1
|
Hu L, Hua Y, Wang L, Mao Z, Jia X, Lei Z, Chang D, Cheng W. Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial. J Perianesth Nurs 2024:S1089-9472(24)00102-3. [PMID: 38980240 DOI: 10.1016/j.jopan.2024.03.009] [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: 07/04/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE There are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents. DESIGN A randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators. METHODS Perioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) > 44, STAI (child) > 36, and mYPAS-SF ≥ 30. FINDINGS No significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child's postoperative anxiety. Furthermore, children's postoperative state anxiety was slightly correlated with postoperative pain. CONCLUSIONS Short-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child.
Collapse
Affiliation(s)
- Lingling Hu
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Yanxiao Hua
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Lingling Wang
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Ziwen Mao
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China; Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Xiaofei Jia
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Zhen Lei
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Danshao Chang
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Weyland Cheng
- Department of Orthopaedic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China; Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China.
| |
Collapse
|
2
|
Almarzouq SSFS, Chua H, Yiu CKY, Lam PPY. Effectiveness of Nonpharmacological Behavioural Interventions in Managing Dental Fear and Anxiety among Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:537. [PMID: 38470648 PMCID: PMC10931341 DOI: 10.3390/healthcare12050537] [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: 12/29/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Non-pharmacological behavioural interventions (NPBIs) have been employed by dentists to alleviate dental fear and anxiety (DFA) among preschool and school children. The aim of this systematic review and meta-analysis was to investigate the effectiveness of different NPBIs in reducing DFA among children aged below 12. METHOD A comprehensive search was conducted using four electronic databases to identify randomised controlled trials that assess the effectiveness of NPBIs among preschool and school children. Two reviewers independently screened and selected the relevant studies, evaluated the risk of bias, and extracted relevant data for qualitative and quantitative syntheses. RESULT A total of 66 articles were included in the study. Except during more invasive dental procedures, the use of distraction techniques was found to result in significantly lower self-rated anxiety, better cooperation, and lower pulse rate compared to the tell-show-do method. However, inconsistent results were reported regarding the efficacy of virtual reality, modelling, visual pedagogies, tell-show-do and other NPBIs in reducing DFA among children. CONCLUSIONS The studies exhibited substantial heterogeneity due to varying age groups, methods of implementing NPBIs, dental treatments performed, and measurement scales employed in the evaluation of DFA.
Collapse
Affiliation(s)
| | - Helene Chua
- National Healthcare Group Polyclinics, Singapore 308433, Singapore
| | - Cynthia K. Y. Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
| | - Phoebe P. Y. Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (C.K.Y.Y.)
| |
Collapse
|
3
|
Wu D, Lan X, Litscher G, Zhao YL, Wu YQ, Dai RJ, Cao K, Wang Y, Chen LQ. Laser acupuncture and photobiomodulation therapy in Bell's palsy with a duration of greater than 8 weeks: a randomized controlled trial. Lasers Med Sci 2024; 39:29. [PMID: 38216803 PMCID: PMC10787006 DOI: 10.1007/s10103-023-03970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
To investigate the efficacy of laser acupuncture and photobiomodulation therapy in alleviating symptoms among patients diagnosed with Bell's palsy with duration of greater than 8 weeks. The randomized controlled trial has been performed from May 2021 to April 2023. Patients were eligible who had Bell's palsy with duration of greater than 8 weeks on out-patient Department of Otorhinolaryngology in Beijing Tongren Hospital. The laser acupuncture group received class IV laser treatment for 3 times per weeks, a total of 72 times. The control group received the same treatment procedure except the laser parameter. The primary outcome measures comprised House-Brackmann facial nerve grading system and electroneurography. Secondary outcome measures comprised Sunnybrook facial grading system, electromyography, and the blink reflex. A total of 84 participants were included (42 control group, 42 laser acupuncture group). After treatment, House-Brackmann facial nerve grading system (OR, 0.11; 95% CI, 0.04-0.30; P < 0.001), and the pathologic numbers of electroneuronography were statistically different between the laser acupuncture group and control group, including orbicularis oculi (OR,0.08; 95% CI, 0.02-0.21; P < 0.001), Frontalis muscle (OR,0.14; 95% CI, 0.05-0.39; P < 0.001), Orbicularis oris (OR,0.13; 95% CI, 0.04-0.36; P < 0.001), Ala nasi muscle (OR,0.06; 95% CI, 0.02-0.18; P < 0.001). In secondary outcomes, Sunnybrook facial grading system, has significant difference between the two groups (20.26; 95% CI, 14.69 to 25.83; P < 0.01). Latency by ENoG, include orbicularis oculi (-0.61; 95% CI, -0.43 to -0.09; P < 0.001), frontalis muscle (-0.12; 95% CI, -0.21 to -0.03; P < 0.01), orbicularis oris (-0.28; 95% CI, -0.41 to -0.16; P < 0.001), and ala nasi muscle (-0.26; 95% CI, -0.38 to -0.16; P < 0.001). All amplitudes of MUAPs and durations by electromyography (EMG) showed statistically significant differences compared with the control group after treatment. For the frontalis muscle, the amplitude of MUAPs was -64.23 (95% CI, -80.89 to -47.56; P < 0.001) and duration was -1.18 (95% CI, -1.49 to -0.87; P < 0.001). For orbicularis oris, amplitude of MUAPs was -29.82 (95% CI, -55.03 to -4.62; P = 0.02) and duration was -0.57 (95% CI, -0.94 to -0.20; P < 0.001). For depressor angulli oris, amplitude of MUAPs was -47.06 (95% CI, -62.15 to -31.97; P < 0.001) and duration was -2.21 (95% CI, -2.69 to -1.72; P < 0.001). Blink reflex, including R1 (OR, 0.03; 95% CI, 0.01-0.16; P < .001), R2 (OR, 0.04; 95% CI, 0.004-0.29; P < .001), and R2 latency differences (OR, 0.15; 95% CI, 0.05-0.51; P < .001), have significant difference between the two groups, respectively. The findings suggest that laser acupuncture relieve symptoms for patients with Bell's palsy with a duration of greater than 8 weeks.Trial registration: ClinicalTrials.gov Identifier: NCT05846217.
Collapse
Affiliation(s)
- Dong Wu
- Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Xin Lan
- Jococo Inc, Los Angeles, CA, USA
| | - Gerhard Litscher
- President of the International Society for Medical Laser Applications (ISLA transcontinental; since 2012), German Vice President of the German-Chinese Research Foundation (DCFG) for TCM (since 2014), Vice Chairperson, World Federation of Chinese Medicine Societies, Committee of Card. Rehab. (2023-2028), Honorary President of the European Federation of Acupuncture and Moxibustion Societies (2023), Honorary Professor of China Beijing International Acupuncture Training Center, China Academy of Chinese Medical Sciences (2023), Former Head of two Research Units at Medical University of Graz, 8036, Graz, Austria
| | - Yan-Ling Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yun-Qing Wu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ru-Jun Dai
- TED Healthcare Technology Ltd (Beijing), Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu Wang
- Institute of Acupuncture-Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu-Quan Chen
- Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
| |
Collapse
|
4
|
Bahrololoomi Z, Zein Al-Din J, Maghsoudi N, Sajedi S. Efficacy of Virtual Reality Distraction in Reduction of Pain and Anxiety of Pediatric Dental Patients in an Iranian Population: A Split-Mouth Randomized Crossover Clinical Trial. Int J Dent 2024; 2024:1290410. [PMID: 38250512 PMCID: PMC10798833 DOI: 10.1155/2024/1290410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 11/08/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024] Open
Abstract
Materials and Methods This crossover clinical trial was conducted with eligible 6-8-year-old children requiring bilateral mandibular molar pulpotomy. At the first treatment visit, pulpotomy was performed for 15 children using VR glasses distraction while the other 15 children received a pulpotomy without any VR glasses; this trend was reversed at the second session and pulpotomy was performed for the contralateral tooth. Pulse rate (PR) and Modified Child Dental Anxiety Scale (MCDAS) measured the anxiety levels. Wong-Baker Faces Pain Scale (WBFP) assessed the pain perception before and after the intervention. Data were analyzed by Statistical Package for the Social Sciences version 25 using the Mann-Whitney and χ2 tests. Results The mean PR was not significantly different between the two groups. However, the test group showed significantly lower scores of MCDAS (P value = 0.02) and WBFP (P value = 0.001) compared with the control group. Conclusion The present results suggest that VR headsets can decrease the level of pain and anxiety of patients during primary mandibular pulpotomy. This trial is registered with IRCT20200315046782N1.
Collapse
Affiliation(s)
- Zahra Bahrololoomi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zein Al-Din
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Maghsoudi
- Department of Pediatrics, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samira Sajedi
- Department of Pediatrics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
5
|
Hutajulu JM, Agustiani H, Setiawan AS. Special Characteristics of Alpha Generation Children Behavior in Dentistry: A Literature Review. Eur J Dent 2024. [PMID: 38198815 DOI: 10.1055/s-0043-1776336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Technological developments and advances have influenced the emergence of a new generation, known as Generation Alpha. This generation comprises those born between 2010 and 2025. Born into a digital-savvy era, this generation has different characteristics from previous generations. This study aims to identify their special characteristics so that an approach can be taken, especially in managing children of the alpha generation in dentistry. A systematic search for articles, published between 2013 and 2023 analyzing the characteristics and behavior of the alpha generation and management behavior found in dentistry was conducted through PubMed, Google Scholar, SCOPUS, and EBSCO. The final analysis was carried out on 47 articles consisting of 10 articles discussing the characteristics of the alpha generation in general and 37 articles discussing the management of their behavior in dentistry. All the published articles found that an alpha child's characteristics are closely related to behavior management in dentistry. The ease with which alpha children adapt to technology is one of the strategies for managing the behavior of alpha children. However, apart from this, the alpha children tend to be unappreciative of the process, which can affect dental behavior management. Specific characteristics of the alpha generation, such as increased exposure to technology, digital media consumption habits, and lack of respect for the process, have important implications for communication and adaptation to patient behavior management in dentistry. Understanding these characteristics is crucial for designing an effective communication strategy and adjusting appropriate behavior management to maintain the quality of dental care for this generation in the dentistry environment.
Collapse
Affiliation(s)
- Jose Mario Hutajulu
- Dental Education Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Hendriati Agustiani
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Arlette Suzy Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| |
Collapse
|
6
|
Wu D, Zhao YL, Sun JY, Dai RJ, Cao K, Qu RK, Wang Y, Wu YQ. A Nonrandomized Trial of the Effects of Near-Infrared Photobiomodulation Therapy on Bell's Palsy with a Duration of Greater Than 8 Weeks. Photobiomodul Photomed Laser Surg 2023; 41:490-500. [PMID: 37738368 DOI: 10.1089/photob.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Objective: To determine whether photobiomodulation therapy (PBMT) by class IV Multiwave Locked System laser treatment as an adjunctive therapy could relieve symptoms in patients with Bell's palsy with a duration of greater than 8 weeks. Materials and methods: This nonrandomized controlled trial was conducted from January 2020 to December 2022. Patients were eligible if they had Bell's palsy with a duration of greater than 8 weeks at the out-patient department of otorhinolaryngology in Beijing Tongren Hospital. The control group consisted of patients recruited between January 1, 2020, and December 31, 2020. The PBMT group consisted of patients recruited between January 1, 2021, and December 31, 2022. In this study, the PBM used has a wavelength of 808 and 905 nm, 1.2 W power (808 nm is 1 W, 905 nm is 200 mW), continuous mode emission (808 nm) and pulsed mode emission (905 nm), 8.35 J/cm2 dosimetry, administered 3 times per week, 72 times of total treatment. The primary outcome measures included the House-Brackmann facial nerve grading system, the Sunnybrook facial grading system, and the Facial Clinimetric Evaluation Scale (FaCE). Secondary outcome measures comprised electroneurography, electromyography, and the blink reflex. Results: A total of 54 participants were included (27 in the control group and 27 in the photobiomodulation group). After 6 months, the House-Brackmann grading system [risk difference, -0.59, confidence interval (95% CI), -0.81 to -0.38, relative risk, 0.27, 95% CI, 0.13-0.56, p < 0.001], Sunnybrook facial grading system (21.14, 95% CI, 11.71-30.58; p < 0.001), and FaCE (-0.20, 95% CI, 0.41-0.02; p = 0.07) had significant difference between the two groups. Latency of ala nasi muscle (10.92, 95% CI, 5.58-16.27; p < 0.001) was not statistically significant after treatment compared with the control group; however, most of the electrophysiological examinations have significant difference between the two groups, respectively. Conclusions: The results of this study suggest that PBMT may relieve symptoms for patients with Bell's palsy with a duration of greater than 8 weeks. Trial Registration: ClinicalTrials.gov Identifier: NCT05585333.
Collapse
Affiliation(s)
- Dong Wu
- Department of Traditional Chinese Medicine and Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan-Ling Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing-Yi Sun
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ru-Jun Dai
- TED Healthcare Technology Ltd (Beijing), Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rong-Kun Qu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu Wang
- Institute of Acupuncture-Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yun-Qing Wu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
7
|
Dahlan M, Alsaywed R, Alamoudi R, Batarfi AA, Basodan OY, Gazzaz Y, Alqarni YA, Alamoudi A. Assessment of Different Distraction Behavioral Methods in Pediatric Dental Clinic: A Systematic Review. Cureus 2023; 15:e42366. [PMID: 37621781 PMCID: PMC10445507 DOI: 10.7759/cureus.42366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/26/2023] Open
Abstract
Dental anxiety is one of the main problems dentists may face during the treatment of pediatric dental patients; therefore, clinicians tend to perform different behavior management techniques to reduce dental anxiety in children. This review aimed to systematically compare and evaluate the published literature regarding the effects of distraction techniques on anxiety, pain perception, and patient experience during dental practice. A detailed electronic search was conducted on 3 databases including PubMed, Google Scholar, and Cochrane Library. The databases were searched for articles published in the English language between 2015 and 2022. Among 102 studies, 27 studies fulfilled the criteria of eligibility and were included in this study to be analyzed. Numerous approaches have been proposed for the reduction of dental anxiety, out of which the use of audio-visual aids and instruments, active distraction such as tablets, smartphones, and virtual reality glasses showed governance in decreasing the children's anxiety followed by cognitive and behavioral methods.
Collapse
Affiliation(s)
- Mohammad Dahlan
- Pediatric Dentistry, North Jeddah Speciality Dental Center, Jeddah, SAU
| | - Rafal Alsaywed
- General Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | - Amal A Batarfi
- General Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | - Yara Gazzaz
- General Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | | |
Collapse
|