互联网交付的术前准备计划（I-PPP）：开发和效果评估。
Internet-delivered, preoperative, preparation program (I-PPP): Development and examination of effectiveness.
机构信息
Department of Psychology, University of Regina, Regina, SK, Canada.
Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Saskatchewan, Saskatoon, SK, Canada.
出版信息
J Clin Anesth. 2017 Jun;39:45-52. doi: 10.1016/j.jclinane.2017.03.007. Epub 2017 Mar 27.
STUDY OBJECTIVE
Limited evidence-based, interactive, Internet-delivered preoperative preparation programs for children and their parents exist. The purpose of this investigation was to develop and examine the effectiveness of the Internet-delivered, preoperative program (I-PPP) in alleviating prepoperative anxiety in children undergoing outpatient surgery. In Study 1, the I-PPP was developed and then evaluated by parent/child dyads and health care professionals. In Study 2, the effectiveness of I-PPP was examined.
DESIGN
This study was a development and effectiveness study.
SETTING
For Study 1, participants were recruited from the community. For Study 2, participants were recruited from the Royal University Hospital.
PATIENTS
In Study 1, participants were 9 parent/child dyads and 5 health care professionals. In Study 2, participants were 32 children (3-7years) scheduled for outpatient surgery and one parent for each child.
INTERVENTION
In Study 1, I-PPP modules were created and parent/child dyads and health care professionals evaluated I-PPP modules and treatment credibility. In Study 2, child patients and their parents completed the I-PPP prior to day of surgery.
MEASUREMENTS
Observer-rated anxiety of child participants was measured during the day surgery experience. Parent state anxiety was measured prior to completing I-PPP, pre- and post-surgery. Post-surgery parents provided comments regarding the I-PPP. Post-surgery child behaviour change was assessed.
MAIN RESULTS
For Study 1, ratings for I-PPP components and treatment credibility surpassed our acceptability criterion. Minor changes were made to I-PPP. For Study 2, mYPAS scores were stable across day surgery. mYPAS scores in current study at induction did not differ significantly from benchmark studies. Significant reduction in parent anxiety was observed pre- to post-surgery. Parents positively endorsed the program. Negative post-operative behaviours were observed in a proportion of children.
CONCLUSIONS
Our findings suggest that I-PPP represents a viable option for preoperative preparation for children and their parents.
研究目的
目前仅有少量基于证据、互动式、互联网形式的针对儿童及其父母的术前准备方案。本研究旨在开发并检验互联网形式的术前准备方案（I-PPP）对减轻门诊手术患儿术前焦虑的效果。在研究 1 中，我们开发了 I-PPP，并由亲子二人组和医疗保健专业人员对其进行评估。在研究 2 中，我们检验了 I-PPP 的效果。
设计
这是一项开发和效果研究。
设置
在研究 1 中，参与者从社区招募。在研究 2 中，参与者从皇家大学医院招募。
患者
在研究 1 中，参与者为 9 对亲子二人组和 5 名医疗保健专业人员。在研究 2 中，参与者为 32 名（3-7 岁）计划接受门诊手术的儿童和每位儿童的一名家长。
干预
在研究 1 中，我们创建了 I-PPP 模块，亲子二人组和医疗保健专业人员对 I-PPP 模块和治疗可信度进行了评估。在研究 2 中，患儿及其家长在手术当天之前完成了 I-PPP。
测量
观察者评估了患儿在日间手术过程中的焦虑程度。父母在完成 I-PPP 之前、手术前和手术后测量了状态焦虑。手术后，父母对 I-PPP 发表了评论。手术后评估了儿童行为的变化。
主要结果
在研究 1 中，I-PPP 组件和治疗可信度的评分超过了我们的可接受标准。我们对 I-PPP 进行了一些小的修改。在研究 2 中，mYPAS 评分在日间手术过程中保持稳定。本研究中诱导时的 mYPAS 评分与基准研究无显著差异。手术前至手术后，父母的焦虑显著降低。家长对该方案给予了积极评价。在一部分儿童中观察到术后出现负面行为。
结论
我们的研究结果表明，I-PPP 是儿童及其父母术前准备的一种可行选择。
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