Ortiz Gabriela S, OʼConnor Todd, Carey Jessa, Vella Adam, Paul Audrey, Rode Diane, Weinberg Alan
From the Child Life and Creative Arts Therapy Department, Mount Sinai's Kravis Children's Hospital, New York, NY.
Pediatr Emerg Care. 2019 Jul;35(7):498-505. doi: 10.1097/PEC.0000000000001065.
Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress.
This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software.
A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P < 0.05), and significant likelihood that the patient would improve relative to the 4 questions, as a result of the child life and music therapy intervention.
Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical impact of child life psychological preparation and psychotherapy-based music therapy interventions in reducing distress in pediatric patients during common medical procedures.
儿童生活专家和音乐治疗师在为儿科患者及其家庭提供心理社会护理方面发挥着独特且不可或缺的作用。这些专业人员经过培训，能够提供临床干预措施，以支持应对和调整，并降低与医院就诊和医疗保健接触相关的心理创伤风险。研究人员设计了一种多模式方法，采用儿童生活与音乐治疗相结合的干预措施，来解决儿科急诊科接受静脉输液（IV）置管患者与操作相关的痛苦。本研究的目的是通过评估家长对其孩子痛苦的感知，来调查这种联合干预措施的效果。
本研究是一项前瞻性分析，调查儿童生活与音乐治疗干预对在儿科急诊科接受IV置管的4至11岁儿童的影响。通过比较一个4题预测试和随后的4题后测试的得分来评估效果，这两个测试要求孩子的家长先评估他们预期孩子对该操作的反应，然后评估他们认为孩子在操作后的实际反应。定性数据以开放式评论的形式收集，在测试结束时进行整理。数据采用 Cochr an - Mantel - Haenszel方法进行分析，以测试重复的有序反应，并在SAS系统软件中使用PROC GENMOD程序进行分析。
本研究共纳入41名参与者。统计分析结果显示，所有预测试和后测试得分之间存在显著差异（P < 0.05），并且由于儿童生活与音乐治疗干预，患者相对于这4个问题有显著改善的可能性。
所有4个问题均显示出改善，表明儿童生活与音乐治疗干预支持了健康、适应性的应对方式，并有助于将患者在IV置管期间所经历的痛苦降至最低。这些结果强调了儿童生活心理准备和基于心理治疗的音乐治疗干预在减少儿科患者在常见医疗程序中的痛苦方面的重要性和潜在临床影响。
