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家长认知驱动对小儿日间手术术前禁食依从性的影响

Influence of Parental Awareness Drive on Preoperative Fasting Compliance in Pediatric Day Care Surgery.

作者信息

Puri Kriti, Kundal Raksha, Kundal Vijay, Pawar Jayadatta Gurudatta, Kumar Ajai, Choudhury Subhasis Roy

机构信息

Department of Anesthesiology, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India.

Department of Pediatric Surgery ABVIMS, Dr RML Hospital, New Delhi, India.

出版信息

J Indian Assoc Pediatr Surg. 2022 Mar-Apr;27(2):236-240. doi: 10.4103/jiaps.JIAPS_390_20. Epub 2022 Mar 1.

Abstract

CONTEXT

Optimum preoperative fasting is imperative for the prevention of aspiration in pediatric patients. The current guidelines advocate 2-4-6 rule for the same. However, direct supervision is lacking in large volume centers.

AIMS

Thus, we aimed to determine the fasting compliance of children preoperatively and to ascertain whether parents understood the significance and purpose of optimum fasting.

MATERIALS AND METHODS

Design - A prospective questionnaire-based study regarding preoperative fasting was performed in pediatric patients aged 1-10 years scheduled for "day care surgery" or "same day admission surgery" over 12 weeks. Thereafter, parental awareness drive was carried out, and a re-audit was performed with a questionnaire in the next cohort of patients.

RESULTS

The number of patients in the pre and postcounseling groups were 98 and 99. Thirteen percent of the patients were optimally fasted for solids initially. Re-audit confirmed compliance increased to 46%. Patients fasting adequately (2-3 h) for clear fluids increased from 22.4% to 51.5% postcounseling. The number for optimally breast-fed children increased postaudit (23.1%-39.1%). Consequent to the drive, parental awareness increased and 49.5% parents knew that only plain water was permitted during fasting. Number of parents considering preoperative fasting important increased from 39.8% to 79.7%. Initially, 27.6% of the parents did not know the reason for fasting, which reduced to 3% postaudit.

CONCLUSION

Parents are misinformed and ignorant about optimum preoperative fasting. Adequate education and awareness to improve their knowledge was associated with increased compliance for optimal fasting.

摘要

背景

最佳术前禁食对于预防儿科患者误吸至关重要。当前指南提倡采用2-4-6规则。然而,大型中心缺乏直接监督。

目的

因此,我们旨在确定儿童术前禁食的依从性,并确定家长是否理解最佳禁食的意义和目的。

材料与方法

设计——对计划在12周内进行“日间手术”或“同日入院手术”的1-10岁儿科患者进行一项基于问卷的前瞻性术前禁食研究。此后,开展家长意识宣传活动,并对下一组患者进行问卷调查重新审核。

结果

咨询前和咨询后组的患者人数分别为98人和99人。最初,13%的患者固体食物禁食情况最佳。重新审核确认依从性提高到了46%。咨询后,清液禁食时间足够(2-3小时)的患者从22.4%增加到51.5%。最佳母乳喂养儿童的数量在审核后有所增加(从23.1%增至39.1%)。宣传活动后,家长的意识有所提高,49.5%的家长知道禁食期间只允许饮用白开水。认为术前禁食重要的家长数量从39.8%增加到79.7%。最初,27.6%的家长不知道禁食的原因,审核后这一比例降至3%。

结论

家长在最佳术前禁食方面信息有误且认识不足。进行充分的教育并提高其意识以增加他们的知识,这与最佳禁食依从性的提高相关。

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本文引用的文献

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Metabolic profiles in children during fasting.儿童禁食期间的代谢特征。
Pediatrics. 2011 Apr;127(4):e1021-7. doi: 10.1542/peds.2010-1706. Epub 2011 Mar 21.

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