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教育视频可提高小儿腰椎穿刺的知情同意率:一项随机对照试验。

An Educational Video Improves Consent in Pediatric Lumbar Puncture: A Randomized Control Trial.

机构信息

Division of Pediatric Neurology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.

Division of Pediatric Neurology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Pediatr Neurol. 2019 Nov;100:74-79. doi: 10.1016/j.pediatrneurol.2019.04.014. Epub 2019 May 13.

Abstract

BACKGROUND

Lumbar puncture is a low-risk procedure performed on pediatric patients for a variety of indications. Parents give consent to this procedure but are often left with concerns. There are no published studies on the nature of the concerns of parents in North America and no studies examining a process to improve pediatric lumbar puncture consent. Here we identify parent concerns with lumbar puncture and determine the utility of an adjunctive educational video.

METHODS

Seventy-two patient-parent dyads were enrolled in a randomized control trial to receive standard consent with or without an educational video. A survey was provided to determine parent self-rated understanding of the procedure, their perception of its safety, their perception of the painfulness, and their overall comfort with their child undergoing lumbar puncture. In addition, demographic characteristics and qualitative information about parent concerns were collected.

TRIAL REGISTRATION

NCT03677219.

RESULTS

The video resulted in significantly greater parent understanding of the procedure (P = 0.015) and perception of its safety (P = 0.021) compared with controls. Parent comfort with the procedure increased after viewing the video (P = 0.002). Parents' top three concerns were pain, infection, and neurological injury.

CONCLUSIONS

Parent concerns in pediatric lumbar puncture include pain, infection, and neurological injury, and viewing an educational video improved parent perception of understanding and safety compared with controls. In addition, there was reduced variability of responses in those who viewed the video. Thus a short educational video on a handheld device is an effective means to address parent concerns and standardize the process of pediatric lumbar puncture consent.

摘要

背景

腰椎穿刺是一种在儿科患者中进行的低风险操作,用于多种适应症。家长同意进行此操作,但通常会有顾虑。目前尚无关于北美的家长顾虑的性质的研究,也没有研究探讨改善小儿腰椎穿刺同意书的流程。在这里,我们确定了家长对腰椎穿刺的担忧,并确定了辅助教育视频的效用。

方法

72 对患儿及其家长参加了一项随机对照试验,以接受标准同意书或附加教育视频。提供了一项调查,以确定家长对手术的自我理解程度、对其安全性的看法、对疼痛的感知以及对孩子进行腰椎穿刺的整体舒适度。此外,还收集了人口统计学特征和家长担忧的定性信息。

试验注册

NCT03677219。

结果

与对照组相比,视频显著提高了家长对手术的理解(P=0.015)和对其安全性的认知(P=0.021)。观看视频后,家长对手术的舒适度提高(P=0.002)。家长最关心的三个问题是疼痛、感染和神经损伤。

结论

小儿腰椎穿刺的家长关注点包括疼痛、感染和神经损伤,观看教育视频可提高家长对理解和安全性的认知,与对照组相比。此外,观看视频的家长的反应差异更小。因此,在手持设备上播放简短的教育视频是解决家长担忧和规范小儿腰椎穿刺同意书流程的有效方法。

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