medical procedure

BackgroundVirtual reality (VR) may enhance the effectiveness of psychological interventions for acute pain. We conducted a meta-analysis to assess the efficacy and safety of VR-based interventions for pain associated with medical procedures.MethodsWe searched PubMed, EMBASE, the Cochrane Library, and PsycINFO until June 17th 2018. We identified randomized controlled trials (RCTs), comparing VR-based psychological interventions to usual care, for pain intensity (primary outcome) or affective and cognitive components of pain (secondary outcomes), assessed real-time or retrospectively. Two independent reviewers performed study selection and data extraction. Risk of bias was independently evaluated by three raters using the revised Cochrane Collaboration tool. A random-effects model using the Paule and Mandel estimator was used for pooling effect sizes.Results27 RCTs (1452 patients) provided enough data for meta-analysis. Compared to usual care, VR-based interventions reduced pain inten...

Objective: Many studies have shown that the level of postoperative distress and anxiety in children is associated with the amount of anxiety during the pre operative period. In this study, we compared the effect of pre-operational attending in a playroom and using play activities on the level of anxiety increment after surgery in an intervention and a control group of Iranian children. Method: In a clinical trial, 75 children aged 5 to 12 enrolled in the intervention and the control group. The anxiety symptoms were assessed using State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Yale modified Pre operative Anxiety Scale. The mean differences of pre and post operative anxiety scores were calculated and compared using the ANCOVA statistical method. Results: The two groups had similar demographic characteristics except for age which was higher in the control group. The baseline anxiety score was lower in the intervention compare to the contr...

PurposeThe study aims to evaluate the effectiveness of combined video game distraction and anesthesia mask exposure and shaping intervention as compared to conventional preoperative preparation on the preoperative anxiety, anesthesia induction compliance and emergence delirium of children undergoing day‐case surgery.Design and MethodsThe CONSORT guidelines were followed in the current study; a randomized clinical trial, two groups, pre posttest, between subjects design with 1:1 allocation ratio was employed. Children (5–11 years of age; N = 128) admitted for day case surgery were invited to participate in the study. Sixty‐four children were assigned to the intervention group receiving combined videogame distraction and anesthesia mask exposure and shaping intervention, and 64 children were assigned to the control group.ResultsThe results showed that children in the intervention group reported statistically significant lower anxiety scores than the children in the control group at th...

Objective: The study was conducted as a randomized controlled trial to determine the effect of watching cartoon during treatment on anxiety and fear in children. Methods: A total of 92 children (43 in the cartoon group and 49 in the control group) were included in the study. The results of the study were obtained using Information Form, Children’s State Anxiety Scale, and Children’s Fear Scale. The children in the cartoon group watched their favourite cartoons during treatment. No distracting method was applied to the children in the control group during their routine treatment. Anxiety and fear levels in children in the cartoon and control groups were evaluated before and during intravenous treatment. Results: Watching cartoon during iv treatment is effective on reducing anxiety and fear in children. Conclusion: Fear and anxiety levels in children can be reduced through watching cartoon during medical procedures. ClinicalTrials.gov identifier: NCT04127097. Keywords: child, anxiety,...

Objective To evaluate the effectiveness of a preoperative tour to a simulated anaesthesia induction at operating theatre on reducing children’s and parents’ preoperative anxiety. Design A pragmatic, single-centre, assessor-blinded, randomised controlled trial. Setting In preoperative anaesthesia clinic and the operating room at a tertiary care centre in Saudi Arabia. Participants One hundred and sixteen children–parents dyads (pairs) (n=57) intervention group (IG); (n=59) control group (CG) with children aged 4–14 years who were planned for day case procedures under general anaesthesia. Interventions Participants’ dyads were randomly allocated through a computer to receive either a preoperative tour to a real operating theatre and simulate anaesthesia induction or standard of care. Main outcome measure The primary study outcome was children’s anxiety levels as measured by the modified-Yale Preoperative Anxiety Scale (m-YPAS), and the parent’s anxiety level as assessed by the Beck An...

Giriş: Bu çalışma ortaokul çocuklarının tıbbi işlem korkularını ve etkileyen faktörleri belirlemek amacıyla tanımlayıcı olarak yapılmıştır. Gereç ve Yöntem: Örneklem seçiminde öncelikle Mağusa bölgesindeki ortaokullar kırsal ve kentsel okullar olarak gruplandırılmış ve tabakalı örnekleme yöntemi ile alınacak öğrenci sayısı evrenin bilindiği durumlarda örneklem hesabı formülü ile belirlenmiştir. Daha sonra her bir okuldan alınacak öğrenci sayısının yarısını kız, diğer yarısını erkek öğrenciler oluşturacak şekilde basit rastgele örneklem yöntemi ile 332 öğrenci çalışmaya alınmıştır. Veriler Tıbbi İşlem Korku Ölçeği ve Tanımlayıcı Soru Formu aracılığı ile toplanmıştır. Verilerin değerlendirilmesinde, yüzde, ortalama, t-test’i ve tek yönlü varyans analizi (Anova) kullanılmıştır. Bulgular: Çalışmada öğrencilerin toplam tıbbi işlem korku puan ortalaması 42,14±9,73 olup, ‘biraz korkan’ grupta yer aldıkları tespit edilmiştir. Öğrencilerin %87,3’ünün tıbbi işlemlerden biraz korktuğu, %4,8’in...

General anesthesia was needed by children with congenital heart disease (CHD) who underwent cardiac catheterization procedure and surgery. Pre-anesthetic anxiety in children with CHD can cause significant problems during induction of anesthesia which leads to negative postoperative outcomes. This study compared the role of maternal presence during anesthesia induction with midazolam premedication on pre-anesthetic anxiety level in children with CHD. Dr. Cipto Mangunkusumo National Hospital on April to September 2014. Forty-five CHD patients aged 2-5 years old who underwent cardiac invasive procedure were divided into P group (received midazolam premedication) and M group (had maternal presence during anesthesia induction). Modified Yale Pre-anxiety Scale (MYPAS) was used for measuring anxiety level in each patient during preoperative visit, on the time patient entered the procedure room and during induction of anesthesia. There was no significant difference of MYPAS scores between t...

Surgical procedures can generate significant preoperative anxiety (POA) in as much as 70% of the paediatric population. The role of hydroxyzine and distractive techniques such as clowns in the management of anxiety is controversial. Our main objective was to evaluate the effect of hydroxyzine on the control of POA. The secondary objective was to assess the potential additive effect of hydroxyzine and distracting techniques. We performed a randomized double-blind, controlled clinical trial in children aged 2–16 years undergoing outpatient surgery ( n = 165 ). Subjects were randomized to hydroxyzine (group 1) or placebo (group 2). For the secondary objective, two further groups were made by allocation by chance to hydroxyzine plus accompaniment with clowns (group 3) and placebo plus clowns (group 4). All patients were accompanied by their parents as the standard procedure. POA was determined by a modified Yale scale of POA (m-YPAS). Compliance of children during induction of anesthesi...

Anxiety is one of the most prevalent preoperative problems in children. It is estimated that approximately 50%–70% of children undergoing surgery experience severe anxiety and distress prior to surgery. Accurate measurement of anxiety is an important role of nurses in the pediatric day surgery setting as high levels of anxiety can lead to adverse consequences both during surgery and post-surgery. Thus, interventions to reduce preoperative anxiety are important for children and families. The aim of this study was to determine the effect of play therapy on reducing one day surgery preoperative anxiety among children at Assiut University Children Hospital. A quazi-experimental research design was used for this study. Setting: This study was conducted in the surgical unit at Assiut University Children's Hospital. Sampling: All children aged 3 to 12 years, who was admitted for one day surgery during a three-month's period. Three tools were used for this study: Tool I: An interviewing questionnaire sheet, Tool II: Modified Yale Preoperative Anxiety Scale (mYPAS), Tool III: The Spielberger State Anxiety Scale for children (SSAS-c). Results: The vast majority (90.3%, 96.8%) of both study and control groups respectively were anxious. More than three fourths (77.4%) of the study group children were experienced severe levels of anxiety before play therapy intervention which reduced to (41.9 %) after play therapy intervention. Highly statistically significant difference (P=0.000) was found between pre and post play therapy intervention in the study group while statistically significant differences (P=0.02, P=0.03) were found between studied children levels of Spielberger State anxiety and their male gender and rural residence respectively during pre and post play therapy intervention. No significant difference was found between studied children levels of anxiety and their age or birth order, also previous hospitalization or previous surgery did not significantly impact the child's level of anxiety. Concluded that play therapy was an effective method for reducing anxiety among children undergoing one day surgery as a feasible and cost effective intervention for children. The study recommended incorporating therapeutic play intervention in the preoperative periods as preoperative preparation.