Rodd H, Hall M, Deery C, Gilchrist F, Gibson B J, Marshman Z
University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield, S10 2TA.
Br Dent J. 2014 Apr;216(8):E17. doi: 10.1038/sj.bdj.2014.333.
This qualitative study sought to obtain children's accounts of having dental extractions under general anaesthesia (GA). The aim was to gain greater understanding of the physical and psychological impacts from a child's perspective.
Ten children, aged 6-11 years, maintained a video diary to document their feelings and experiences before, and following their hospital admission. Two semi-structured home interviews supplemented the video diary data and analysis was guided by narrative approaches.
This research revealed new insights into children's experiences of having teeth removed under GA. Several of the post-operative impacts correlated with those previously reported by parents/carers. These were notably nausea, bleeding and tiredness, although children used different terminology. However, additional physical and psychological outcomes, both positive and negative, emerged from the children's narratives. Negative aspects included hunger, disturbed eating, being scared/worried and experiencing discomfort from the IV cannula. Interestingly, pain was not a strong theme. Positive outcomes were also reported, such as satisfaction with the resolution of their dental problem and receipt of rewards and attention from family members.
These accounts have implications for improving patient experiences and outcomes throughout the dental GA care pathway. A review of pre-operative fasting protocols should be a priority.
本定性研究旨在获取儿童对全身麻醉下拔牙经历的描述。目的是从儿童的角度更深入地了解其身体和心理影响。
10名6至11岁的儿童通过视频日记记录他们入院前后的感受和经历。两次半结构化的家庭访谈对视频日记数据进行补充,分析采用叙事方法。
本研究揭示了儿童在全身麻醉下拔牙经历的新见解。一些术后影响与父母/照顾者之前报告的相关。这些明显包括恶心、出血和疲劳,尽管儿童使用了不同的术语。然而,儿童的叙述中还出现了其他积极和消极的身体及心理结果。消极方面包括饥饿、进食受扰、害怕/担忧以及静脉套管带来的不适。有趣的是,疼痛并非突出主题。也有积极结果的报告,比如对牙齿问题得到解决感到满意,以及得到家人的奖励和关注。
这些描述对改善整个牙科全身麻醉护理路径中的患者体验和结果具有启示意义。术前禁食方案的审查应成为优先事项。