Department of Psychology, University of Regina, Regina, SK, Canada.
Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.
Can J Anaesth. 2019 Aug;66(8):966-986. doi: 10.1007/s12630-019-01387-8. Epub 2019 May 16.
The purpose of this systematic review was to examine the effect of technology-based preoperative preparation interventions on children's and parents' anxiety.
PsycINFO, Cochrane, Science Direct, Taylor and Francis, and Pubmed MEDLINE databases were searched. Studies were restricted to those reporting on technology-based preoperative preparation interventions for pediatric patients (0-18 yr old) receiving elective surgery under general anesthesia.
Thirty-eight studies that provided level II or level III evidence were included (33 randomized-controlled trials and five non-randomized-controlled studies). Of the 38 studies, preoperative anxiety (measured by various indices of anxiety) was significantly reduced in children and parents in 25 and 11 studies, respectively. For children, tablet and handheld devices with interactive components were the most encouraging strategies. Video preparation alone may provide sufficient information to manage preoperative anxiety in parents.
The available literature is extremely heterogeneous and limits the ability to make definitive conclusions about the efficacy of technology-based preoperative preparation interventions. The available literature suggests that, for children, tablet and handheld devices with interactive capacity may represent a viable option to address preoperative anxiety. The findings are more mixed for parents, with video preparation a possible option. Execution of well-designed, methodologically sound studies is required to facilitate a better understanding of the efficacy of technology-based preoperative preparation.
本系统评价旨在考察基于技术的术前准备干预措施对儿童和家长焦虑的影响。
PsycINFO、Cochrane、Science Direct、Taylor and Francis 和 Pubmed MEDLINE 数据库进行了检索。研究仅限于报告针对接受全身麻醉下择期手术的儿科患者(0-18 岁)的基于技术的术前准备干预措施的研究。
纳入了 38 项提供 II 级或 III 级证据的研究(33 项随机对照试验和 5 项非随机对照研究)。在这 38 项研究中,25 项研究中儿童的术前焦虑(通过各种焦虑指标测量)显著降低,11 项研究中家长的术前焦虑显著降低。对于儿童,具有互动功能的平板电脑和手持设备是最令人鼓舞的策略。单独的视频准备可能提供足够的信息来管理家长的术前焦虑。
现有文献极具异质性,限制了对基于技术的术前准备干预措施疗效做出明确结论的能力。现有文献表明,对于儿童来说,具有互动能力的平板电脑和手持设备可能是解决术前焦虑的一种可行选择。对于家长来说,结果则更为复杂,视频准备可能是一种可行的选择。需要执行设计良好、方法合理的研究,以更好地了解基于技术的术前准备的疗效。