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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.
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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
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Raybin JL, Zhou W, Pan Z, Jankowski C. Quality of Life Outcomes With Creative Arts Therapy in Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:155-167. [PMID: 35467438 DOI: 10.1177/27527530211055988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Children with cancer experience distress and decreased quality of life (QOL). Creative arts therapy (CAT) is a therapeutic modality which may improve QOL. This study examined the relationship between CAT and QOL in children and adolescents with cancer. Secondary aims explored relationships between CAT and emotional reactions, resilience, and posture (to investigate future potential as an objective biomarker of QOL). Methods: Children aged 3-18 years undergoing cancer treatments and a parent proxy completed the PedsQL3.0 Cancer Module, Faces Scale for emotional reactions, Resilience Scale in adolescents (>12 years), and an inclinometer to measure thoracic kyphosis before and after CAT. CAT exposure (number of sessions) was recorded. Results: Ninety-eight children with cancer (mean age 7.8 years, range 3-17) and parent proxy were enrolled. Of the 83 participants included in the final analysis, 18 received no CAT, 32 received low dose, and 33 received high dose CAT. A significant improvement in QOL was seen with high dose CAT in (slope change, p = .015), but the overall time by group interaction was not significant. Slope change response patterns suggested that CAT led to improved posture as compared to no CAT (time by group interaction, p = .044). Discussion: CAT may be an effective intervention to improve QOL in this population. Because initial evidence suggests that posture also improves with CAT, further investigation of posture as a potential objective biomarker of QOL is supported. Further study with a randomized controlled trial is warranted.
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Affiliation(s)
- Jennifer L Raybin
- Pediatric Palliative Care, Center for Cancer and Blood Disorders, Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Wenru Zhou
- Colorado School of Public Health-Biostatistics and Informatics, CO, USA
| | - Zhaoxing Pan
- Department of Pediatrics, Anschutz School of Medicine, 129263University of Colorado, CO, USA
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Follow up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF multicenter descriptive prospective study. Pain 2022; 163:2224-2231. [PMID: 35239543 DOI: 10.1097/j.pain.0000000000002620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
ABSTRACT In pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children below 18 years of age scheduled for an elective outpatient procedure in one of the participating centers were eligible. Parents were invited to provide daily information for 10 days regarding their child's pain and comfort via a smartphone App using the Parents' Postoperative Pain Measure - Short Form (PPPM-SF). Children over 6 years old could also provide self-assessments of pain using a Numerical Rating Scale (NRS-11). Data regarding pain medication, preoperative anxiety, postoperative nausea and vomiting, and parent satisfaction were also analyzed. Repeated-measures analyses of variance (ANOVAs) were used to compare the self- and hetero-assessments of pain. Eleven centers participated in the study, and 1,573 patients were recruited. Forty-nine percent of parents (n = 772) actually used the App at least once. In all surgeries, the average pain rating on the PPPM-SF scale did not exceed 3/10 throughout the follow-up period, as well as for the four main surgical specialties. Age, visceral surgery, and preoperative anxiety ≥ 4/10 were identified as independent risk factors for experiencing at least one episode of pain ≥ 4/10 during the first 48 postoperative hours. While these findings indicated that postoperative pain management appears to be satisfactory in the families who used the App, some improvements in anxiety management are suggested. This study shows that inviting parents to use a smartphone App to assess and report the quality of postoperative management in pediatric patients, provides useful information. A continuous report is possible, regarding pain and adverse events, over a postoperative ten days period, by a self-reporting or a parent's contribution. Future studies should investigate the ability of live data collection using an App to ensure fast, efficient interactions between patients and physicians.
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Raybin JL, Hendricks-Ferguson V, Cook P, Jankowski C. Associations between demographics and quality of life in children in the first year of cancer treatment. Pediatr Blood Cancer 2021; 68:e29388. [PMID: 34626456 DOI: 10.1002/pbc.29388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/05/2022]
Abstract
Symptom distress and decreased quality of life (QOL) among children with cancer are well documented. Research is emerging on the child's voice in QOL-symptom reports, but existing QOL questionnaires are burdensome and objective biologic markers are lacking. We examined children's symptoms and QOL from parent and child perspectives and compared the results to one biologic marker (body posture). A cross-sectional secondary analysis of prospective data from children receiving creative arts therapy explored potential associations among demographics with and between QOL measures (PedsQL, Faces Scale, posture). Children (n = 98) ranged in age from 3 to 17 years (M = 7.8) and were in the first year of cancer treatment. No significant associations were found among the child's sex, race/ethnicity, socioeconomic status (SES), or distance from hospital, and total PedsQL. Older age was associated with worse total PedsQL, pain, nausea, worry, and posture (all P < 0.05). Greater worry (β = 0.51) and worse posture (β = 0.41) were the QOL variables most strongly correlated with older age. Poorer posture was associated with worse child PedsQL (total score, nausea, treatment anxiety, cognitive) and parent PedsQL (pain, nausea). Worse scores on the Faces Scale, PedsQL, and posture were all correlated (r = 0.21-0.39, all P < 0.05). Interventions to improve QOL could target nausea, worry, and older patients. Accuracy and interpretation of symptom distress in children are problematic. The Faces Scale and posture may be suitable, readily obtained measures of QOL in pediatric oncology that hold promise.
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Affiliation(s)
- Jennifer L Raybin
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado.,University of Colorado Anschutz Medical Campus, College of Nursing and School of Medicine, Aurora, Colorado
| | | | - Paul Cook
- University of Colorado Anschutz Medical Campus, College of Nursing and School of Medicine, Aurora, Colorado
| | - Catherine Jankowski
- University of Colorado Anschutz Medical Campus, College of Nursing and School of Medicine, Aurora, Colorado
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Delivet H, Beauvais D, Mialot A, Vacher T, Marsac L, Brasher C, Michelet D, Dahmani S. Description of typical personality factors and events that lead to anxiety at induction of anesthesia in French children. Paediatr Anaesth 2018; 28:987-998. [PMID: 30251353 DOI: 10.1111/pan.13492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/02/2018] [Accepted: 08/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Preventive strategies are available to reduce preoperative anxiety in children, the ideal time for implementing such strategies remains poorly determined. AIMS The aim of this study was to determine psychological factors and events involved in the development of preoperative anxiety in children. METHODS This study consisted of prospective evaluations of anxiety trait and state during the preoperative period. Attendance at a preanesthetic consultation is obligatory for all patients undergoing surgery in France. Anxiety trait and state assessments were quantified in mothers and children before and after the preanesthetic consultation using visual analog and faces numerical scales. Preoperative anxiety in children was assessed immediately before induction of anesthesia using an analog scale. Other data recorded included demographic and medical data and type of hospital stay. Univariate and multivariate logistic regression analyses were used. RESULTS Overall 111 consecutive patients were included. The following factors emerged leading to anxiety state at induction of anesthesia: maternal anxiety state before the preanesthetic consultation, a feeling of not being reassured by the anesthesiologist, maternal anxiety state after the consultation, and anxiety trait in the child. Logistic regression found this combination of factors (OR = 4 [1.4 -12]) and inpatient stay (OR = 3 [1.4-7]), predicting anxiety with an accuracy of 69%. CONCLUSION The present study identified a combination of psychological factors and events associated with the development of anxiety at induction of anesthesia in children. Parental anxiety impacts upon children and occurs before the preanesthetic consultation. This result may assist clinicians to prescribe personalized preventive strategies against anxiety.
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Affiliation(s)
- Honorine Delivet
- Department of Pain Management, Robert Debré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,René Descarte University, Boulogne-Billancourt Cedex, France
| | - Delphine Beauvais
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France
| | - Adelaide Mialot
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France
| | - Thomas Vacher
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France
| | - Lucile Marsac
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France
| | - Christopher Brasher
- Department of Anesthesia and Pain Management, Royal Children's Hospital, Melbourne, VIC, Australia.,Anesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Daphné Michelet
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France
| | - Souhayl Dahmani
- Department of Anaesthesia and Intensive Care, RobertDebré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.,Denis Diderot University, Paris, France.,DHU PROTECT INSERM U 1141, Robert Debré University Hospital, Paris, France
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Lejus C, Orliaguet G, Servin F, Dadure C, Michel F, Brasher C, Dahmani S. Peri-operative management of overweight and obese children and adolescents. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 1:311-322. [PMID: 30169186 DOI: 10.1016/s2352-4642(17)30090-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/27/2017] [Accepted: 08/15/2017] [Indexed: 12/11/2022]
Abstract
Obesity has become endemic, even in children. Systemic complications associated with obesity include metabolic syndrome, cardiovascular disease, and respiratory compromise. These comorbidities require adequate investigation, targeted optimisation, and, if surgery is required, specific management during the peri-operative period. Specific peri-operative strategies should be used for paediatric patients who are overweight or obese to prevent postoperative complications, and optimising the respiratory function during surgery is particularly crucial. This Review aims to provide up-to-date information on peri-operative management for physicians who are caring for children and adolescents (usually younger than 18 years) who are overweight or obese undergoing surgery, including bariatric surgery. We have particularly focussed on the physiological consequences of obesity-namely, obstructive sleep apnoea, respiratory compromise, and pharmacological considerations.
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Affiliation(s)
- Corinne Lejus
- Department of Anaesthesia and Intensive care, Hôtel Dieu Hospital, Nantes, France
| | - Gilles Orliaguet
- Department of Anaesthesia and Intensive Care, Assistance Publique Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France; EA08 Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte, Paris-Descartes and Paris Descartes University (Paris V), PRES Paris Sorbonne Cité, Paris, France
| | - Frederique Servin
- Department of Anaesthesia and Intensive Care, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - Christophe Dadure
- Department of Anaesthesia and Intensive care, Lapeyronie University Hospital, Montpellier, France; Institut de Neuroscience de Montpellier, Unité INSERM, Montpellier, France
| | - Fabrice Michel
- Department of Anaesthesia and Intensive Care, La Timone Hospital, Marseille, France; Espace Ethique Méditerranéen, Aix-Marseille Université, Hôpital Timone Adulte, Marseille, France
| | - Christopher Brasher
- Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, VIC, Australia; Anesthesia and Pain Management Research Group, Murdoch Children's Research Institute, VIC, Australia
| | - Souhayl Dahmani
- DHU PROTECT, INSERM U1141, Paris, France; Department of Anaesthesia and Intensive Care, Robert Debré University Hospital, Assistance Publique Hôpitaux de Paris, Paris Diderot University, PRES Paris Sorbonne Cité, Paris, France.
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