Chorney Jill MacLaren, Torrey Carrie, Blount Ronald, McLaren Christine E, Chen Wen-Pin, Kain Zeev N
Department of Anesthesiology, University of California, Irvine, Orange, CA, USA.
Anesthesiology. 2009 Dec;111(6):1290-6. doi: 10.1097/ALN.0b013e3181c14be5.
To date, no study has evaluated the impact of specific healthcare provider and parent behaviors on children's distress and coping during anesthesia induction.
Extensive digital video data were collected on 293 two- to ten-yr-old children undergoing anesthesia induction with a parent present. Anesthesiologist, nurse, and parent behavior and children's distress and coping were coded using the Revised Preoperative Child-Adult Medical Procedure Interaction Scale administered using specialized coding software.
Anesthesiologists and parents engaged in higher rates of most behaviors than nurses. Overall, adult emotion-focused behavior such as empathy and reassurance was significantly positively related to children's distress and negatively related to children's coping behaviors. Adult distracting behavior such as humor and distracting talk showed the opposite pattern. Medical reinterpretation by anesthesiologists was significantly positively related to children's coping behaviors, but the same behavior by parents was significantly positively related to children's distress.
The data presented here provide evidence for a relation between adult behaviors and children's distress and coping at anesthesia induction. These behaviors are trainable, and hence it is possible to test whether modifying physician behavior can influence child behavior in future studies.
迄今为止，尚无研究评估特定医疗服务提供者及家长行为对儿童麻醉诱导期的痛苦及应对方式的影响。
收集了293名2至10岁在家长陪伴下接受麻醉诱导的儿童的大量数字视频数据。使用专门的编码软件，通过修订后的术前儿童-成人医疗程序互动量表对麻醉医生、护士及家长的行为以及儿童的痛苦和应对方式进行编码。
麻醉医生和家长比护士表现出更多的大多数行为。总体而言，诸如共情和安慰等成人以情绪为中心的行为与儿童的痛苦显著正相关，与儿童的应对行为负相关。诸如幽默和分散注意力的谈话等成人分散注意力的行为则呈现相反的模式。麻醉医生进行的医学解释与儿童的应对行为显著正相关，但家长的同样行为与儿童的痛苦显著正相关。
此处呈现的数据为成人行为与儿童麻醉诱导期的痛苦及应对方式之间的关系提供了证据。这些行为是可训练的，因此在未来研究中有可能测试改变医生行为是否会影响儿童行为。
