Departments of Orthopaedic Surgery.
Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA.
J Pediatr Orthop. 2022 Jan 1;42(1):30-34. doi: 10.1097/BPO.0000000000002005.
The aim of the present study was to evaluate the effectiveness of the Bedside Entertainment and Relaxation Theater (BERT) on fear, anxiety, and pain outcomes in pediatric orthopaedic patients associated with cast removal and/or pin removal in the outpatient clinic setting.
A total of 66 pediatric patients between the ages of 2 and 6 undergoing clinic procedures were recruited for this study and randomized into the control group or the intervention (BERT) group. Patients in the control group received standard of care during the cast room procedure; patients in the BERT group were given headphones and watched a movie on a projector during the procedure. Fear, anxiety, and pain were measured before and after the procedure. Procedures included cast removal, pin removal, or a combination of the 2.
Patients in the BERT group reported less fear and anxiety overall after the procedure than patients in the control group (P=0.009, 0.015). Adjusting for procedure type (ie, pin removal), patients in the BERT group reported a 0.67 point decrease (95% confidence interval: 0.04, 1.30) on the fear scale after the procedure (P=0.039) and a 1.81 point decrease (95% confidence interval: 0.04, 3.59) on the anxiety scale associated with the procedure (P=0.045), compared with the control group. Patients and caregivers reported high satisfaction with BERT.
This randomized, controlled trial demonstrates an evidence-based distraction tool that can be implemented across medical centers for pediatric patients undergoing office based orthopaedic procedures. BERT can be used to reduce fear and anxiety associated with these procedures, and increase patient and parent satisfaction.
Level I.
本研究旨在评估床边娱乐放松剧院（BERT）对小儿矫形科门诊患者在去除石膏和/或去除钢针过程中恐惧、焦虑和疼痛结果的影响。
共有 66 名年龄在 2 至 6 岁之间的小儿患者参与了这项研究，并被随机分为对照组或干预组（BERT 组）。对照组患者在石膏室程序中接受标准护理；BERT 组患者在程序中使用耳机观看投影仪上的电影。在程序前后测量恐惧、焦虑和疼痛。程序包括去除石膏、去除钢针或两者的组合。
与对照组相比，BERT 组患者在程序后总体上报告的恐惧和焦虑程度较低（P=0.009，0.015）。调整程序类型（即去除钢针）后，BERT 组患者在程序后恐惧量表上的评分降低了 0.67 分（95%置信区间：0.04，1.30）（P=0.039），在焦虑量表上的评分降低了 1.81 分（95%置信区间：0.04，3.59）（P=0.045），与对照组相比。患者和护理人员对 BERT 报告了高度满意度。
这项随机对照试验证明了一种基于证据的分散注意力工具，可以在医疗中心为接受门诊骨科手术的儿科患者实施。BERT 可用于减少与这些程序相关的恐惧和焦虑，并提高患者和家长的满意度。
I 级。
