Brewer Stephanie, Gleditsch Shannon L, Syblik Dorothy, Tietjens Mary E, Vacik Heidi W
Department of Same Day Surgery, Texas Children's Hospital, Houston, TX 77030, USA.
J Pediatr Nurs. 2006 Feb;21(1):13-22. doi: 10.1016/j.pedn.2005.06.004.
Although many hospitals offer a surgical preparation program to children and families, minimal research has been conducted specifically on preparation by child life specialists. The purpose of this double-blind intervention study was to determine if children prepared for day surgery by a child life specialist exhibited less anxiety than those who received routine standard of care. One hundred forty-two children, aged between 5 and 11 years old, undergoing elective otolaryngology surgery completed the study. The "Child Drawing: Hospital" instrument developed by Clatworthy, Simon, and Tiedeman [Clatworthy, S., Simon, K., & Tiedeman, M. E. (1999). Child Drawing: Hospital - An instrument designed to measure the emotional status of hospitalized school-aged children. Journal of Pediatric Nursing, 14, 2-9] was used to determine children's anxiety levels preintervention and postintervention. Eighty children received formal preparation for their surgeries by a child life specialist and 62 received no intervention. The data were analyzed using a repeated-measures model with intervention, age, sex, and level of surgery for main effects. The anxiety score change was significantly better for the patients in the child life intervention group than for those in the nonintervention group, F(1,135) = 4.24, p = .04. The increase in anxiety scores in the nonintervention group suggests that children could benefit from preoperative preparation. Health professionals, including nurses, may impact children's abilities to cope with a surgical process. The information in this study will be useful in deciding whether all children, not just those with a perceived need, should be prepared prior to an elective day surgery.
尽管许多医院为儿童及其家庭提供手术准备项目，但专门针对儿童生活专家所做准备工作的研究却很少。这项双盲干预研究的目的是确定由儿童生活专家为日间手术做准备的儿童是否比接受常规标准护理的儿童表现出更少的焦虑。142名年龄在5至11岁之间、接受择期耳鼻喉科手术的儿童完成了该研究。使用克拉特沃西、西蒙和蒂德曼开发的“儿童绘画：医院”工具[克拉特沃西，S.，西蒙，K.，& 蒂德曼，M. E.（1999年）。儿童绘画：医院——一种旨在测量住院学龄儿童情绪状态的工具。《儿科护理杂志》，14，2 - 9]来确定儿童在干预前和干预后的焦虑水平。80名儿童由儿童生活专家为其手术进行了正式准备，62名儿童未接受干预。使用重复测量模型对数据进行分析，将干预、年龄、性别和手术级别作为主要效应因素。儿童生活干预组患者的焦虑评分变化明显优于非干预组，F(1,135) = 4.24，p = .04。非干预组焦虑评分的增加表明儿童可以从术前准备中受益。包括护士在内的卫生专业人员可能会影响儿童应对手术过程的能力。本研究中的信息将有助于决定是否所有儿童，而不仅仅是那些被认为有需要的儿童，都应该在择期日间手术前做好准备。
