Lamparyk Katherine, Mahajan Lori, Lamparyk Christopher, Debeljak Ashley, Aylward Laura, Flynt Kimberly, Steffen Rita
Cleveland Clinic Children's Hospital, USA.
UH Cleveland Medical Center, USA.
Int J Pediatr. 2019 Jan 1;2019:7569194. doi: 10.1155/2019/7569194. eCollection 2019.
High-resolution anorectal manometry (HRM) is associated with significant patient and parent anxiety, which can impact the success and efficiency of the procedure. The nature of HRM necessitates cooperation of an alert child. This study examined effects of psychoeducation intervention on decreasing procedural distress in both pediatric patients and their parents.
A prospective randomized study of children aged 3-12 years, undergoing HRM, was performed utilizing child-centric educational video. Patients received either psychological preparation intervention or treatment-as-usual. Distress was assessed through self-reported and parent-reported anxiety measures (STAIC-S; STAI-S), physiological arousal measurements, and an observational scale of procedural distress (PBCL).
A total of 63 children, aged 3-12 yrs (6.7 ± 2.5), completed the study. Measures of observed and reported distress and anxiety (PBCL; STAIC-S) were significantly less in children receiving intervention. Parents of children in the intervention group also reported significantly less preprocedural anxiety (STAI-S). Effects on physiological arousal were mixed, with significant preprocedural decrease in systolic blood pressure but no difference in heart rate from baseline.
Preprocedural psychological preparation was effective in decreasing pediatric patient and parental self-reported anxiety associated with HRM. Intervention decreased physician time necessary to successfully complete the study and significantly decreased the number of times patients had to endure balloon inflation.
高分辨率肛门直肠测压法（HRM）会给患者及其家长带来显著焦虑，这可能会影响该检查的成功率和效率。HRM的性质要求患儿保持清醒并配合。本研究探讨了心理教育干预对减轻儿科患者及其家长检查过程中痛苦的效果。
对3至12岁接受HRM检查的儿童进行一项前瞻性随机研究，使用以儿童为中心的教育视频。患者接受心理准备干预或常规治疗。通过自我报告和家长报告的焦虑量表（STAIC-S；STAI-S）、生理唤醒测量以及程序痛苦观察量表（PBCL）来评估痛苦程度。
共有63名3至12岁（6.7±2.5）的儿童完成了研究。接受干预的儿童在观察到的和报告的痛苦及焦虑（PBCL；STAIC-S）方面的测量结果显著更低。干预组儿童的家长也报告术前焦虑（STAI-S）显著更低。对生理唤醒的影响不一，术前收缩压显著下降，但心率与基线相比无差异。
术前心理准备有效地减轻了儿科患者及其家长与HRM相关的自我报告焦虑。干预减少了成功完成研究所需的医生时间，并显著减少了患者忍受气囊充气的次数。
