adenoidectomy surgery. This study aims to investigate the attitudes and perceptions of patients and caregivers on social media, through thematic content-analysis of social media posts regarding adenoidectomy. Study Design Non-real world qualitative study. Setting Twitter and Instagram social media platforms. Methods Public posts uploaded between February, 2021 and February, 2023 using the hashtags "#adenoidectomy," and "#adenoidectomyrecovery" were searched. Posts were excluded if they were unrelated to adenoidectomy or were in a non-English language. Relevant posts were stratified demographically as patient or caregiver and pre- or postoperative, and categorized into relevant themes for analysis. Outcomes were measured as the total number of posts. Results A total of 394 relevant posts were analyzed. A significance threshold of P < 0.05 was used. Patients posted significantly more posts regarding procedure pain (P = 0.002) and concern for appearance (P = 0.048) compared to caregivers. Caregivers posted significantly (P < 0.001) more posts regarding condition awareness and were significantly (P < 0.001) more likely to spread positivity in their posts compared to patients themselves. Posts made by female caregivers were more likely to reference fear, while those made by male caregivers were more likely to provide education (P = 0.002). Conclusion Patients may worry about appearance and mental health while caregivers are more likely to spread information and positivity. Male and female caregivers may also use social media differently. A better understanding of patient and caregiver concerns may optimize physician interaction and involvement.
Collapse
Affiliation(s)
- Nikhil B. Godbole
- Department of OtolaryngologyTulane University School of MedicineNew OrleansLouisianaUSA
| | | | - Avi A. Gajjar
- Department of NeurosurgeryHospital of University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Nithin Gupta
- Department of OtolaryngologyCampbell University School of Osteopathic MedicineLillingtonNorth CarolinaUSA
| | - Alexander Nguyen
- Department of OtolaryngologyCreighton University School of MedicinePhoenixArizonaUSA
| | - Andrew Nguyen
- Department of Otolaryngology, College of MedicineUniversity of FloridaGainesvilleFloridaUSA
| | | |
Collapse
|
5
|
LiaBraaten BM, Linneman N, Czarnecki M, Davies WH, Zhang L, Simpson PM, Jastrowski Mano KE, Weisman SJ, Hainsworth KR. Stress Numerical Rating Scale-11: Validation in Pediatric Inpatient and Outpatient Pain Settings. Pain Manag Nurs 2023:S1524-9042(23)00076-0. [PMID: 37059666 DOI: 10.1016/j.pmn.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 04/16/2023]
Abstract
Stress is a commonly reported issue in pediatric populations of chronic and acute pain. Both outpatient and inpatient settings impose time constraints, which decreases opportunities to measure and address patient stress. The aim of these studies was to evaluate the validity of the Stress Numeric Rating Scale-11 (SNRS-11) in both inpatient and outpatient settings. The SNRS-11 is a single item stress measure ranging from 0 to 10 with endpoint anchors: 0 = "No stress" and 10 = "Highest stress possible". Results showed discriminative validity in the inpatient sample and convergent and discriminant validity in both outpatient and inpatient samples. Additionally, approximately 40% to 50% of the sample reported moderate-severe stress on all post-operative days. The SNRS-11 shows promise as a quick, easy, and free stress measure to be used in both inpatient and outpatient settings.
Collapse
Affiliation(s)
- Brynn M LiaBraaten
- Department of Anesthesiology, Medical College of Wisconsin, and Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Milwaukee, Wisconsin.
| | - Nina Linneman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - W Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Liyun Zhang
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pippa M Simpson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Steven J Weisman
- Department of Anesthesiology, Medical College of Wisconsin, and Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Milwaukee, Wisconsin; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Keri R Hainsworth
- Department of Anesthesiology, Medical College of Wisconsin, and Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
6
|
Fenikowski D, Tomaszek L. Factors Related to Anxiety in Paediatric Patients and Their Parents before and after a Modified Ravitch Procedure-A Single-Centre Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16701. [PMID: 36554581 PMCID: PMC9779648 DOI: 10.3390/ijerph192416701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To assess the factors related to perioperative state anxiety in paediatric patients and their parents. METHODS A cohort study was conducted on paediatric patients 9-17 years of age, who underwent the modified Ravitch procedure (n = 96), and their parents (n = 96). The level of anxiety was measured using the State-Trait Anxiety Inventory questionnaire. Multivariable linear regression models were calculated to find the relationships between the pre- and postoperative state anxiety of the patients/parents and the independent variables, both demographic (age, gender) and clinical (e.g., postoperative pain, trait anxiety). RESULTS Preoperative anxiety in the paediatric patients was positively correlated with their trait anxiety (β = 0.47; 95% CI: 0.29 to 0.64) and preoperative parental anxiety (β = 0.24; 95% CI: 0.07 to 0.42). The high level of preoperative anxiety (vs. low and moderate) (β = 0.40; 95% CI: 0.22 to 0.58), trait anxiety (β = 0.22; 95% CI: 0.04 to 0.40) and average postoperative pain at rest (β = 0.18; 95% CI: 0.01 to 0.34) had a positive impact on the postoperative anxiety in patients. However, the patients' age was negatively correlated with postoperative anxiety (β = -0.19; 95% CI: -0.35 to -0.02). Three variables were found to predict preoperative parental anxiety: their trait anxiety (β = 0.41; 95% CI: 0.23 to 0.59), female gender (β = 0.18; 95% CI: 0.002 to 0.36) and the intravenous route for the postoperative pain management in the patients (β = -0.18; 95% CI: -0.36 to -0.001). The parental postoperative anxiety was influenced by their trait anxiety (β = 0.24; 95% CI: 0.04 to 0.43), preoperative anxiety in patients (β = 0.21; 95% CI: 0.02 to 0.40) and female gender of children (β = 0.19; 95% CI: 0.001 to 0.39). CONCLUSIONS Trait anxiety was a strong factor positively affecting the perioperative state anxiety. In addition, paediatric patient anxiety before surgery was related to their parents' anxiety, and, after surgery, this was associated with high preoperative anxiety, pain and age. The parents' anxiety before surgery was influenced by gender and the type of postoperative analgesia in the patients, while, after surgery, this was influenced by the patients' preoperative anxiety/gender.
Collapse
Affiliation(s)
- Dariusz Fenikowski
- Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, Poland
| | - Lucyna Tomaszek
- Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, 34-700 Rabka-Zdrój, Poland
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland
| |
Collapse
|
7
|
Ding X, Wen J, Yue X, Zhao Y, Qi C, Wang D, Wei X. Effect of comprehensive nursing intervention for congenital heart disease in children: A meta-analysis. Medicine (Baltimore) 2022; 101:e31184. [PMID: 36253978 PMCID: PMC9575750 DOI: 10.1097/md.0000000000031184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This meta-analysis aimed to assess the impact of nursing interventions (e.g., educational and empathic interviewing, motor exercise, therapeutic play interventions) on the perioperative outcome of children with congenital heart disease (CHD). METHODS We searched PubMed, Embase, Web of Science, Scopus, Cochrane, EBSCO, The Chinese National Knowledge Infrastructure, Wan Fang Data and the VIP Chinese Journal Service platform from the date of database creation to August 2021. Our study adhered to the recommendations of the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RevMan 5.4 and Stata 16.0 were used to complete the meta-analysis. RESULTS This meta-analysis showed that comprehensive nursing intervention reduced both the length of hospital stay (weighted mean difference [WMD] = -1.982, 95%CI [-2.329, -1.634], P < .001) and the related risk of post-operative complications [OR = 0.345, 95%CI (0.225, 0.528), P < .001]. In addition, nursing intervention increased parental satisfaction with the care provided [OR = 0.308, 95%CI (1.923, 6.863), P < .001]. Nursing interventions have also had a positive impact in reducing preoperative anxiety [WMD = -6.721, 95% CI (-7.194, -6.249), P < .001] and postoperative pain [WMD = -7.103, 95% CI (-7.103, -7.663), P < .001] in children. CONCLUSIONS This meta-analysis confirms the beneficial effects of comprehensive nursing interventions in terms of reduced complication rates and shorter hospital stays. The effectiveness of comprehensive nursing in reducing anxiety and pain levels was also demonstrated. The findings support the implementation of comprehensive care interventions in the perioperative period for children with CHD to improve clinical outcomes.
Collapse
Affiliation(s)
- Xueying Ding
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Jiaxuan Wen
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Xinxin Yue
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Yudan Zhao
- Department of Cardiology, Affiliated Medical College of Weifang Medical College, Weifang, Shandong province, China
| | - Cuiping Qi
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Di Wang
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Xiuhong Wei
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
- *Correspondence: Xiuhong Wei, School of Nursing, Weifang Medical University, 7166 Baotong West Street, Weifang 261053, Shandong province, China (e-mail: )
| |
Collapse
|