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Yu C, Weaver S, Walker M, Hess J, Mac A, Ross T. Opportunities for play in paediatric healthcare environments: a scoping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1415609. [PMID: 38872999 PMCID: PMC11169685 DOI: 10.3389/fresc.2024.1415609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024]
Abstract
Play spaces are important components of paediatric healthcare environments. They provide children with critical opportunities to experience the social, emotional, and developmental benefits of play while in healthcare settings for appointments or hospitalizations. These spaces can help to mitigate stress, provide a sense of normalcy in unfamiliar environments, and facilitate social engagement for children and their families. Given the benefits of play spaces in paediatric healthcare settings, it is important to understand how these spaces can be designed to enhance children's inclusion and quality of care. The aim of this scoping review was to explore the current understanding of paediatric play space design. Using search terms related to children, health care, and play space, six interdisciplinary databases were searched over a 30-year period. The search found 2,533 records from which eighteen were included for review. Findings suggest that although it is well-documented that play spaces offer valuable social and emotional benefits, little is known about the specific design features that can and should be incorporated to enhance play opportunities and ensure that they benefit all children and families. Further, the literature mostly considers play spaces in the context of designated play or recreational rooms. Scholars are encouraged to consider how play opportunities can be incorporated into the designs of paediatric healthcare environments beyond the boundaries of these rooms. Future studies should also consider the diversity of play space users, including children of varying ages and abilities, to create more accessible and inclusive paediatric play spaces for children and their families. Advancing knowledge on play space design can help to optimize the quality of these important spaces and to ensure their designs meaningfully enhance children's play experiences and quality of care.
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Affiliation(s)
- Clarissa Yu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sophie Weaver
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Julia Hess
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amanda Mac
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Timothy Ross
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Geography & Planning, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Daşar U, Altun O, Ergişi Y, Arıkan O, Özdemir E. The midterm psychological effect of cast removal procedures in children. Jt Dis Relat Surg 2024; 35:404-409. [PMID: 38727121 PMCID: PMC11128970 DOI: 10.52312/jdrs.2024.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/04/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES This study aimed to compare the course of anxiety change in children who used headphones during cast removal with controls in midterm follow-up. PATIENTS AND METHODS Sixty-six patients who underwent forearm fracture treatment with closed reduction and long arm casting between June 2021 and March 2023 were retrospectively reviewed. Patients were divided into two groups based on the use of headphones (n=27; 21 males, 6 females; mean age: 8.0±1.8 years; range, 6 to 12 years) or not (n=39; 27 males, 12 females; mean age: 8.9±1.8 years; range, 6 to 12 years) during cast removal with an oscillating saw. Primary outcome measures included preprocedure, postprocedure, and six-month anxiety assessments with the State-Trait Anxiety Inventory. RESULTS There was an acute increase in the mean state anxiety scores after the procedure, which returned to below baseline at the six-month follow-up in the headphone (31.4±8.3, 33.3±8.7, and 25.1±4.1, respectively) and control groups (34.9±11.1, 37.4±9.5, and 27.3±5.3, respectively). The mean trait anxiety scores before the procedure, after the procedure, and at six months remained similar in the headphone (33.6±3.0, 34.6±3.2, and 32.4±2.8; p>0.05) and control groups (34.1±2.7, 33.7±3.0, and 33.7±3.0, p>0.05). CONCLUSION This study suggests that the acute anxiety during cast removal did not create anxiety sequelae in the sixth month regardless of headphone use.
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Affiliation(s)
| | | | | | | | - Erdi Özdemir
- Karabük Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, 78200 Karabük, Türkiye.
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Wong CL, Li H, Li CK, Chan CWH, Cheung YT, Choi KC, So WKW. Effects of immersive virtual reality for alleviating anxiety, nausea and vomiting among patients with paediatric cancer receiving their first chemotherapy: protocol for a randomised controlled trial. BMJ Open 2024; 14:e079837. [PMID: 38401901 PMCID: PMC10895243 DOI: 10.1136/bmjopen-2023-079837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION Anxiety, nausea and vomiting are common side effects suffered by paediatric patients receiving chemotherapy. Emerging evidence supports the efficacy of immersive virtual reality (IVR) on improving anxiety and distress symptoms including nausea and vomiting in this vulnerable group. This trial aims to evaluate the effects of IVR intervention on anxiety, chemotherapy-induced nausea and vomiting and anticipatory nausea and vomiting in patients with paediatric cancer receiving first chemotherapy. METHOD AND ANALYSIS An assessor-blinded, randomised controlled trial with a mixed methods evaluation approach. On the basis of our pilot results, 128 chemotherapy-naive patients with paediatric cancer scheduled to receive their first intravenous chemotherapy will be recruited from a public hospital and randomly allocated to intervention (n=64) or control groups (n=64). The intervention group will receive the IVR intervention for three sessions: 2 hours before the first chemotherapy, 5 min before and during their first chemotherapy and 5 min before and during their second chemotherapy, respectively. The control group will receive standard care only. A subsample of 30 participants in the intervention group will be invited for a qualitative interview. Study instruments are: (1) short form of the Chinese version of the State Anxiety Scale for Children, (2) visual analogue scale for anticipatory nausea and vomiting, (3) Chinese version of the Multinational Association of Supportive Care in Cancer Antiemesis Tool and (4) individual face-to-face semistructured interviews to explore intervention participants' perceptions of the IVR intervention. ETHICS AND DISSEMINATION This study has been approved by the Hong Kong Children's Hospital Research Ethics Committee (HKCH-REC-2021-009). The findings will be disseminated in peer-reviewed journals and through local or interventional conference presentations. TRIAL REGISTRATION NUMBER ChiCTR2100048732.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Chi Kong Li
- Deparment of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Ceylan M, Erkut Z. The effect of finger puppet on pain and emotional manifestation for venous blood collection in the pediatric emergency department: A randomized controlled trial. Int Emerg Nurs 2023; 70:101348. [PMID: 37708789 DOI: 10.1016/j.ienj.2023.101348] [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: 03/17/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023]
Abstract
AIM To determine the effect of distraction with a finger puppet for venous blood collection in the pediatric emergency department on children's pain and emotional manifestation. METHODS Randomized controlled trial with 80 children (aged 3-6 years) who applied to the pediatric emergency department between October 2021 and March 2022. The attention of child was distracted from the procedure by playing with finger puppets before and during the venous blood collection in the finger puppet group. The children in the control group underwent routine blood collection. The procedural pain was measured with the Face, Legs, Activity, Cry, Consolability Scale (FLACC) and the emotional response was measured with the Children's Emotional Manifestation Scale (CEMS). RESULTS The mean FLACC pain scores of the children in the finger puppet group were statistically significantly lower than the children in the control group (p < 0.001). It was also found that the finger puppet group's mean scores of CEMS before and during the procedure were statistically lower than those of the control group (p < 0.001). CONCLUSIONS Finger puppets can be used to reduce pain and positively change children's emotional responses during painful procedures such as blood collection.
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Affiliation(s)
- Murat Ceylan
- Pediatric Emergency Department, Kartal Dr. Lütfi Kirdar City Hospital, Istanbul, Turkey.
| | - Zeynep Erkut
- Department of Pediatric Nursing, School of Nursing, Maltepe University, Istanbul, Turkey.
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Ayan G, Şahin ÖÖ. Effect of therapeutic play based training program on pre- and post-operative anxiety and fear: A study on circumcision surgery in Turkish Muslim children. J Pediatr Urol 2023:S1477-5131(23)00194-8. [PMID: 37202291 DOI: 10.1016/j.jpurol.2023.04.032] [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: 12/06/2022] [Revised: 03/29/2023] [Accepted: 04/26/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Developmentally appropriate pre-surgical educational programs can help alleviate the anxiety of both children and parents. As one of the most common pediatric surgical procedures is circumcision; and they may experience anxiety and fear before and after this surgical procedure, this study is considered to make an important contribution to the literature. OBJECTIVE This study aimed to examine the effect of therapeutic play based training program on pre- and post-operative anxiety and fear levels of children aged 8-11 years who would undergo circumcision. STUDY DESIGN This was a quasi-experimental study that consisted of a pre- and post-intervention and control groups; and concluded with 60 children aged 8-11 years (intervention group: 30 and no intervention/control group: 30). Child and Parent Information Form, Childhood Anxiety Sensitivity Index (CASI) and Fear for Medical Procedures Scale (FMPS) were used as data collection tools. Children in the intervention group applied a "therapeutic play-based training program" 2 h before they underwent circumcision surgery. Therapeutic toys used in the educational program has designed by researchers. RESULTS After the training program, children in the intervention group obtained lower CASI (preop t = 6.383, p < .001; postop t = 8.763, p < .001) and FMPS (preop t = 6.331, p < .001; postop t = 9.366, p < .001) total mean scores than those in the control group. DISCUSSION This study was concluded that the therapeutic play based training program used to prepare children for circumcision surgery was effective in reducing their pre- and post-operative anxiety and medical fears. Considering that male circumcision is a religious and cultural necessity in Turkey, further studies can also examine whether the anxiety and medical fear scores differ in study groups that include children who are not Muslim or live in a different country, and whether the training program will be effective in reducing their anxiety and medical fears. CONCLUSIONS A therapeutic play based training program can be used to prepare children for circumcision in the preoperative period.
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Affiliation(s)
- Gülbahar Ayan
- Pediatric Clinic, Karabuk Provincial Health Directorate, Safranbolu State Hospital, Karabuk, Türkiye
| | - Özlem Öztürk Şahin
- Department of Pediatric Nursing, Faculty of Heath Sciences, Karabuk University, Karabuk, Türkiye.
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Burkhart RJ, Hecht CJ, McNassor R, Mistovich RJ. Interventions to Reduce Pediatric Anxiety During Orthopaedic Cast Room Procedures: A Systematic and Critical Analysis Review. JBJS Rev 2023; 11:01874474-202302000-00006. [PMID: 36791237 DOI: 10.2106/jbjs.rvw.22.00181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cast room procedures can be a source of considerable distress for pediatric patients. High levels of anxiety can make it difficult to perform procedures effectively and may negatively affect the doctor-patient relationship. We sought to evaluate available interventions to reduce anxiety in pediatric patients undergoing orthopaedic cast room procedures. METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, we performed a systematic review to answer our study question (PROSPERO registration of the study protocol: CRD42022333001, May 28, 2022). PubMed, EBSCO host, MEDLINE, Cochrane, and Google Scholar electronic databases were used to identify all studies evaluating interventions to reduce pediatric anxiety during orthopaedic cast room procedures between January 1, 1975, and June 1, 2022. The quality of included studies was assessed using the Jadad scale. RESULTS Our initial search yielded 1,490 publications, which were then screened for appropriate studies that aligned with the purpose of our review. Fourteen studies comprising 8 prospective cohort and 6 randomized controlled trials were included. The total sample size of included studies consisted of 1,158 patients with participant age ranging from 1 to 21 years. The interventions investigated included noise reduction headphones, musical therapy, inclusion of a certified child life specialist, casting shears, virtual reality, Bedside Entertainment and Relaxation Theater (BERT), children's and instructional videos, and video games. Most of the included interventions were effective at reducing anxiety during cast room procedures. However, there was variation in anxiety reduction across cast room procedure and treatment modality. CONCLUSION The use of physical or technology-based distraction tools can play an important interventional role in improving patient satisfaction during cast room procedures. The majority were inexpensive, readily applicable to the clinical setting, and of negligible risk to the patient. LEVEL OF EVIDENCE Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Robert J Burkhart
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Christian J Hecht
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ryan McNassor
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - R Justin Mistovich
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.,MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Wong CL, Choi KC. Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e230001. [PMID: 36795410 PMCID: PMC9936341 DOI: 10.1001/jamanetworkopen.2023.0001] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
IMPORTANCE Venipuncture is one of the most painful and distressing procedures experienced by pediatric patients. Emerging evidence suggests that providing procedural information and distraction using immersive virtual reality (IVR) may reduce pain and anxiety among children undergoing needle-related procedures. OBJECTIVES To examine the effects of IVR on reducing the pain, anxiety, and stress experienced by pediatric patients undergoing venipuncture. DESIGN, SETTING, AND PARTICIPANTS This 2-group randomized clinical trial recruited pediatric patients aged 4 to 12 years undergoing venipuncture from a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March to May 2022. INTERVENTIONS Participants were randomly allocated to an intervention (an age-appropriate IVR intervention offering distraction and procedural information) or a control (standard care only) group. MAIN OUTCOMES AND MEASURES The primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure (rated on a 40 point scale, with higher scores indicating greater satisfaction). Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure. RESULTS A total of 149 pediatric patients were recruited, with 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group (mean [SD] age, 7.21 [2.49] years), the 75 participants in the IVR group (mean [SD] age, 7.21 [2.43] years) reported significantly less pain (β = -0.78; 95% CI, -1.21 to -0.35; P < .001) and anxiety (β = -0.41; 95% CI, -0.76 to -0.05; P = .03) immediately after the intervention. Health care professional satisfaction in the IVR group (mean [SD] score, 34.5 [4.5]) was significantly higher than that in the control group (mean [SD] score, 32.9 [4.0]; P = .03). Moreover, the length of venipuncture procedure in the IVR group (mean [SD] duration, 4.43 [3.47] minutes) was significantly shorter than that in the control group (mean [SD] duration, 6.56 [7.39] minutes; P = .03). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, integrating procedural information and distraction in an IVR intervention for pediatric patients undergoing venipuncture significantly improved pain and anxiety in the IVR group compared with the control group. The results shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR1800018817.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Lee Wong C, Li CK, Choi KC, Wei So WK, Yan Kwok JY, Cheung YT, Chan CWH. Effects of immersive virtual reality for managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: An exploratory randomised controlled trial. Eur J Oncol Nurs 2022; 61:102233. [DOI: 10.1016/j.ejon.2022.102233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
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Zhao R, Wu Y, Shen X, Jian D, Fu L, Liu H, Zhai Y, Chen J, Shen Q, Xu H, Gu Y, Zhou Q. A Therapeutic Play Program for Children Undergoing Kidney Biopsy With Local Anesthesia: Construction and Feasibility Evaluation. J Perianesth Nurs 2022; 37:939-945. [PMID: 36153207 DOI: 10.1016/j.jopan.2022.04.007] [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: 01/15/2022] [Revised: 04/06/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To construct a therapeutic play program for children undergoing preparation for kidney biopsy under local anesthesia and explore the feasibility of the program from stakeholders' perspectives. DESIGN The program was constructed by a multidisciplinary team and the feasibility and acceptability of the program were explored by a descriptive qualitative study. METHODS Based on Lazarus & Folkman's stress-coping model and Piaget's theory of play, and using on-site participatory field observation, a multidisciplinary team constructed a therapeutic play program for children undergoing kidney biopsy under local anesthesia. The feasibility and acceptability of the program were evaluated by interviewing children, their caregivers, and physicians. FINDINGS The main tools constructed for the intervention were a 15-page picture book titled Kidney Biopsy Treasure Hunt and a homemade kidney biopsy play package. The therapeutic play intervention for kidney biopsy under local anesthesia was led by nurses and followed the steps of kidney biopsy, using the picture book, and group play simulation. Through informed in-depth interviews with 10 children and their caregivers, we showed that the therapeutic play program materials were accessible, clinically feasible, and necessary for kidney biopsy under local anesthesia in children. The children and their caregivers had high acceptance of the content of the picture book, the format of the play, and high satisfaction with the overall program. CONCLUSIONS The therapeutic play program we constructed for children undergoing kidney biopsy with local anesthesia was simple, feasible, and well accepted in the clinical setting.
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Affiliation(s)
- Rui Zhao
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yuanyuan Wu
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xia Shen
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Duying Jian
- Department of Social Work, Children's Hospital of Fudan University, Shanghai, China
| | - Lili Fu
- Department of Social Work, Children's Hospital of Fudan University, Shanghai, China
| | - Haimei Liu
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yihui Zhai
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Jing Chen
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Qian Shen
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Gu
- Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Qing Zhou
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China.
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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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Wong CL, Li CK, Choi KC, So WKW, Kwok JYY, Cheung YT, Chan CWH. Effects of immersive virtual reality for preventing and managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: A study protocol for an exploratory trial. PLoS One 2021; 16:e0258514. [PMID: 34648568 PMCID: PMC8516310 DOI: 10.1371/journal.pone.0258514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anxiety, nausea and vomiting are common side effects suffered by paediatric patients receiving chemotherapy. Emerging evidence supports the efficacy of immersive virtual reality (IVR) on improving anxiety and distress symptoms including nausea and vomiting among this vulnerable group. This trial aims to assess the feasibility and acceptability of IVR for preventing and managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy. METHOD AND ANALYSIS An exploratory trial supplemented by qualitative methods will be conducted. We will recruit 20 paediatric patients who are aged between 6 and 12 years, chemotherapy naïve, scheduled to receive their first intravenous chemotherapy and able to understand Chinese. Participants will be randomly allocated to intervention or control groups. The intervention group will receive the IVR intervention for three sessions as follows: 4 hours before chemotherapy, 5 minutes before and during their first course chemotherapy and 5 minutes before and during their second course chemotherapy. The control group will receive standard care only. Main outcome measures included (1) key parameters for the design of a definitive trial (i.e. screening, eligibility, consent and withdrawal rates); (2) anxiety, anticipatory and acute chemotherapy-induced nausea and vomiting for collection of preliminary data; (3) feasibility and acceptability of the intervention. Semi-structured interviews will be conducted with patients, parents and oncology nurses. Generalized estimating equations model will be used to compare each of the outcome measures across the time points between the two groups. Qualitative data will be analysed by conventional content analysis. EXPECTED RESULTS The results of this exploratory trial will inform the design and conduct of future definitive trial. TRIAL REGISTRATION NUMBER ChiCTR1900021694; Pre-results.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- * E-mail:
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Mohamed-Zain NA, Jamil K, Penafort R, Singh A, Ibrahim S, Abdul-Rashid AH. Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective Trial. Malays Orthop J 2021; 15:122-128. [PMID: 34429832 PMCID: PMC8381665 DOI: 10.5704/moj.2107.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/12/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods. Material and methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children’s Fear Scale (CFS). Results: There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05). Conclusion: The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.
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Affiliation(s)
- N A Mohamed-Zain
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - K Jamil
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Penafort
- Department of Orthopaedics, KPJ Damansara Specialist Centre, Kuala Lumpur, Malaysia
| | - A Singh
- Department of Orthopaedics and Traumatology, Tengku Ampuan Rahimah Hospital, Klang, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abdul-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Department of Orthopaedics, KPJ Damansara Specialist Centre, Kuala Lumpur, Malaysia.,Department of Orthopaedics and Traumatology, Tengku Ampuan Rahimah Hospital, Klang, Malaysia
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Precut Cast: An Easier and Less Stressful Cast Removal Procedure for Pediatric Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3700. [PMID: 34285857 PMCID: PMC8284763 DOI: 10.1097/gox.0000000000003700] [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] [Received: 02/19/2021] [Accepted: 05/27/2021] [Indexed: 11/26/2022]
Abstract
During hospitalization, pediatric patients or their parents may feel stressed. If patients need to stay in the hospital with a cast, they are prone to feeling more stressed. Fixation using a cast is an important clinical option, particularly in the case of skin grafts wherein fixation of the foot and ankle is essential to ensure the survival of the graft skin. However, the removal of the cast is also stressful for patients because it needs to be removed with a cast saw. To avoid further stress in pediatric patients, we cut the cast intraoperatively and then fixed the cast again using nylon cable ties. One week after surgery, we separated the patient's cast. Instead of using a cast saw, we used only scissors or nippers. Our cast removal method was easy, safe, and less stressful.
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Sodhai VM, Patwardhan SA, Shyam AK, Haphiz A, Sancheti P. Ponseti Cast Removal: Video Technique. J Orthop Case Rep 2021; 10:50-52. [PMID: 33954135 PMCID: PMC8051574 DOI: 10.13107/jocr.2020.v10.i03.1744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Ponseti casting method is the gold standard for the management of congenital talipes equinovarus in neonates, which consists of weekly manipulation and serial casting. Using oscillatory saw for cast removal is user-dependant and has been fraught with complications consisting of saw burns, thermal abrasions, anxiety, and fear of the saw (especially in children). The aim of this article is to describe our technique of cast removal using visual media format. Technique: This video describes an easy method of cast soakage with lukewarm water. Once the cast is soaked in water, the knob is identified, and the loosened outer layer of the cast is unwrapped in layers. Complete procedure can be done at home by parents. Since no equipment is utilized, the technique eliminates all complications associated with an oscillating saw. Conclusion: Cast soakage with lukewarm water followed by unwrapping is a simple and cost-effective method of Ponseti cast removal which can be done by parents at home improving the overall satisfaction of the family.
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Affiliation(s)
- Vivek M Sodhai
- Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Sandeep A Patwardhan
- Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Ashok K Shyam
- Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,Department of Research, Indian Orthopaedic Research Group, Thane, Maharashtra, India
| | - Askhar Haphiz
- Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Parag Sancheti
- Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
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15
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Maia EBS, La Banca RO, Nascimento LC, Schultz LF, de Carvalho Furtado MC, Sulino MC, de Lima RAG. Nurses' Perspectives on Acquiring Play-Based Competence Through an Online Course: A Focus Group Study in Brazil. J Pediatr Nurs 2021; 57:e46-e51. [PMID: 33082034 DOI: 10.1016/j.pedn.2020.10.008] [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: 06/17/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The main stage of developing an educational health technology is meeting the expectations of users. Nurses in Brazil can benefit from online training about therapeutic play interventions. This study identified the learning demands of nurses for acquiring competence in the use of therapeutic play to build an online course. DESIGN AND METHODS Focus groups study, guided by the COREQ guidelines. Nurses experienced in pediatric care participated in eight groups held in hospitals across all Brazilian regions in 2018. The focus group interviews had a mean duration of two hours and were moderated by the main researcher and an observer, both of whom were nurses experienced in qualitative research. All interviews were audio recorded. The transcripts of the audios were coded, from which the themes were developed, and thematic analysis performed. RESULTS Nurses (N = 53, 8.5 ± 6.3 years of experience in pediatric care) reported their learning demands in three themes: "Learning theoretical concepts", "Developing therapeutic play skills", and "Learning the therapeutic play in a fun, interactive and motivational online environment". CONCLUSION Nurses learning demands involve theoretical concepts and skills to implement therapeutic play through an interesting online course. PRACTICE IMPLICATIONS By developing play-based competence through an online learning environment nurses can feel confident in implementing therapeutic play into their pediatric practice, setting the stage for a future of positive interaction between nurses and children in pediatric health care.
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Affiliation(s)
- Edmara Bazoni Soares Maia
- Ribeirao Preto College of Nursing, University of Sao Paulo - PAHO/WHO Collaborating Center for Nursing Research Development, SP, Brazil; Paulista School of Nursing, Federal University of Sao Paulo, SP, Brazil
| | - Rebecca Ortiz La Banca
- Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, MA, USA
| | - Lucila Castanheira Nascimento
- Ribeirao Preto College of Nursing, University of Sao Paulo - PAHO/WHO Collaborating Center for Nursing Research Development, SP, Brazil
| | | | - Maria Cândida de Carvalho Furtado
- Ribeirao Preto College of Nursing, University of Sao Paulo - PAHO/WHO Collaborating Center for Nursing Research Development, SP, Brazil
| | - Mariane Caetano Sulino
- Ribeirao Preto College of Nursing, University of Sao Paulo - PAHO/WHO Collaborating Center for Nursing Research Development, SP, Brazil
| | - Regina Aparecida Garcia de Lima
- Ribeirao Preto College of Nursing, University of Sao Paulo - PAHO/WHO Collaborating Center for Nursing Research Development, SP, Brazil
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16
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Maharjan P, Murdock D, Tielemans N, Goodall N, Temple B, Askin N, Wittmeier K. Interventions to Improve the Cast Removal Experience for Children and Their Families: A Scoping Review. CHILDREN-BASEL 2021; 8:children8020130. [PMID: 33578958 PMCID: PMC7916681 DOI: 10.3390/children8020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cast removal can be a distressing experience for a child. This scoping review aims to provide a comprehensive review of interventions designed to reduce anxiety and improve the child's and family's experience of pediatric cast removal. METHODS A scoping review was conducted (Medline, Embase, PsycINFO, CINAHL, Scopus, grey literature sources). INCLUSION CRITERIA studies published January 1975-October 2019 with a primary focus on pediatric patients undergoing cast removal/cast room procedures. Screening, full text review, data extraction, and quality appraisal were conducted in duplicate. RESULTS 974 unique articles and 1 video were screened. Nine articles (eight unique studies) with a total of 763 participants were included. Interventions included the following, alone or in combination: noise reduction, electronic device use, preparatory information, music therapy, play therapy, and child life specialist-directed intervention. Heart rate was used as a primary (88%) or secondary (12%) outcome measure across studies. Each study reported some positive effect of the intervention, however effects varied by age, outcome measure, and measurement timing. Studies scored low on outcome measure validity and blinding as assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials. CONCLUSION Various methods have been tested to improve the pediatric cast removal experience. Results are promising, however the variation in observed effectiveness suggests a need for the use of consistent and valid outcome measures. In addition, future research and quality improvement projects should evaluate interventions that are tailored to a child's age and child/family preference.
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Affiliation(s)
- Pramila Maharjan
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Orthopedic Technology Services, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada
| | - Dustin Murdock
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R33 0T6, Canada; (D.M.); (N.T.)
| | - Nicholas Tielemans
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R33 0T6, Canada; (D.M.); (N.T.)
| | - Nancy Goodall
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Orthopedic Technology Services, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada
| | - Beverley Temple
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2M6, Canada;
| | - Nicole Askin
- WRHA Virtual Library, University of Manitoba, Winnipeg, MB R3E 3P5, Canada;
| | - Kristy Wittmeier
- Physiotherapy Department, Health Sciences Centre Winnipeg–Shared Health, Winnipeg, MB R3A 1R9, Canada; (P.M.); (N.G.)
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Correspondence:
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17
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Liu MC, Chou FH. Play Effects on Hospitalized Children With Acute Respiratory Infection: An Experimental Design Study. Biol Res Nurs 2020; 23:430-441. [PMID: 33334144 DOI: 10.1177/1099800420977699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Acute respiratory infection is a major health issue and a primary cause of morbidity and mortality among preschool-aged children worldwide. Disease and hospitalization are chief stressors for children during their development. Therapeutic play has been used in pediatric care processes and has been demonstrated to be effective by most studies that have targeted children undergoing surgeries or invasive medical treatments. Currently, few published studies have focused on children receiving acute inpatient care. Additionally, not all types of therapeutic play produce significant results, and few studies have elaborated on the purposes, principles, and concrete measures of therapeutic play. Therefore, this study aimed to design therapeutic play that would reduce the stress responses of preschool-aged children hospitalized with acute respiratory infection. An experimental design with a pretest/posttest was conducted with 105 preschool children recruited from a regional teaching hospital in southern Taiwan. The children in the experimental group received the therapeutic play, while those in the control group received routine nursing care. Children in the experimental group showed significantly greater reductions in their physiological, psychological, and behavioral stress responses than those in the control group. Future studies could apply therapeutic play to children from different age groups with diverse health issues before recommending it be used in pediatric health settings.
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Affiliation(s)
- Mei-Chun Liu
- 63408Chung-Jen College of Nursing, Health Sciences and Management, Chia-Yi.,210832College of Nursing, Kaohsiung Medical University, Kaohsiung
| | - Fan-Hao Chou
- 210832College of Nursing, Kaohsiung Medical University, Kaohsiung
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18
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Jivraj BA, Schaeffer E, Bone JN, Stunden C, Habib E, Jacob J, Mulpuri K. The use of virtual reality in reducing anxiety during cast removal: a randomized controlled trial. J Child Orthop 2020; 14:574-580. [PMID: 33343753 PMCID: PMC7740687 DOI: 10.1302/1863-2548.14.200090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE While virtual reality (VR) has been shown to be an effective distractor in children across a range of procedures, no studies have looked at its use within paediatric orthopaedics. The purpose of this study was to look at the use of VR in reducing anxiety levels in children during cast removal. In addition, the study aimed to find ways to enhance the efficiency of future VR trials in paediatrics. METHODS A non-blinded randomized control trial took place in children aged four to 18 years. Intraprocedural anxiety was measured using the Children's Emotional Manifestation Scale (CEMS), while pre- and post-procedural anxiety was measured using the Short State Anxiety Inventory Scale. Additional data was collected on trait anxiety, nausea levels, desire for future VR use and areas of improvement for future VR studies. RESULTS A total of 90 subjects were included in the study (control n = 45, intervention n = 45) with a mean age of 10.25 years (sd 3.35). Post-procedural anxiety and intraprocedural anxiety were 18% (p = 0.03) and 24% (p = 0.01) lower in the VR group, respectively, with the CEMS facial component showing a 31% (p < 0.001) reduction in the VR group. In all, 99% (n = 89) of subjects experienced no nausea, with one patient experiencing mild nausea that may have been present prior to VR use. Finally, 90% (n = 81) of subjects said they would like to use VR again, 1% (n = 1) said 'no' and 9% (n = 8) said 'maybe'. CONCLUSION VR appears to be an effective distraction technique in reducing anxiety levels in children during cast removal.
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Affiliation(s)
- Bejaan A. Jivraj
- Department of Family Medicine, University of British Columbia, Vancouver, Canada
| | - Emily Schaeffer
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada,Department of Orthopaedic Surgery, BC Children’s Hospital, Vancouver, Canada
| | - Jeffrey N. Bone
- Department of Obstetrics and Gynaecology, BC Children’s Hospital, Vancouver, Canada
| | | | - Eva Habib
- Department of Orthopaedic Surgery, BC Children’s Hospital, Vancouver, Canada
| | - John Jacob
- Digital Lab, BC Children’s Hospital, Vancouver, Canada,Strategy and Innovation, BC Children’s Hospital, Vancouver, Canada
| | - Kishore Mulpuri
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada,Department of Orthopaedic Surgery, BC Children’s Hospital, Vancouver, Canada,Correspondence should be sent to Kishore Mulpuri, Department of Orthopaedic Surgery, BC Children’s Hospital, 1D.66-4480 Oak Street, Vancouver, BC V6H 3V4, Canada. E-mail:
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19
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Aufegger L, Bùi KH, Bicknell C, Darzi A. Designing a paediatric hospital information tool with children, parents, and healthcare staff: a UX study. BMC Pediatr 2020; 20:469. [PMID: 33032549 PMCID: PMC7542856 DOI: 10.1186/s12887-020-02361-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The hospital patient pathway for having treatment procedures can be daunting for younger patients and their family members, especially when they are about to undergo a complex intervention. Opportunities to mentally prepare young patients for their hospital treatments, e.g. for surgical procedures, include tools such as therapeutic clowns, medical dolls, or books and board games. However, while promising in reducing pre-operative anxiety and negative behaviours, they may be resource intensive, costly, and not always readily available. In this study, we co-designed a digital hospital information system with children, parents and clinicians, in order to prepare children undergoing medical treatment. METHOD The study took place in the UK and consisted of two parts: In part 1, we purposively sampled 37 participants (n=22 parents, and n=15 clinicians) to understand perceptions and concerns of an hospital information platform specifically design for and addressed to children. In part 2, 14 children and 11 parents attended an audio and video recorded co-design workshop alongside a graphic designer and the research team to have their ideas explored and reflected on for the design of such information technology. Consequently, we used collected data to conduct thematic analysis and narrative synthesis. RESULTS Findings from the survey were categorised into four themes: (1) the prospect of a hospital information system (parents' inputs); (2) content-specific information needed for the information system (parents' and clinicians' inputs); (3) using the virtual information system to connect young patients and parents (parents' inputs); and (4) how to use the virtual hospital information system from a clinician's perspective (clinicians' inputs). In contrast, the workshop highlighted points in times children were most distressed/relaxed, and derived the ideal hospital visit in both their and their parents' perspectives. CONCLUSIONS The findings support the use of virtual information systems for children, in particular to explore and learn about the hospital, its facilities, and the responsibilities of healthcare professionals. Our findings call for further investigations and experiments in developing safer and more adequate delivery of care for specific age groups of healthcare users. Practical and theoretical implications for improving the quality and safety in healthcare delivery are discussed.
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Affiliation(s)
- Lisa Aufegger
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK.
| | - Khánh Hà Bùi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Colin Bicknell
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
| | - Ara Darzi
- (NIHR) Imperial Patient Safety Translation Research Centre (PSTRC), Imperial College London, 10 S Wharf Rd, London, W2 1PE, UK
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20
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Ünver S, Güray Ö, Aral S. Effectiveness of a Group Game Intervention in Reducing Preoperative Anxiety Levels of Children and Parents: A Randomized Controlled Trial. AORN J 2020; 111:403-412. [DOI: 10.1002/aorn.12990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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21
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Bray L, Appleton V, Sharpe A. 'If I knew what was going to happen, it wouldn't worry me so much': Children's, parents' and health professionals' perspectives on information for children undergoing a procedure. J Child Health Care 2019; 23:626-638. [PMID: 31431048 DOI: 10.1177/1367493519870654] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Children undergoing procedures such as blood tests and X-rays experience less anxiety and upset if they are well prepared and informed. Currently the provision of information about procedures can be ad hoc and there are barriers to children understanding this information. This study explored the perspectives of 32 children undergoing procedures (aged between 8 and 12 years), 27 parents and 19 health professionals on the provision of preparatory information to children. Qualitative interviews, prompted by visual images, were thematically analysed. The three themes, 'accessing information', 'understanding information' and 'using information', resonated with the central tenets of health literacy. Children reported mainly accessing information second-hand through their parents and demonstrated misconceptions about their procedure. Children identified that procedural information would help them to know what was going to happen and enable them to feel less worried and scared about their procedure. This study highlights that children can have low levels of health literacy in relation to a planned procedure. Their health literacy in this context is heavily influenced by the adults (parents and health professionals) around them. There needs to be further work conducted, informed directly by children, to improve the health literacy of children attending hospital for planned procedures.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Victoria Appleton
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Ashley Sharpe
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
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22
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Wong CL, Lui MMW, Choi KC. Effects of immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a study protocol for a randomized controlled trial. Trials 2019; 20:369. [PMID: 31221208 PMCID: PMC6585051 DOI: 10.1186/s13063-019-3443-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 05/13/2019] [Indexed: 12/22/2022] Open
Abstract
Background Venipuncture is one of the most painful and distressing procedure experienced by pediatric patients. Evidence suggests that distraction combined with age-appropriate procedural information can effectively decrease procedural pain and anxiety in pediatric patients. Immersive virtual reality (IVR) can simultaneously provide complete distraction and procedural information to patients. Methods Guided by the gate control theory and Lazarus and Folkman’s theory, this study aims to examine the effects of IVR intervention on reducing the pain, anxiety and stress, the duration of venipuncture, and the satisfaction of healthcare providers for the procedure. A randomized controlled trial with repeated assessments will be conducted. A total of 200 pediatric patients aged 4–12 years will be recruited from a regional public hospital and randomly assigned to either the intervention or control group. The study will use two age-appropriate IVR modules that consist of procedural information. The intervention group will receive IVR intervention, whereas the control group will receive standard care only. The cost-effectiveness of IVR intervention will be compared with that of standard care. Outcome evaluation will be conducted at four time points: 10 min before, during, immediately after, and 30 min after the procedure. Intention to treat and generalized estimating equation model will be used to analyze the data. Discussion This study is the first of its kind to adopt IVR intervention with age-appropriate procedural information for pediatric patients undergoing venipuncture. Findings of the proposed study may: (1) provide a novel, facile, and cost-effective intervention that can be used virtually at any time and place to manage pain and anxiety; and (2) shed light on the global trends of research and clinical development of IVR as an intervention for other painful and stressful medical procedures. Trial registration Chinese Clinical Trial Registry, ChiCTR1800018817. Registered on 11 October 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3443-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Room 824, 8/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
| | - Miranda Mei Wa Lui
- Paediatrics & Adolescent Medicine, Tseung Kwan O Hospital, Hospital Authority, Hong Kong, People's Republic of China
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Room 824, 8/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China
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