Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom.
Royal Manchester Children's Hospital, Manchester, United Kingdom.
J Med Internet Res. 2020 Aug 11;22(8):e17367. doi: 10.2196/17367.
There is increasing interest in finding novel approaches to improve the preparation of children for hospital procedures such as surgery, x-rays, and blood tests. Well-prepared and informed children have better outcomes (less procedural anxiety and higher satisfaction). A digital therapeutic (DTx) platform (Xploro) was developed with children to provide health information through gamification, serious games, a chatbot, and an augmented reality avatar.
This before and after evaluation study aims to assess the acceptability of the Xploro DTx and examine its impact on children and their parent's procedural knowledge, procedural anxiety, and reported experiences when attending a hospital for a planned procedure.
We used a mixed methods design with quantitative measures and qualitative data collected sequentially from a group of children who received standard hospital information (before group) and a group of children who received the DTx intervention (after group). Participants were children aged between 8 and 14 years and their parents who attended a hospital for a planned clinical procedure at a children's hospital in North West England. Children and their parents completed self-report measures (perceived knowledge, procedural anxiety, procedural satisfaction, and procedural involvement) at baseline, preprocedure, and postprocedure.
A total of 80 children (n=40 standard care group and n=40 intervention group) and their parents participated in the study; the children were aged between 8 and 14 years (average 10.4, SD 2.27 years) and were attending a hospital for a range of procedures. The children in the intervention group reported significantly lower levels of procedural anxiety before the procedure than those in the standard group (two-tailed t=2.740; P=.008). The children in the intervention group also felt more involved in their procedure than those in the standard group (t=-2.238; P=.03). The children in the intervention group also reported significantly higher levels of perceived procedural knowledge preprocedure (t=-4.892; P=.001) than those in the standard group. As for parents, those with access to the Xploro intervention reported significantly lower levels of procedural anxiety preprocedure than those who did not (t=1.985; P=.05). During the semistructured write and tell interviews, children stated that they enjoyed using the intervention, it was fun and easy to use, and they felt that it had positively influenced their experiences of coming to the hospital for a procedure.
This study has shown that the DTx platform, Xploro, has a positive impact on children attending a hospital for a procedure by reducing levels of procedural anxiety. The children and parents in the intervention group described Xploro as improving their experiences and being easy and fun to use.
人们越来越关注寻找新方法来提高儿童对医院手术、X 光和血液检查等程序的准备程度。准备充分且知情的儿童会有更好的结果（程序焦虑更少，满意度更高）。一款名为 Xploro 的数字治疗 (DTx) 平台是与儿童共同开发的，通过游戏化、严肃游戏、聊天机器人和增强现实虚拟形象为儿童提供健康信息。
本项前后评估研究旨在评估 Xploro DTx 的可接受性，并检验其对儿童及其父母在接受计划程序的医院就诊时的程序知识、程序焦虑和报告体验的影响。
我们采用混合方法设计，使用定量测量和定性数据，依次从一组接受标准医院信息的儿童（前组）和一组接受 DTx 干预的儿童（后组）中收集。参与者为 8 至 14 岁的儿童及其父母，他们在英格兰西北部的一家儿童医院接受计划中的临床程序。儿童及其父母在基线、术前和术后完成自我报告的测量（感知知识、程序焦虑、程序满意度和程序参与度）。
共有 80 名儿童（标准护理组 40 名，干预组 40 名）及其父母参与了这项研究；儿童年龄在 8 至 14 岁之间（平均 10.4 岁，标准差 2.27 岁），并接受了各种程序的治疗。与标准组相比，接受干预的儿童在术前报告的程序焦虑程度显著较低（双侧 t=2.740；P=.008）。与标准组相比，接受干预的儿童还感觉更能参与到自己的手术中（t=-2.238；P=.03）。干预组的儿童在术前也报告了更高的感知程序知识水平（t=-4.892；P=.001）。对于父母来说，那些可以使用 Xploro 干预措施的人在术前报告的程序焦虑水平显著低于那些不能使用的人（t=1.985；P=.05）。在半结构式写作和讲述访谈中，儿童表示他们喜欢使用干预措施，它有趣且易于使用，他们觉得它对他们来医院接受手术的体验产生了积极的影响。
这项研究表明，数字治疗平台 Xploro 通过降低程序焦虑水平，对前往医院接受程序治疗的儿童产生了积极影响。接受干预组的儿童和父母将 Xploro 描述为改善了他们的体验，且易于使用、有趣。
