Maharjan Pramila, Murdock Dustin, Tielemans Nicholas, Goodall Nancy, Temple Beverley, Askin Nicole, Wittmeier Kristy
Physiotherapy Department, Health Sciences Centre Winnipeg-Shared Health, Winnipeg, MB R3A 1R9, Canada.
Orthopedic Technology Services, Health Sciences Centre Winnipeg-Shared Health, Winnipeg, MB R3A 1R9, Canada.
Children (Basel). 2021 Feb 10;8(2):130. doi: 10.3390/children8020130.
Cast removal can be a distressing experience for a child. This scoping review aims to provide a comprehensive review of interventions designed to reduce anxiety and improve the child's and family's experience of pediatric cast removal.
A scoping review was conducted (Medline, Embase, PsycINFO, CINAHL, Scopus, grey literature sources).
studies published January 1975-October 2019 with a primary focus on pediatric patients undergoing cast removal/cast room procedures. Screening, full text review, data extraction, and quality appraisal were conducted in duplicate.
974 unique articles and 1 video were screened. Nine articles (eight unique studies) with a total of 763 participants were included. Interventions included the following, alone or in combination: noise reduction, electronic device use, preparatory information, music therapy, play therapy, and child life specialist-directed intervention. Heart rate was used as a primary (88%) or secondary (12%) outcome measure across studies. Each study reported some positive effect of the intervention, however effects varied by age, outcome measure, and measurement timing. Studies scored low on outcome measure validity and blinding as assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials.
Various methods have been tested to improve the pediatric cast removal experience. Results are promising, however the variation in observed effectiveness suggests a need for the use of consistent and valid outcome measures. In addition, future research and quality improvement projects should evaluate interventions that are tailored to a child's age and child/family preference.
去除石膏对儿童来说可能是一段痛苦的经历。本范围综述旨在全面回顾旨在减轻焦虑并改善儿童及其家庭在小儿石膏去除过程中的体验的干预措施。
进行了一项范围综述（检索了Medline、Embase、PsycINFO、CINAHL、Scopus和灰色文献来源）。
发表于1975年1月至2019年10月的研究，主要关注接受石膏去除/石膏室操作的儿科患者。筛选、全文审查、数据提取和质量评估均进行了两次。
筛选了974篇独特文章和1个视频。纳入了9篇文章（8项独特研究），共763名参与者。干预措施包括以下一项或多项的单独或组合使用：降噪、使用电子设备、提供准备信息、音乐疗法、游戏疗法以及儿童生活专家指导的干预。在各项研究中，心率被用作主要（88%）或次要（12%）结局指标。每项研究均报告了干预措施的一些积极效果，但效果因年龄、结局指标和测量时间而异。根据乔安娜·布里格斯研究所随机对照试验关键评估清单评估，研究在结局指标有效性和盲法方面得分较低。
已对各种方法进行了测试，以改善小儿石膏去除体验。结果很有前景，但观察到的有效性差异表明需要使用一致且有效的结局指标。此外，未来的研究和质量改进项目应评估针对儿童年龄以及儿童/家庭偏好量身定制的干预措施。
