El Hachem May, Carnevale Claudia, Diociaiuti Andrea, Ranieri Cristiana De, Giancristoforo Simona, Zambruno Giovanna, Ciofi Degli Atti Marta L
Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Clinical Psychology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatr Dermatol. 2018 Jan;35(1):112-116. doi: 10.1111/pde.13347. Epub 2017 Dec 15.
BACKGROUND/OBJECTIVES: A few studies have documented the effect of local anesthesia for minor dermatologic surgical procedures on children and their parents. Our objective was to evaluate the psychological effect and global satisfaction of a patient-centered approach to dermatologic surgery under local anesthesia.
Two self-administered questionnaires were used to evaluate the distress and global satisfaction of 388 children who underwent dermatologic surgery under local anesthesia, accompanied by oral and written therapeutic education measures (structured information and a cartoon brochure illustrating the procedure) addressed to children and parents. Distraction techniques were also used during the procedures.
Although 54.5% of patients manifested some degree of fear, all other parameters analyzed (pain, surgery-related distress, surgical team-patient and -family relationship, global satisfaction) indicated that the procedures resulted in limited distress and that the large majority of children and parents tolerated them well.
Specific measures for therapeutic pediatric patient education may be helpful in limiting discomfort, anxiety, and pain perception linked to procedures performed under local anesthesia. Further controlled studies are required to more precisely assess the benefits of specific therapeutic education measures.
背景/目的：少数研究记录了局部麻醉用于儿童小型皮肤科手术对儿童及其父母的影响。我们的目的是评估以患者为中心的局部麻醉下皮肤科手术方法的心理影响和总体满意度。
使用两份自填式问卷评估388例接受局部麻醉下皮肤科手术的儿童的痛苦程度和总体满意度，同时向儿童及其父母提供口头和书面治疗教育措施（结构化信息以及说明手术过程的卡通手册）。手术过程中还采用了分散注意力的技巧。
尽管54.5%的患者表现出某种程度的恐惧，但分析的所有其他参数（疼痛、与手术相关的痛苦、手术团队与患者及家属的关系、总体满意度）表明，手术造成的痛苦有限，绝大多数儿童和父母对手术耐受良好。
针对儿科患者的特定治疗教育措施可能有助于减少与局部麻醉下手术相关的不适、焦虑和疼痛感知。需要进一步的对照研究来更精确地评估特定治疗教育措施的益处。
