1
|
Franconi I, Faragalli A, Palego G, Canonici S, Gatti L, Simonini A, Bindi E, Cobellis G, Carle F. Preoperative anxiety management in children. Benefits of humanoid robots: an experimental study. Front Surg 2023; 10:1322085. [PMID: 38145215 PMCID: PMC10739395 DOI: 10.3389/fsurg.2023.1322085] [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: 10/15/2023] [Accepted: 11/14/2023] [Indexed: 12/26/2023] Open
Abstract
Objective The purpose of this study was to determine whether the use of a humanoid robot (Estrabot) could reduce preoperative anxiety levels in children. Methods An experimental study was conducted at Azienda Ospedaliero Universitaria delle Marche Hospital, involving the Pediatric Surgery ward and the Operating Room (OR). Patients aged between 2 and 14 years who underwent minor surgery were included. The Instruments used were the Children's Emotional Manifestation Scale to evaluate anxiety levels, and Estrabot, a humanoid robot that interacts with people. Medical records between April and May 2023 were analyzed and the data was anonymous. The level of anxiety is extrapolated in Pediatric Surgery during the administration of oral pre-medication, and in the Operating Room, during the induction of anesthesia. Patients were divided into an intervention group treated with Estrabot, and a control group without a robot. Results The population consists of 60 patients (86.7% male) with a median (IQR) age of 6 (4-8) years. The median (IQR) anxiety score during premedication was 7 (5-11), while the median (IQR) anxiety score during anesthesia was 6 (5-10). A significantly lower level of anxiety was reported in the Estrabot group. Patients in the Estrabot group had significantly lower anxiety levels in different age groups. Conclusion A humanoid robot can reduce preoperative anxiety levels in children during premedication and the induction of anesthesia.
Collapse
Affiliation(s)
- Ilaria Franconi
- Operating Room, Salesi Children’s Hospital, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Andrea Faragalli
- Department of Biomedical Sciences and Public Health, Center of Epidemiology, Biostatistics and Medical Information Technology, Marche Polytechnic University, Ancona, Italy
| | - Giulia Palego
- AOU delle Marche, Salesi Hospital Foundation Onlus, Ancona, Italy
| | - Samuele Canonici
- AOU delle Marche, Salesi Hospital Foundation Onlus, Ancona, Italy
| | - Ludovica Gatti
- Operating Room, Salesi Children’s Hospital, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Alessandro Simonini
- Pediatric Intensive Care Unit, Salesi Children’s Hospital, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Edoardo Bindi
- Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy
- Department of Clinical Specialty Sciences and Odontostomatology, Università Politecnica of Marche, Ancona, Italy
| | - Giovanni Cobellis
- Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy
- Department of Clinical Specialty Sciences and Odontostomatology, Università Politecnica of Marche, Ancona, Italy
| | - Flavia Carle
- Department of Biomedical Sciences and Public Health, Center of Epidemiology, Biostatistics and Medical Information Technology, Marche Polytechnic University, Ancona, Italy
| |
Collapse
|
2
|
Zhang MQ, Xu MZ, He Y, Su YW, Ma J, Zuo YX. Comparison of S-ketamine and midazolam for intravenous preoperative sedative and anxiolytic effects in preschool children: study protocol for a randomized controlled clinical trial. Trials 2023; 24:724. [PMID: 37957769 PMCID: PMC10644481 DOI: 10.1186/s13063-023-07767-2] [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: 05/31/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Preoperative anxiety management is gaining particular attention in paediatric anaesthesia. Pharmacological and non-pharmacological resorts can be implemented to address this special issue. Despite the various approaches currently used for preoperative sedation in children, the different sedative and anti-anxiety effects between the newly marketed anaesthetic, S-ketamine, and the traditional sedative, midazolam, are still unclear. METHODS This is a patient- and assessor-blinded randomized controlled clinical trial. Participants (n = 110) will receive S-ketamine (0.5 mg/kg) or midazolam (0.08 mg/kg) intravenously administrated at a ratio of 1:1 in the anaesthesia holding area. The primary outcome of this study is the sedative effect evaluated via the change in the modified Yale preoperative anxiety scale. It will be performed at two timepoints: in the pre-anaesthetic holding area before premedication (baseline, marked as T0) and about 5 min after premedication in the operating room without the existence of their guardians (marked as T1). Our secondary objectives include the parent separation anxiety score, postoperative agitation, caregivers' and anaesthesia care providers' satisfaction, and mask compliance. DISCUSSION This randomized controlled trial is the first study to compare the anti-anxiety effect of intravenous S-ketamine and midazolam. We will provide a new approach for the clinical management of preoperative anxiety in preschool children posted for elective surgery. TRIAL REGISTRATION ChiCTR2300069998. Registered on 30 March 2023.
Collapse
Affiliation(s)
- Meng-Qiu Zhang
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ming-Zhe Xu
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yi He
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yong-Wei Su
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jun Ma
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yun-Xia Zuo
- Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
3
|
Aşkan F, Lafcı Bakar D. The Effect of Hand Massage on Preoperative Anxiety Level and Hemodynamic Variables in Children: A Randomized Controlled Trial. J Perianesth Nurs 2023; 38:773-781. [PMID: 37452817 DOI: 10.1016/j.jopan.2023.01.013] [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: 06/06/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The study was conducted to determine the effect of hand massage applied to preoperative children on anxiety level and hemodynamic variables. DESIGN This research study is a randomized controlled trial with control and study groups, pre- and post-tests. METHODS This study was conducted between April and September 2017 with 84 children who were planned to receive an operation by applying general/local anesthesia in a province in the south of Turkey. The population of the research was composed of children between the ages 9 and 12 (study group = 42 and control group = 42). The data were collected through "Child and Parent Information Form," "State-Trait Anxiety Inventory for Children," "Physical Symptoms Follow-up Form for Anxiety," and "Satisfaction Evaluation Scale." FINDINGS The state-trait anxiety mean after hand massage was found to be 25.78 ± 5.90 in the study group, and 31.80 ± 6.51 in the control group (P < .05). There was a statistically significant difference (P < .05) between the systolic blood pressures and heart rate averages of the children in the study group after hand massage. There was a negative correlation between the satisfaction hand massage and state-trait anxiety means of the study group children (P < .05). CONCLUSIONS Hand massage was found to have a positive effect on reducing anxiety, systolic blood pressure and heart rate. No effect was found on diastolic blood pressure, respiratory rate and SpO2. We recommend that more extensive studies on hand massage are performed.
Collapse
Affiliation(s)
- Fahri Aşkan
- Faculty of Health Sciences, Van Yüzüncü Yıl University, Van, Turkey
| | | |
Collapse
|
4
|
Liu W, Sun R, Gao X, Wang S. Effects of preoperative nasal spray esketamine on separation anxiety and emergence agitation in pediatric strabismus surgery: A randomized clinical trial. Medicine (Baltimore) 2022; 101:e32280. [PMID: 36595799 PMCID: PMC9794350 DOI: 10.1097/md.0000000000032280] [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: 12/28/2022] Open
Abstract
OBJECTIVE To investigate the effects of preoperative nasal spray esketamine on separation anxiety and postoperative emergence agitation in pediatric strabismus surgery. METHOD Ninety children aged 3 to 6 years who underwent elective strabismus surgery were randomly divided into 3 groups that received 0.5 mg/kg (group S1), 1 mg/kg of esketamine (group S2), and the same volume of normal saline (group C) by nasal spray 10 minutes before surgery. The observation indicators of this test include the Ramsay sedation score, separation anxiety score, mask induction score, and the incidences of postoperative emergence agitation. Patient's heart rate, blood oxygen, post anesthesia care unit stay time, and any adverse events were recorded. RESULTS The Ramsay sedation score was significantly lower in group C than those in groups S1 and S2 (P < .001). The separation anxiety scores and the mask induction scores were significantly higher in group C than those in groups S1 and S2 (P < .001). The incidences of emergence agitation in groups S1 and S2 were significantly lower than that in C group (P < .001). No obvious clinical complication was observed. CONCLUSION Preoperative nasal spray esketamine reduced the preoperative separation anxiety and decrease emergence agitation in pediatric strabismus surgery.
Collapse
Affiliation(s)
- Wei Liu
- Department of Anesthesiology, Tianjin Eye Hospital, Tianjin, China
| | - Ruiqiang Sun
- Department of Anesthesiology, Tianjin Eye Hospital, Tianjin, China
| | - Xuesong Gao
- Department of Anesthesiology, Tianjin Eye Hospital, Tianjin, China
| | - Shuzhen Wang
- Department of Anesthesiology, Tianjin Eye Hospital, Tianjin, China
| |
Collapse
|
5
|
Yang CQ, Yu KH, Huang RR, Qu SS, Zhang JM, Li YL. Comparison of different sedatives in children before general anaesthesia for selective surgery: A network meta-analysis. J Clin Pharm Ther 2022; 47:1495-1505. [PMID: 36029118 DOI: 10.1111/jcpt.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE It is estimated that 60% of children undergoing anaesthesia develop severe preoperative anxiety. The anxiety is associated with adverse reactions. Sedatives such as dexmedetomidine, midazolam, clonidine, ketamine, and melatonin can be used as premedication against preoperative anxiety. However, no consensus has been reached on the choice of pre-anaesthetic sedatives in children before selective surgery. Therefore, the current network meta-analysis (NMA) was carried out to evaluate different sedatives in children aged between 1 and 7 before general anaesthesia for selective surgery. METHODS Randomized clinical trials (RCTs) were retrieved from Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases from inception to October 22, 2021. Primary outcomes showed satisfactory sedation at parent separation and also at induction or mask acceptance. Secondary outcomes were those related to added benefits and side effects. The present NMA was conducted using the R software. Results of the study were reported as Relative Risk (RR) or Mean Difference (MD) at a 95% credible intervals (CrIs). RESULTS AND DISCUSSION A total of 48 trials were included in the present study. It was found that the effectiveness of dexmedetomidine, midazolam, clonidine, and ketamine were superior to that of placebo in satisfactory sedation at parent separation and induction or mask acceptance. There was no significant difference between melatonin and placebo in satisfactory sedation at induction or mask acceptance. Dexmedetomidine, ketamine, clonidine, and melatonin were superior to placebo in reducing emergence delirium (ED). In addition, midazolam prolonged the length of stay in the post anaesthesia care unit (PACU) as compared with placebo. Dexmedetomidine caused a significant reduction in systolic blood pressure (SBP) and heart rate (HR). Nevertheless, it was noted that the hemodynamic changes were roughly within safety limits. WHAT IS NEW AND CONCLUSION It was evident that the studied drugs can provide effective sedation with exception of melatonin and placebo. However, it was found that midazolam, ketamine, and clonidine lead to several side effects. The findings of the present study supported that dexmedetomidine, especially intranasal administration, has potential in the optimal selection of the sedatives for premedication in children. This is because the drug has effective sedation, reduced incidence of ED, side effects, and onset time.
Collapse
Affiliation(s)
- Chuan-Qi Yang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Kai-Hua Yu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Rong-Rong Huang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Shan-Shan Qu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China.,The Reproductive Medicine Center, The First Hospital of Lanzhou University, Lanzhou, China
| | - Jun-Mei Zhang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yu-Lan Li
- Department of Anesthesiology, The First Hospital of Lanzhou University, Lanzhou, China
| |
Collapse
|
6
|
Wu J, Yan J, Zhang L, Chen J, Cheng Y, Wang Y, Zhu M, Cheng L, Zhang L. The effectiveness of distraction as preoperative anxiety management technique in paediatric patients: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2022; 130:104232. [DOI: 10.1016/j.ijnurstu.2022.104232] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022]
|
7
|
Liang Y, Huang W, Hu X, Jiang M, Liu T, Yue H, Li X. Preoperative anxiety in children aged 2-7 years old: a cross-sectional analysis of the associated risk factors. Transl Pediatr 2021; 10:2024-2034. [PMID: 34584872 PMCID: PMC8429856 DOI: 10.21037/tp-21-215] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/15/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Preoperative anxiety in children is harmful. Despite this, there is a scarcity of studies examining the incidence of preoperative anxiety and its related effects in China. This study investigated preoperative anxiety in children aged 2 to 7 in the pediatric surgery department of a tertiary hospital in China. The factors influencing preoperative anxiety in these children were identified. METHODS The researchers used the Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS) and the Short Form of CmYPAS (CmYPAS-SF) to assess the preoperative anxiety state of children aged 2 to 7 who underwent elective surgery in the pediatric department of a tertiary hospital in China from July 1, 2020 to September 30, 2020 were enrolled in this study. The generalized estimating equation model was used to analyze the factors influencing preoperative anxiety in children. RESULTS The preoperative anxiety rate of 220 children in the tertiary hospital was 67.6%. Multivariate analysis revealed that children who attended elementary school had a lower risk of preoperative anxiety compared to children who did not attend school [odd ratio (OR) =0.39, 95% confidence interval (CI), 0.19 to 0.79, P=0.010]. Children whose caregivers felt very worried experienced an increased risk of preoperative anxiety compared to children whose caregivers were not worried about the surgery at all (OR =3.40, 95% CI, 1.35 to 8.56, P=0.009). Children who were very resistant, cried violently, twisted their bodies during puncturing the needle were 5.8 times more likely to experience preoperative anxiety compared to children who were very cooperative. The risk of preoperative anxiety in children who cooperated with a staff member was about 1.5 times higher than that of children who were very cooperative. CONCLUSIONS The incidence of preoperative anxiety in children aged 2 to 7 in the tertiary hospital in China was similar to the children in other countries. The caregivers' degree of concern priored to the operation and the degree of cooperation from the children during puncturing the indwelling needle were the main factors influencing the occurrence of preoperative anxiety.
Collapse
Affiliation(s)
- Yuanyuan Liang
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Wenjiao Huang
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Xinyu Hu
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Meiling Jiang
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Tian Liu
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong Yue
- Department of Pediatric Surgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaoling Li
- West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
8
|
Seyedhejazi M, Sharabiani BA, Davari A, Taghizadieh N. A comparison of preoperative psychological preparation with midazolam premedication to reduce anxiety in children undergoing adenotonsillectomy. Afr J Paediatr Surg 2020; 17:10-14. [PMID: 33106446 PMCID: PMC7818662 DOI: 10.4103/ajps.ajps_62_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Considering the multiplicity of adenotonsillectomy in children 2-10-year old at the paediatric surgery centres, patient anxiety leads to an increase in surgical and anaesthetic complications. Patients' unfamiliarity with surgical and anaesthetic interventions may increase their stress. Midazolam premedication reduces patient anxiety. In previous studies, psychological preparation before surgery using understandable terms to children, has reduced their anxiety. The aim of this study was to compare and study behavioural reflections among the children in two groups: the first group was prescribed oral midazolam, and the second group received psychological preparation with the booklet about anaesthesia and anaesthesia-resident explanation. MATERIALS AND METHODS This study is a clinical trial conducted on 48 children undergoing adenotonsillectomy. Children in the first group (midazolam group) received oral midazolam 0.5 mg/kg, 20 min before surgery. A booklet containing pictures and information about anaesthesia and the operating room was given to the second group (psychological preparation group) the night before surgery and anaesthesia resident explained the booklet to the children. The anxiety level was measured in both groups using the State-Trait Anxiety Inventory for Children questionnaire the night before surgery and on the morning of surgery (after giving midazolam to Group II). The results were analysed using SPSS. RESULTS In this study, 58.3% of the first group and 45.8% of the second group were male. The mean age of the first and second groups was 8.45 ± 1.86 and 9.12 ± 1.72 years, respectively. The anxiety in the first group significantly decreased in the morning before surgery compared to the night before operation (P < 0.001). The anxiety in the second group significantly decreased in the morning before surgery compared to the night before as well (P < 0.001). CONCLUSION The results showed that midazolam and psychological preparation prior to surgery can reduce the anxiety of children before adenotonsillectomy.
Collapse
Affiliation(s)
- Mahin Seyedhejazi
- Department of Anesthesiology, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Afshin Davari
- Department of Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Nasrin Taghizadieh
- Department of Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| |
Collapse
|
9
|
Newman N, Kogan S, Stavsky M, Pintov S, Lior Y. The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience. Pediatr Rep 2019; 11:8165. [PMID: 31579203 PMCID: PMC6769359 DOI: 10.4081/pr.2019.8165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 12/27/2022] Open
Abstract
While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12- hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.
Collapse
Affiliation(s)
- Nitza Newman
- Pediatric Surgery Department, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva
| | - Slava Kogan
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
- Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
| | - Moshe Stavsky
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
- Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
| | - Shay Pintov
- The Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Yotam Lior
- Joyce and Irwing Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
- Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva
| |
Collapse
|
10
|
Abstract
Background Receiving preoperative information is a right of all parents whose children are admitted for surgery. Information for parents can help to prepare children and lessen anxiety for both parent and child. Aim This study aims to assess the preoperative information needs of parents. Methods This was a cross-sectional descriptive study. A non-probability convenience sampling technique was used to select 100 parents whose children, aged between 0 and 18 years, were admitted for surgery. The Parents Desire for Information scale was used to collect the data, which were then analysed using descriptive statistics. Results The majority of the sample indicated that it is essential to receive preoperative information. The aspects of preoperative information rated as essential were as follows: need for the surgery; duration of hospitalisation; informed consent; fasting time; investigations; medications; physical preparations; dress code for the child; waiting time and place; parental involvement in the operating theatre/recovery/ward; pain management; post-operative care including eating, drinking, ambulation, wound care, discharge instructions and follow up. The majority (60%) of the parents said that they prefer to receive verbal instructions. The majority (63%) of the study participants said that it was the doctors who provided the information, and of these, 70% rated the information received as good. Conclusions The present study concludes that parents of children undergoing surgery welcome comprehensive preoperative information.
Collapse
|
11
|
Vagnoli L, Bettini A, Amore E, De Masi S, Messeri A. Relaxation-guided imagery reduces perioperative anxiety and pain in children: a randomized study. Eur J Pediatr 2019; 178:913-921. [PMID: 30944985 DOI: 10.1007/s00431-019-03376-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/06/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022]
Abstract
Several studies have shown the efficacy of psychological interventions in reducing preoperative anxiety in children undergoing surgery. This study aims to investigate the effectiveness of a specific non-pharmacological technique, the relaxation-guided imagery, in reducing both preoperative anxiety and postoperative pain in a sample of 60 children (6-12 years old) undergoing minor surgery who were randomly assigned to the experimental group (N = 30) or the control group (N = 30). The first group received the relaxation-guided imagery, before the induction of general anesthesia; the second group received standard care. The levels of preoperative anxiety and postoperative pain were assessed using, respectively, the modified Yale Preoperative Anxiety Scale and the Face, Legs, Activity, Cry, and Consolability Scale. The results showed a statistically significant difference between groups, with less anxiety and less pain for children included in the experimental group (p < .001; p < .001).Conclusion: Results suggest that relaxation-guided imagery reduces preoperative anxiety and postoperative pain in children. Future studies should focus on developing protocols and studying the eventual reduction of administered drugs for anesthesia and pain. What is Known: • Literature suggests the usefulness of relaxation-guided imagery in reducing anxiety and pain in the perioperative period. • Stronger evidences are needed to support the application of relaxation-guided imagery as routine care in pediatric surgery. What is New: • To our knowledge, this is the first randomized study to investigate the efficacy of relaxation-guided imagery in reducing preoperative anxiety and postoperative pain within a single pediatric sample. • The present study provides stronger evidence in an area that is lacking in research.
Collapse
Affiliation(s)
- Laura Vagnoli
- Pediatric Psychology, Meyer Children's Hospital, Via G. Pieraccini 24, 50139, Florence, Italy.
| | - Alessandra Bettini
- Pediatric Psychology, Meyer Children's Hospital, Via G. Pieraccini 24, 50139, Florence, Italy
| | - Elena Amore
- Pediatric Psychology, Meyer Children's Hospital, Via G. Pieraccini 24, 50139, Florence, Italy
| | - Salvatore De Masi
- Clinical Trial Office, Meyer Children's Hospital, Via G. Pieraccini 24, 50139, Florence, Italy
| | - Andrea Messeri
- Pain Service & Palliative Care, Meyer Children's Hospital, Via G. Pieraccini 24, 50139, Florence, Italy
| |
Collapse
|
12
|
Pomicino L, Maccacari E, Buchini S. Levels of anxiety in parents in the 24 hr before and after their child's surgery: A descriptive study. J Clin Nurs 2017; 27:278-287. [DOI: 10.1111/jocn.13895] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Laura Pomicino
- Pediatric Oncology and Hematology Department; Institute for Maternal and Child Health-IRCCS Burlo Garofolo; Trieste Italy
| | - Elena Maccacari
- Pediatric Intensive Care Unit; St George's University Hospitals-NHS Foundation Trust; London UK
| | - Sara Buchini
- Unit of Research and Professional; Organizational Development of Health Professionals; Institute for Maternal and Child Health-IRCCS Burlo Garofolo; Trieste Italy
| |
Collapse
|
13
|
Cagiran E, Sergin D, Deniz MN, Tanattı B, Emiroglu N, Alper I. Effects of sociodemographic factors and maternal anxiety on preoperative anxiety in children. J Int Med Res 2014; 42:572-80. [PMID: 24501165 DOI: 10.1177/0300060513503758] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the effects of sociodemographic factors and maternal anxiety levels on behaviour in children undergoing surgery. METHODS This study included children aged 3-12 years who were scheduled for surgery, and their respective mothers. Each mother completed a questionnaire concerning sociodemographic and economic characteristics. Maternal anxiety was assessed using the State-Trait Anxiety Inventory (STAI) form Tx-1, following transfer of the child to the operating room. An anaesthesiologist rated preoperative anxiety in each child using the Frankl Behaviour Rating Scale (FBRS) and Venham Picture Test (VPT). RESULTS One hundred children (mean ± SD age 7 ± 2.7 years) who received dental (47%), plastic (39%) or urological (14%) surgery, and 100 mothers (mean ± SD age 34 ± 6.6 years) were included. A statistically significant difference between maternal STAI Tx-1 scores and children's VPT scores was revealed. There was no significant difference between maternal STAI Tx-1 scores and children's FBRS scores. Maternal education level and socioeconomic status had no effect on FBRS, VPT and STAI Tx-1 scores. CONCLUSION Maternal knowledge and experience of anaesthesia, and high levels of maternal anxiety, may be related to increased anxiety in children undergoing surgery.
Collapse
Affiliation(s)
- Esra Cagiran
- Department of Anaesthesia and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey
| | | | | | | | | | | |
Collapse
|
14
|
Healy K. A descriptive survey of the information needs of parents of children admitted for same day surgery. J Pediatr Nurs 2013; 28:179-85. [PMID: 22892072 DOI: 10.1016/j.pedn.2012.07.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 06/18/2012] [Accepted: 07/05/2012] [Indexed: 11/30/2022]
Abstract
Going to the hospital for surgery is an event that most people may find daunting. Anticipation of the unknown, lack of control over events and unfamiliarity with the environment may result in feelings of anxiety and stress. This research paper used a quantitative descriptive survey to establish the information needs of parents of children admitted for same day surgery. The main aims of this study were to establish what information parents had received prior to their child's admission for same day surgery, and how they perceived this information. It also determined what other information they required. The findings demonstrated that the majority of parents in this study were satisfied with the information they had received. However they wanted further advice on the waiting times involved, the equipment used in the operating room department, pain relief and the procedures in the recovery room.
Collapse
Affiliation(s)
- Kathy Healy
- Nurse Practice Development Unit, Cork University Hospital, Health Service Executive (South), Wilton, Cork, Ireland.
| |
Collapse
|
15
|
Kafka T, Economos C, Folta S, Sacheck J. Children as subjects in nutrition research: a retrospective look at their perceptions. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:103-109. [PMID: 21392713 DOI: 10.1016/j.jneb.2010.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 03/09/2010] [Accepted: 03/15/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To explore children's motivations for and perceived benefits and barriers to nutrition research participation. To explore children's perspectives on how to improve the research experience. DESIGN Seven focus group sessions were conducted during March 2008 with research participants from a trial that examined the effects of pre-exercise snacks on physical activity and exercise stress in children. The Health Belief Model for Behavior Change served as the framework for understanding perceived benefits and barriers to research participation and cues to action to help children's readiness for future research participation. SETTING Indoor sports center in Acton, Massachusetts. PARTICIPANTS Thirty-five children, 15 males and 20 females, aged 7-10 years. PHENOMENON OF INTEREST Children's participation in nutrition research. ANALYSIS Transcripts were reviewed, coded, and sorted according to recurring trends and patterns using NVIVO software. RESULTS Participants were overwhelmingly motivated to participate in research because of financial incentives. The biggest barrier to participation was anxiety over finger pricks. Children suggested demonstrating different aspects of data collection during recruitment to reduce trepidation and using distraction techniques to improve the experience during anxiety-provoking data collection. CONCLUSION AND IMPLICATIONS Themes for benefits and barriers to research participation were identified. Data also provide a guide to promote readiness and to improve the research experience for children in future nutrition trials.
Collapse
Affiliation(s)
- Tamar Kafka
- The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, The John Hancock Center for Physical Activity and Nutrition, Tufts University, Boston, MA 02111, USA.
| | | | | | | |
Collapse
|
16
|
Abstract
In the study of holistic perspectives in perioperative care the following article focuses on the care required for paediatric patients through the perioperative period. This incorporates an understanding of the anatomical, physiological and pharmacological differences from adult practice, acknowledging the most important principles of patient safety. The planning, implementation, equipment adaptations and psychological challenges associated with this group will be discussed in relation to improving the overall perioperative experience.
Collapse
Affiliation(s)
- Sue Clarke
- Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD.
| |
Collapse
|
17
|
Salmela M, Salanterä S, Aronen ET. Coping with hospital-related fears: experiences of pre-school-aged children. J Adv Nurs 2010; 66:1222-31. [DOI: 10.1111/j.1365-2648.2010.05287.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
18
|
Salmela M, Salanterä S, Ruotsalainen T, Aronen ET. Coping strategies for hospital-related fears in pre-school-aged children. J Paediatr Child Health 2010; 46:108-14. [PMID: 20105255 DOI: 10.1111/j.1440-1754.2009.01647.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to describe the child-reported coping strategies for hospital-related fears in 4-6-year-old children. METHOD The data were collected by semi-structured interviews of 4-6-year-old volunteering children (n= 82) in Finland. Thirty-four children were interviewed in hospital, and 48 in kindergarten. The children were chosen through a purposive sampling method, in which volunteers were asked to take part in the study. The data were analysed with quantitative and qualitative methods. RESULTS The most frequent child-reported coping strategies were: the presence of parents and other family members (81/517, 15.7%), the help of the hospital personnel (58/517, 11.2%), positive images and humour (57/517, 11%), play (57/517, 11%) and the child's own safety toy (45/517, 8.7%). The children interviewed in hospital mentioned significantly more often play (P= 0.000) as their coping strategy than children interviewed in a kindergarten. Children interviewed in kindergarten expressed significantly more often the presence of parents (P= 0.032) and the help of the doctor (P= 0.012) as their coping strategy than the children interviewed in the hospital. CONCLUSIONS The results showed that children have many coping strategies, especially ones in which the children themselves play an active role. Besides, the traditional methods for alleviating fear, children need possibilities to use coping methods in which they have an active role giving them a feeling of some control over the hospital environment and medical procedures.
Collapse
Affiliation(s)
- Marja Salmela
- Faculty of Medicine, University of Helsinki, Finland.
| | | | | | | |
Collapse
|
19
|
Wennström B, Hallberg LRM, Bergh I. Use of perioperative dialogues with children undergoing day surgery. J Adv Nurs 2008; 62:96-106. [DOI: 10.1111/j.1365-2648.2007.04581.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
O'Conner-Von S. Preparation of Adolescents for Outpatient Surgery: Using an Internet Program. AORN J 2008; 87:374-98. [DOI: 10.1016/j.aorn.2007.07.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 07/19/2007] [Accepted: 07/19/2007] [Indexed: 11/17/2022]
|