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Namazinia M, Mohajer S, Abbaspour S, Lopez V, Sarboozi-Hoseinabadi T. Effects of virtual reality on pain induced by arteriovenous fistula needle insertion in patients undergoing hemodialysis: A randomized clinical trial. J Vasc Access 2024:11297298231225755. [PMID: 38326286 DOI: 10.1177/11297298231225755] [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: 02/09/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is characterized by irreversible damage to renal function. For patients undergoing replacement therapies like hemodialysis (HD), the pain caused by arteriovenous fistula (AVF) cannulation becomes a significant aspect of their daily lives. This study aimed to examine the impact of virtual reality (VR) distraction techniques on the pain experienced during AVF needle insertion in patients undergoing HD. MATERIALS AND METHODS This randomized clinical trial (RCT) recruited a total of 60 patients undergoing HD from the 9 Dey Hospital in Torbat Heydariyeh, Iran, between March and August 2022. These patients were then divided into two groups: the intervention group and the control group. The intervention group received distraction techniques using the Shinecon 4th Gen Virtual Reality Headset, while the control group received routine care services. To assess the level of pain experienced during AVF cannulation, the Visual Analog Scale (VAS) was utilized. The collected data were analyzed using SPSS20. Various statistical tests, including the Chi-square test, Mann-Whitney U test, Multiple linear regression, and independent-samples t-test, were employed for data analysis. Additionally, Cohen's d was used to determine the effect size of the intervention. RESULTS The analysis of the data revealed a statistically significant difference in the mean (SD) pain scores between the control group (7.6 ± 0.8) and the intervention group (5.1 ± 0.9) (p < 0.002 after Bonferroni correction). Furthermore, it was observed that a majority of patients in the intervention group reported experiencing moderate pain, whereas the control group experienced more severe pain. CONCLUSIONS The study findings demonstrated that the use of virtual reality (VR) was effective in reducing the intensity of pain experienced during AVF needle insertion in patients undergoing HD. Based on these results, it is recommended to incorporate VR as a routine practice in the HD department of the hospital. TRIAL REGISTRATION This study, with the code no. IRCT20180429039463N3, was registered on the Iranian Registry of Clinical Trials on 28/03/2022.
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Affiliation(s)
- Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
| | - Samira Mohajer
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, Iran
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Seddigheh Abbaspour
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
| | - Violeta Lopez
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Tahere Sarboozi-Hoseinabadi
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Razavi Khorasan, Iran
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Mounier S, Cambonie G, Baleine J, Le Roux M, Bringuier S, Milési C. Music Therapy During Basic Daily Care in Critically Ill Children: A Randomized Crossover Clinical Trial. J Pediatr 2024; 264:113736. [PMID: 37722559 DOI: 10.1016/j.jpeds.2023.113736] [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: 05/29/2023] [Revised: 08/10/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To assess whether music therapy (MT) is effective to reduce pain during daily personal hygiene care (DPHC), a procedure performed in all patients in a pediatric intensive care unit. METHODS Fifty critically ill children were enrolled in a crossover controlled clinical trial with random ordering of the intervention, that is, passive MT, and standard conditions, and blind assessment of pain on film recordings. The primary outcome was variation of the Face Legs Activity Cry Consolability (FLACC) score (range, 0-10) comparing before and during DPHC. Secondary outcomes were changes in heart rate, respiratory rate, and mean arterial blood pressure, and administration of analgesic or sedative drugs during DPHC. Mixed-effects linear model analysis was used to assess effect size (95% CI). RESULTS The median (Q25-Q75) age and weight of the patients were 3.5 years (1.0-7.6 years) and 15.0 kg (10.0-26.8 kg). Consecutive DPHC were assessed on days 3 (2-5) and 4 (3-7) of hospitalization. In standard conditions, FLACC score was 0.0 (0.0-3.0) at baseline and 3.0 (1.0-5.5) during DPHC. With MT, these values were, respectively, 0.0 (0.0-1.0) and 2.0 (0.5-4.0). Rates of FLACC scores of >4 during DPHC, which indicates severe pain, were 42% in standard conditions and 17% with MT (P = .013). Mixed-effects model analysis found smaller increases in FLACC scores (-0.54 [-1.08 to -0.01]; P = .04) and heart rate (-9.00; [-14.53; -3.40]; P = .001) with MT. CONCLUSIONS MT is effective to improve analgesia in critically ill children exposed to DPHC. TRIAL REGISTRATION This study was recorded (April 16, 2019) before patient recruitment on the National Library of Medicine registry (NCT03916835; https://clinicaltrials.gov/ct2/show/NCT03916835).
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Affiliation(s)
- Sophie Mounier
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Gilles Cambonie
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France; Pathogenesis and Control of Chronic Infection, INSERM UMR 1058, University of Montpellier, Montpellier, France.
| | - Julien Baleine
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Manon Le Roux
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Sophie Bringuier
- Department of Medical Statistics and Epidemiology, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
| | - Christophe Milési
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, University of Montpellier, Montpellier, France
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Kuuse AK, Paulander AS, Eulau L. Characteristics and impacts of live music interventions on health and wellbeing for children, families, and health care professionals in paediatric hospitals: a scoping review. Int J Qual Stud Health Well-being 2023; 18:2180859. [PMID: 36880806 PMCID: PMC10013212 DOI: 10.1080/17482631.2023.2180859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
PURPOSE The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care. METHODS We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis. RESULTS Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes. CONCLUSIONS Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance.
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Affiliation(s)
- Anna-Karin Kuuse
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Ann-Sofie Paulander
- Royal College of Music in Stockholm, Department of Music Pedagogy, Stockholm, Sweden
| | - Louise Eulau
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
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Signorelli C, Robertson EG, Valentin C, Alchin JE, Treadgold C. A Review of Creative Play Interventions to Improve Children's Hospital Experience and Wellbeing. Hosp Pediatr 2023; 13:e355-e364. [PMID: 37830155 DOI: 10.1542/hpeds.2022-006994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
CONTEXT Being in the hospital can be stressful for children and caregivers. Evidence-based play interventions to reduce this stress, such as play therapy or Child Life services, have been introduced in hospitals globally, with growing awareness of potential benefits. OBJECTIVES To evaluate the impact of nonmedical/illness-specific creative or play-based programs in hospital settings on children's (<18 years) and their caregivers' hospital experiences, wellbeing, and other health outcomes. DATA SOURCES PubMed, CINAHL, Google Scholar. METHODS We conducted a systematic review of original articles published since 2011, screening 2701 de-duplicated articles. RESULTS We identified 25 eligible articles, representing 1629 children (57% male), 422 caregivers, and 128 health professionals. Included studies most commonly evaluated professional children's entertainers (n = 8 studies), music therapy (n = 4), unstructured play (n = 3), and humanoid/animal robots (n = 3). Most studies evaluated the impact on the child's level of anxiety (n = 14/25), mostly supporting a reduction (n = 13/14 studies). Several studies provided evidence for a reduction in children's pain (n = 4/6), and negative emotional/behavioral outcomes (eg, sadness, anger, irritability; n = 5/6 studies). There was mixed evidence for the impact of the included interventions on physiologic outcomes (eg, systolic pressure, heart frequency; n = 3/5 studies) and fatigue (n = 1/2 studies). Evidence on caregiver outcomes and the impact on health care services was limited. CONCLUSIONS The findings of our review generally supported the value of play-based interventions on children's' wellbeing while in the hospital, particularly reducing anxiety and pain. Further evaluation of their impact on caregivers' outcomes and the health care system is needed.
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Affiliation(s)
- Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
| | - Eden G Robertson
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
- Starlight Children's Foundation, Naremburn, NSW, Australia
| | - Chelsea Valentin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Joseph E Alchin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
| | - Claire Treadgold
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, NSW, Australia
- Starlight Children's Foundation, Naremburn, NSW, Australia
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Wang X, Zhang J, Xin H, Tan W, Liu Y, Wan J. Effectiveness of two distraction strategies in reducing preoperative anxiety in children in China: A randomized controlled trial. J Pediatr Nurs 2023; 68:e8-e15. [PMID: 36402600 DOI: 10.1016/j.pedn.2022.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Music and animation are the most common and affordable distraction strategies to reduce preoperative anxiety in children; however, their effects are inconsistent. This study aimed to examine the effectiveness of two distraction strategies (music or animation) in reducing preoperative anxiety in children. DESIGN AND METHODS In this randomized controlled trial, 183 children who underwent surgery were divided into music, animation, and control groups using a single-blind block randomized design. Children in the control group underwent routine preoperative visits. Meanwhile, the children in the intervention groups could choose their favorite music and cartoons as intervention content. Study outcomes included anxiety levels, degree of cooperation, heart rate, and blood pressure. Data were collected before entering the operating room, entering the operating room, and before the induction of anesthesia; only the degree of cooperation was collected before the induction of anesthesia. RESULTS Only animation significantly reduced preoperative anxiety in the children (P < 0.05) upon entering the operating room. Both music and animation reduced the level of preoperative anxiety before induction of anesthesia; however, there was no significant difference between them (P > 0.05). The induction compliance score was significantly lower in the music and animation groups than in the control group (P < 0.05). Heart rates differed significantly between the three groups from before entering the operating room to before induction of anesthesia. Children in the control group had the highest systolic blood pressure upon entering the operating room (P < 0.05). CONCLUSIONS Music and animation strategies can significantly reduce preoperative anxiety in children and improve surgical cooperation during anesthesia induction. TRIAL REGISTRATION Clinical. TRIALS gov NCT05285995.
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Affiliation(s)
- Xiao Wang
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Jie Zhang
- School of nursing, Hunan University of Chinese Medicine, Changsha 410208, China
| | - He Xin
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Wenhong Tan
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Yinghong Liu
- The Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - Jingjing Wan
- The Third Xiangya Hospital of Central South University, Changsha 410013, China.
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Caponnetto P, LaMattina G, Quattropani MC. Music therapy and psychological-clinical impact in surgery: a systematic review. Health Psychol Res 2022; 10:38615. [PMID: 36425235 PMCID: PMC9680838 DOI: 10.52965/001c.38615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Music therapy is a discipline that makes use of music, active or passive, to produce beneficial effects on the psyche of subjects. The field of use of music therapy has recently been broadened with the introduction of music therapy interventions to treat various problems, such as anxiety and stress, arising from pre- and post-operative psychophysical conditions. This review aims to examine the use of music therapy and its outcomes in the context of surgery in recent years. METHODS The main procedure was to search for studies on various scientific platforms such as PubMed, Medline, PsycINFO and CINAHL.Many studies pertaining to the topic in question were examined and from the variety of articles available, thirty-four were selected that fully reflected the focus of this review. CONCLUSIONS The use of music therapy is still little exploited in hospital conditions such as the one reported in this review, but despite its reduced use compared to other treatments, it has proved to be an effective technique for reducing anxiety and stress prior to surgery and for improving psychophysical conditions following surgery. Above all, the absence of side effects is emphasised since it is a nonpharmacological treatment. Further research is needed for additional confirmation of the effectiveness of music therapy mainly because this method is still being explored worldwide.
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Affiliation(s)
- Pasquale Caponnetto
- Department of Educational Sciences, University of Catania; Department of Clinical and Experimental Medicine, Center of Excellence for the acceleration of Harm Reduction (CoEHAR), University of Catania
| | - Gaia LaMattina
- Department of Educational Sciences, University of Catania
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Kuner R, Kuner T. Sounding out pain. Science 2022; 377:155-156. [DOI: 10.1126/science.add0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A circuit for sound-induced analgesia has been found in the mouse brain
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Affiliation(s)
- Rohini Kuner
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany
| | - Thomas Kuner
- Department of Functional Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany
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Karsenty C, Hadeed K, Djeddai C, Lateyron J, Guitarte A, Vincent R, DeBarros N, Combes N, Briot J, Dulac Y, Yrondi A, Acar P. Impact of 3D-printed models in meetings with parents of children undergoing interventional cardiac catheterisation. Front Pediatr 2022; 10:947340. [PMID: 36699296 PMCID: PMC9869040 DOI: 10.3389/fped.2022.947340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Paediatric interventional catheterisation has consistently improved in recent decades, with often highly successful outcomes. However, progress is still required in terms of the information delivered to parents and how parental anxiety is managed. AIM To investigate the impact of cardiac printed models on improving parental understanding and alleviating anxiety before interventional catheterisation. METHODS The parents of children undergoing interventional cardiac catheterisation were prospectively enrolled in the study. A questionnaire highlighting knowledge and understanding of the condition and cardiac catheterisation per se was scored on a scale of 1-30. The State-Trait Anxiety Inventory (STAI), which generates current anxiety scores, was also used before and after the pre-catheterisation meeting. The "printing group" received an explanation of catheterisation using the device and a three-dimensional (3D) model, while the "control group" received an explanation using only the device and a manual drawing. RESULTS In total, 76 parents of 50 children were randomly assigned to a "control group" (n = 38) or "printing group" (n = 38). The groups were comparable at baseline. The level of understanding and knowledge improved after the "control group" and "printing group" meetings (+5.5±0.8 and +10.2±0.8; p < 0.0001 and p < 0.0001, respectively). A greater improvement was documented in the "printing group" compared to the "control group" (p < 0.0001). The STAI score also improved after the explanation was given to both groups (-1.8±0.6 and -5.6±1.0; p < 0.0001 and p < 0.0001). The greatest improvement was noted in the "printing group" (p = 0.0025). Most of the parents (35/38 from the "printing group") found the models to be extremely useful. CONCLUSION 3D-printed models improve parental knowledge and understanding of paediatric cardiac catheterisation, thereby reducing anxiety levels.
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Affiliation(s)
- Clément Karsenty
- Department of Paediatric Cardiology, University Hospital, Toulouse, France.,Institut Des Maladies Métaboliques Et Cardiovasculaires (Institute of Metabolic and Cardiovascular Diseases), University of Toulouse, INSERM U1048, I2MC, 1, Avenue Jean Poulhès-BP84225, Toulouse, France.,Department of Cardiology, Clinique Pasteur (Pasteur Clinic), Toulouse, France
| | - Khaled Hadeed
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Camelia Djeddai
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Julie Lateyron
- Department of Psychiatry, Marchant Hospital, Toulouse, France
| | - Aitor Guitarte
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Remi Vincent
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Nathalie DeBarros
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Nicolas Combes
- Department of Paediatric Cardiology, University Hospital, Toulouse, France.,Department of Cardiology, Clinique Pasteur (Pasteur Clinic), Toulouse, France
| | - Jerome Briot
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Yves Dulac
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
| | - Antoine Yrondi
- Department of Psychiatry, University Hospital, Toulouse, France
| | - Philippe Acar
- Department of Paediatric Cardiology, University Hospital, Toulouse, France
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Deka S, Tiwari P, Tripathi KM. Raga todi intervention on state anxiety level in female young adults during COVID-19. MATERIALS TODAY: PROCEEDINGS 2022; 57:2152-2155. [PMID: 34963878 PMCID: PMC8696384 DOI: 10.1016/j.matpr.2021.12.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brault A, Vaillancourt G. Group Telehealth Music Therapy With Caregivers: A Qualitative Inquiry. J Patient Exp 2022; 9:23743735221107241. [PMID: 35734471 PMCID: PMC9208043 DOI: 10.1177/23743735221107241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Informal caregivers of older adults are faced with increased responsibilities as health and social systems fail to respond to the rising demands associated with the aging populations. For many caregivers, the COVID-19 pandemic has severely impacted their access to already sparse supportive resources, highlighting the importance of varying service delivery methods to meet caregivers’ needs. This qualitative study explored the experiences of informal caregivers of older adults who took part in group telehealth music therapy. Semi-structured interviews with 5 women caregivers were conducted. Through a thematic analysis process, the following themes were identified: (a) affordances of group telehealth music therapy, (b) challenges of group telehealth music therapy, and (c) music as a health resource. Telehealth considerations, clinical implications, as well as ways to support caregiver agency are discussed.
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Affiliation(s)
- Annabelle Brault
- Department of Creative Arts Therapies, Concordia University, Montréal, QC, Canada
- Annabelle Brault, Department of Creative Arts Therapies, Concordia University, 1455 Boulevard de Maisonneuve W, Montréal, QC, H3G 1M8, Canada.
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Santapuram P, Stone AL, Walden RL, Alexander L. Interventions for Parental Anxiety in Preparation for Pediatric Surgery: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111069. [PMID: 34828782 PMCID: PMC8623601 DOI: 10.3390/children8111069] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/28/2021] [Accepted: 11/17/2021] [Indexed: 11/19/2022]
Abstract
The preoperative experience can cause significant anxiety for both pediatric patients and their parents in the lead up to a surgical procedure. Pediatric anxiety in a preoperative setting has been shown to have significant negative downstream effects on the clinical outcomes of children and the healthcare system as a whole. Studies have found that preoperative parental anxiety has significant negative effects on children, regarding anxiety and emotional response. Therefore, interventions for parental preoperative anxiety are important to reduce the child’s anxiety. This review provides a brief overview of a broad range of strategies used to alleviate parental anxiety in a preoperative setting. Preoperative education, play-based interventions, music therapy, the presence of parents at induction of anesthesia, and integrative preoperative preparation programs have all demonstrated some evidence for reducing parental preoperative anxiety. The ultimate goal of using interventions for parental preoperative anxiety is to equip healthcare systems to better support families and optimize the perioperative outcomes of children.
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Affiliation(s)
- Pooja Santapuram
- School of Medicine, Vanderbilt University, Nashville, TN 37212, USA
- Correspondence: (P.S.); (L.A.); Tel.: +1-615-936-0023 (L.A.)
| | - Amanda L. Stone
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37212, USA;
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Rachel Lane Walden
- Annette and Irwin Eskind Family Biomedical Library, Vanderbilt University, Nashville, TN 37212, USA;
| | - Louise Alexander
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37212, USA;
- Correspondence: (P.S.); (L.A.); Tel.: +1-615-936-0023 (L.A.)
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Buyuk ET, Odabasoglu E, Uzsen H, Koyun M. The effect of virtual reality on Children's anxiety, fear, and pain levels before circumcision. J Pediatr Urol 2021; 17:567.e1-567.e8. [PMID: 34006462 DOI: 10.1016/j.jpurol.2021.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Circumcision is one of the oldest and most frequently performed surgical interventions in many societies across the world. Boys undergoing this procedure experience anxiety and fear during the preoperative period. In addition, postoperative pain in children is reported to be associated with anxiety and fear. AIM This study aimed to examine the effects of using virtual reality (VR) intervention before circumcision on the pre-and postoperative anxiety and fear levels and postoperative pain symptoms in children. MATERIAL AND METHODS This randomized controlled experimental study included 5-10-year-old boys referred to a pediatric hospital for circumcision between June and September 2019. Randomization was performed using the randomized block design, and the subjects were divided into control (n = 38) and experimental (n = 40) groups. The data were collected using a participant information form, the children's fear scale (CFS), the children's anxiety meter scale (CAM-S), and the Wong-Baker Faces Pain Rating Scale (WBS); data were analyzed using SPSS 22.0 package program. RESULTS Of the children included in the study, 59% were between the ages of five and six years and 78.2% had no previous hospital experience. Children in the experimental group had significantly lower mean scores of CAM-S and CFS in the pre-and postoperative periods than those in the control group. Also, the mean postoperative WBS score was significantly lower in the experimental group than in the control group. DISCUSSION Results of this study were similar to those reported previously that VR interventions were effective in reducing fear and anxiety in the preoperative period (Dehghan et al., 2019, Ryu et al., 2018; Olbrechta et al., 2020). Previous studies have shown that patient immersion in interactive VR provides a distraction from painful stimuli and can decrease an individual's perception of the pain (Pouarmand et al., 2018; Chad et al., 2018). CONCLUSION Distracting children using a VR intervention before circumcision decreased their anxiety and fear both before and after the surgery, and it was found that the pain symptoms were lower in the postoperative period.
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Affiliation(s)
- Esra Tural Buyuk
- Ondokuz Mayis University Faculty of Health Sciences Department of Pediatric Nursing, Samsun, Turkey.
| | - Emel Odabasoglu
- İstanbul-Cerrahpaşa University Faculty of Florence Nightingale Department of Pediatric Nursing, İstanbul, Turkey.
| | - Hatice Uzsen
- Ondokuz Mayis University Faculty of Health Sciences Department of Pediatric Nursing, Samsun, Turkey.
| | - Merve Koyun
- Ondokuz Mayis University Faculty of Health Sciences Department of Pediatric Nursing, Samsun, Turkey.
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Giordano F, Rutigliano C, De Leonardis F, Rana R, Neri D, Brienza N, Santoro N. Covid-19 and absence of music therapy: Impact on mother-child dyad during invasive procedures in pediatric oncology. ARTS IN PSYCHOTHERAPY 2021; 75:101839. [PMID: 34334856 PMCID: PMC8316673 DOI: 10.1016/j.aip.2021.101839] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/07/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
During COVID-19 pandemic, Italian pediatric oncology departments were obliged to adopt restrictive measures to minimize the risk of in-hospital infections in frail patients and staff members. Access to the wards was significantly reduced and music therapy (MT) activities were suspended. The aim of this study was to compare the level of anxiety and sedation in pediatric patients undergoing invasive procedure before (T1), during(T2) and after(T3) the pandemic, with and without the presence of MT. From January to September 2020, all children aged 2–15 with oncological and hematological diseases undergoing to invasive procedure were enrolled. During T1 and T3 children received preoperative preparation with MT by a certified music-therapist. In T2 they received music or video by clinical staff. Preoperative anxiety scores were measured with the m- YPAS scale. Interviews with mothers were performed. The average consumption of drugs used was analyzed. Significant differences in preoperative anxiety levels between scores in T1, T2 (p.value = 0,0000014) and in T2, T3 (p.value = 0,0000031) were observed. No difference between T1-T3 (p.value = 0,96). Higher dosage of midazolam in T2 (1,14 mg 0,189) compared to T1 (0, 71 mg 0,399) and T2 (1,14 mg 0,189) were observed. Mothers also recorded higher scores on anxiety and stress without music therapy.
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Affiliation(s)
- Filippo Giordano
- University of Bari, School of Medicine, Section of Pediatric Hemathology-Oncology, University Hospital of Bari, Italy.,Section of Pediatric Hemathology-Oncology, University Hospital of Bari, Italy
| | - Chiara Rutigliano
- Section of Pediatric Hemathology-Oncology, University Hospital of Bari, Italy
| | | | - Roberta Rana
- Section of Pediatric Hemathology-Oncology, University Hospital of Bari, Italy
| | - Daniela Neri
- Section of Anesthesia and Intensive Care Unit, University Hospital of Bari, Italy
| | - Nicola Brienza
- University of Bari, Section of Anesthesia and Intensive Care Unit, Department of Interdisciplinary Medicine, Italy
| | - Nicola Santoro
- Section of Pediatric Hemathology-Oncology, University Hospital of Bari, Italy
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14
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de Witte M, Orkibi H, Zarate R, Karkou V, Sajnani N, Malhotra B, Ho RTH, Kaimal G, Baker FA, Koch SC. From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review. Front Psychol 2021; 12:678397. [PMID: 34366998 PMCID: PMC8336579 DOI: 10.3389/fpsyg.2021.678397] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear how and why the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review (Nstudies = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: “embodiment,” “concretization,” and “symbolism and metaphors.” The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Kennisontwikkeling Vaktherapieën (KenVaK) Research Centre for the Arts Therapies, Heerlen, Netherlands.,Hogeschool van Arnhem en Nijmegen University of Applied Sciences, Nijmegen, Netherlands.,Stevig Specialized and Forensic Care for Patients With Intellectual Disabilities, Dichterbij, Oostrum, Netherlands
| | - Hod Orkibi
- Faculty of Social Welfare and Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Rebecca Zarate
- Division of Expressive Therapies, Lesley University, Cambridge, MA, United States
| | - Vicky Karkou
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom
| | - Nisha Sajnani
- Educational Theatre & Rehabilitation Science Ph.D. Programs, New York University, New York, NY, United States
| | - Bani Malhotra
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Rainbow Tin Hung Ho
- Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Felicity A Baker
- Music Therapy Department, Norwegian Academy of Music, Oslo, Norway.,Faculty of Fine Arts and Music, The University of Melbourne, Parkville, VIC, Australia
| | - Sabine C Koch
- SRH University Heidelberg, Heidelberg, Germany.,Department for Creative Arts Therapies and Therapy Science, Alanus University of Arts and Social Sciences, Alfter, Germany
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15
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Scheufler A, Wallace DP, Fox E. Comparing Three Music Therapy Interventions for Anxiety and Relaxation in Youth With Amplified Pain. J Music Ther 2021; 58:177-200. [PMID: 33251538 DOI: 10.1093/jmt/thaa021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Research in pediatric hospitals has shown that active music engagement, preferred music listening, and music-assisted relaxation can decrease anxiety and increase relaxation responses. However, there is little research on the use of music therapy with pediatric chronic pain conditions such as amplified pain syndromes. The purpose of the current study was to examine the effects of 3 specific music therapy interventions (active music engagement, live patient-selected music, and music-assisted relaxation) on anxiety and relaxation levels in youth (ages 10-18) participating in a 40 hr per week hospital-based intensive interdisciplinary pain treatment program. A sample of 48 patients participated in this study which utilized a 3-period, 3-treatment cross-over design with 3 interventions delivered in a quasi-randomized order determined by when the patients started the treatment program. State anxiety was measured via the state form of the State-Trait Inventory for Cognitive and Somatic Anxiety for Children and relaxation scores were assessed with a Visual Analog Scale. Statistically significant changes were found in anxiety and relaxation outcomes across all interventions provided. Results suggest that music therapy services (using active music engagement, live patient-selected music, and music-assisted relaxation) may be an effective modality to decrease anxiety and increase relaxation levels in pediatric patients with amplified pain syndromes.
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Affiliation(s)
| | | | - Emily Fox
- Children's Mercy Hospital, Kansas City, MO, USA
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16
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Sugimoto D, Slick NR, Mendel DL, Stein CJ, Pluhar E, Fraser JL, Meehan WP, Corrado GD. Meditation Monologue can Reduce Clinical Injection-Related Anxiety: Randomized Controlled Trial. J Evid Based Integr Med 2021; 26:2515690X211006031. [PMID: 33904781 PMCID: PMC8082977 DOI: 10.1177/2515690x211006031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background. Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not. Methods. A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate. Results. There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999). Conclusion. Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration:ClinicalTrials.gov NCT02690194
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Affiliation(s)
- Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - Nathalie R Slick
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA
| | - David L Mendel
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA
| | - Cynthia J Stein
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Emily Pluhar
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Joana L Fraser
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Gianmichel D Corrado
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
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17
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Jin Y, Jiang A, Jiang W, Wu W, Ye L, Kong X, Liu L, Jin Z. Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study. BMC Ophthalmol 2021; 21:163. [PMID: 33827488 PMCID: PMC8028828 DOI: 10.1186/s12886-021-01922-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery. Methods In this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups (n = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded. Results The mYPAS scores at T2 and T3 were higher than T1(p < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3(p < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C(p < 0.05). The incidence of agitation in Group A was lower than that in Group C(p < 0.05). Conclusions Based on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well. Trial registration The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1900025116, Date: 08/12/2019). Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01922-6.
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Affiliation(s)
- Yuexi Jin
- Department of Anesthesiology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Xueyuan Road #270, Wenzhou, Zhejiang, China
| | - Aifen Jiang
- Department of Anesthesiology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Xueyuan Road #270, Wenzhou, Zhejiang, China
| | - Wanna Jiang
- Department of Anesthesiology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Xueyuan Road #270, Wenzhou, Zhejiang, China
| | - Wenxin Wu
- Department of Anesthesiology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Xueyuan Road #270, Wenzhou, Zhejiang, China
| | - Lisha Ye
- Department of Anesthesiology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Xueyuan Road #270, Wenzhou, Zhejiang, China
| | - Xiaojiang Kong
- Wenzhou Medical University, Wenzhou Chashan Senior education park, Ouhai District, Wenzhou, Zhejiang, China
| | - Le Liu
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang Town, Wenzhou, Zhejiang, China
| | - Zhousheng Jin
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang Town, Wenzhou, Zhejiang, China.
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18
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Chen C, Wang H, Zhang L, Wang K, Jiang L, Li S, Xiang W, Song L, Hu S, Yang C, Zhou J. Clinical study of preoperative psychological distress and its related factors in the primary caregivers of patients with glioma. Clin Neurol Neurosurg 2020; 200:106364. [PMID: 33348302 DOI: 10.1016/j.clineuro.2020.106364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/18/2020] [Accepted: 11/07/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the preoperative psychological distress in the primary caregivers of glioma patients and its influencing factors and to determine the relationship between preoperative psychological states of glioma patients and their caregivers. METHODS Using a mixed methods design, the caregivers of patients with malignant glioma were interviewed and completed questionnaires about anxiety/depression and family function during preoperative period. RESULTS Caregivers of glioma patients had different types of psychological distress before surgery. A total of 46 caregivers (36.5 %) had preoperative psychological depression or anxiety symptom; 30 caregivers (23.8 %) had depression symptoms, 39 caregivers (31.0 %) had anxiety symptoms, and 23 (18.3 %) had both preoperative anxiety and depression symptoms. Female gender was an influential factor for both preoperative depression and anxiety symptoms in caregivers, surgical information was a risk factor for caregivers' preoperative depression symptoms and residence was a risk factor for caregivers' preoperative anxiety symptoms. The preoperative psychological states of patients was positively correlated with the preoperative anxiety and depression symptoms of caregivers. CONCLUSION The rural female caregivers are more likely to experience psychological distress before surgery, and the preoperative psychological states of patients was positively correlated with the psychological distress in caregivers.
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Affiliation(s)
- Chaoyi Chen
- School of Nursing, Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Department of Anorectal, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Chunhui Road 16#, Lu Zhou, 646000, China.
| | - Haorun Wang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Liying Zhang
- School of Nursing, Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China
| | - Ke Wang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Lin Jiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Shenjie Li
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Wei Xiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Li Song
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China
| | - Shasha Hu
- Department of Psychiatry, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China
| | - Changmei Yang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China.
| | - Jie Zhou
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Taiping Street 25#, Lu Zhou, 646000, China; Neurosurgery Clinical Medical Research Center of Sichuan Province, Taiping Street 25#, Lu Zhou, 646000, China.
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19
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Lim J, Kim WJ. Dramatic Decrease in Ocular Deviation 1 Day before Surgery in Patients with Intermittent Exotropia. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:361-366. [PMID: 33099557 PMCID: PMC7597611 DOI: 10.3341/kjo.2020.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/14/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the clinical characteristics of patients with intermittent exotropia who exhibited a dramatic decrease in ocular deviation 1 day before surgery. Methods This study retrospectively enrolled patients with intermittent exotropia who underwent surgery between December 2013 and December 2019. Those who exhibited a decrease in ocular alignment ≥10 prism diopters (PD) at the last examination (1 day before surgery) compared with the largest previous angle of deviation were included. A monocular occlusion test was performed to re-confirm the largest angle of ocular deviation. Results Among 547 patients with intermittent exotropia, 10 (six females; mean age, 8.6 years) exhibited a dramatic decrease in ocular deviation before impending surgery. The mean largest angle of deviation was 31.0 PD (range, 20 to 50 PD) at distance and 34.5 PD (range, 20 to 55 PD) at near. The mean control scores using the LACTOSE (Look and Cover then Ten Seconds of Observation Scale for Exotropia) scoring system were 2.5 at distance, 1.8 at near, and 4.3 when combined. Mean ocular deviation prior to the impending surgery decreased to 7.4 PD (range, 0 to 10 PD) at distance and 6.2 PD (range, -10 to 10 PD) at near. The largest angle of ocular deviation was re-confirmed using the monocular occlusion test in all patients. All patients underwent surgery as planned, and none exhibited postoperative overcorrection. Conclusions A relatively small number of patients with intermittent exotropia exhibited a dramatic decrease in ocular alignment 1 day before surgery but demonstrated a relatively better level of control. The monocular occlusion test was helpful in re-confirming the largest angle of ocular deviation.
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Affiliation(s)
- Jinam Lim
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Won Jae Kim
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
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20
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Baum P, Diers J, Lichthardt S, Kastner C, Schlegel N, Germer CT, Wiegering A. Mortality and Complications Following Visceral Surgery: A Nationwide Analysis Based on the Diagnostic Categories Used in German Hospital Invoicing Data. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:739-746. [PMID: 31774053 DOI: 10.3238/arztebl.2019.0739] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 06/24/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The in-hospital mortality after visceral surgery in Germany is unknown. METHODS In this retrospective, descriptive analysis, nationwide hospital billing data based on diagnosis-related groups (DRG) over the period 2009-2015 were studied to determine the in-hospital mortality, complications and their management, and deaths after documented severe complications (failure to rescue, FTR) after visceral surgery in Germany. Organ-system subgroups were defined and subdivided into frequent operations (inguinal hernia repair, appendectomy, thyroid operations, cholecystec- tomy), colorectal operations, and complex operations (surgery of the esophagus, pancreas, liver, and stomach). RESULTS 3 287 199 patients from 1392 hospitals were included in the analysis. The in-hospital mortality after visceral surgery was 1.9%. The lowest mortality was after the frequently performed operations (0.04-0.4%), the highest after complex surgery of the esophagus (8.6%) and stomach (11.7%). Severe complications were most commonly seen after complex surgery of the pan- creas (27.7%), liver (24.3%), esophagus (37.8%), and stomach (36.7%). 90.6% of deaths occurred after colorectal or complex operations, which together accounted for 23% of all operations. The FTR rate was 8.4% after appendectomy and cholecystec- tomy (95% confidence interval [8.34; 8.46]) and 20.3% after esophageal surgery ([19.8; 20.8]). CONCLUSION In Germany, in-hospital mortality after visceral surgery is not uncommon, with a frequency of nearly 2%. Improved complication management after complex operations appears necessary. A limitation of this study is the identification of compli- cations from anonymized billing data.
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Affiliation(s)
- Philip Baum
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery University Hospital of Würzburg; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg; Biochemistry and Molecular Biology, University of Würzburg
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21
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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: 2.0] [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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22
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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: 1.0] [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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23
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Matsuo M, Masuda F, Sumi Y, Takahashi M, Yoshimura A, Yamada N, Kadotani H. Background Music Dependent Reduction of Aversive Perception and Its Relation to P3 Amplitude Reduction and Increased Heart Rate. Front Hum Neurosci 2019; 13:184. [PMID: 31316359 PMCID: PMC6610262 DOI: 10.3389/fnhum.2019.00184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/20/2019] [Indexed: 11/24/2022] Open
Abstract
Music is commonly used to modify mood and has attracted attention as a potential therapeutic intervention. Despite the well-recognized effects of music on mood, changes in affective perception due to music remain majorly unknown. Here, we examined if the perception of aversive stimuli could be altered by mood-changing background music. Using subjective scoring data from 17 healthy volunteers, we assessed the effect of relaxing background music (RelaxBGM), busy background music (BusyBGM), or no background music (NoBGM) conditions on response to aversive white noise stimulation. Interestingly, affective response to the white noise was selectively alleviated, and white noise-related P3 component amplitude was reduced in BusyBGM. However, affective responses as well as P3 amplitude to reference pure tone stimuli were similar regardless of background music conditions. Interestingly, heart rate (HR) increased in BusyBGM, whereas no increase in HR was found in similar distress, NoBGM condition. These findings suggest that increase in HR, which happens during BusyBGM exposure, can be a reflecting feature of music that ameliorates the affective response to aversive stimuli, possibly through selective reduction in neurophysiological responses.
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Affiliation(s)
- Masahiro Matsuo
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Fumi Masuda
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Masahiro Takahashi
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Yoshimura
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Hiroshi Kadotani
- Department of Sleep and Behavioral Science, Shiga University of Medical Science, Otsu, Japan
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Chorna O, Emery L, Hamm E, Moore-Clingenpeel M, Shrivastava H, Miller A, Richard C, Maitre NL. Standardized music therapy with and without acclimatization, to improve EEG data acquisition in young children with and without disability. J Neurosci Methods 2019; 321:12-19. [DOI: 10.1016/j.jneumeth.2019.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 11/15/2022]
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Shao J, Xiao T, Shi M, Zhou X, Wang Z, Lin T, Xu R, Ni H, Zhang A. Effect of multimedia-based nursing visit on perioperative anxiety in esophageal squamous cell carcinoma patients undergoing video-assisted thoracoscopic surgery. PSYCHOL HEALTH MED 2019; 24:1198-1206. [PMID: 30907130 DOI: 10.1080/13548506.2019.1595687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jingjing Shao
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Ting Xiao
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Minxin Shi
- Department of Thoracic Surgery, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaomei Zhou
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Zhiwei Wang
- Department of Breast, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tianlong Lin
- Department of Thoracic Surgery, Shanghai Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongfang Xu
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Hongxia Ni
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Aihua Zhang
- Department of Nursing, The Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu Province, China
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McLaughlan R, Sadek A, Willis J. Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:130-146. [PMID: 30526092 DOI: 10.1177/1937586718810878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Ulrich's (1991) definition of "positive distraction" includes that which "elicits positive feelings and holds attention," implying that the capacity of an environmental feature to hold attention is a necessary component. This article examines whether, in the context of a pediatric hospital, a distraction needs to "hold attention" to secure positive benefits for patient well-being. BACKGROUND Data collected from 246 patients at Melbourne's Royal Children's Hospital (Australia) revealed a discrepancy between what children and young people told us they did, and valued, within the hospital, relative to the time they spent engaging in, or paying attention to, these same features. This motivated a closer interrogation of the relationship between well-being, distraction, and socialization within the pediatric context. METHOD Data were collected using a mixed-methods approach that included 178 surveys, 43 drawings contributed by patients/siblings within the outpatient waiting room, 25 photo-elicitation interviews with patients, and 100 hr of spatial observations within public and waiting room spaces. This was supplemented by interviews with architects and hospital staff. CONCLUSIONS The mechanism by which we have understood positive distraction to contribute to well-being within the pediatric hospital environment is more complex than existing models accept. Within this context, environmental features that can positively transform expectations of visiting the hospital-that can ignite the imagination and incite a desire to return-can offer significant benefits to well-being. This is particularly relevant in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.
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Affiliation(s)
- Rebecca McLaughlan
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
| | - Ahmed Sadek
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Willis
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
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