虚拟家长陪伴并给予指导以减轻儿童术前焦虑：一项可行性和试点随机对照试验。
Virtual parental presence with coaching for reducing preoperative anxiety in children: a feasibility and pilot randomized controlled trial.
作者信息
Matava Clyde T, Bordini Martina, Sullivan Ben O', Garcia-Tejedor Gabriela Alcaraz, Gai Nan, Petroz Guy, Donnell Conor Mc, Alam Fahad, Brazel Katie, Caldeira-Kulbakas Monica
机构信息
The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada; University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada.
The Hospital for Sick Children, Department of Anesthesia, Toronto, Ontario, Canada; University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, Ontario, Canada; University of Bologna, Department of Medical and Surgical Sciences (DIMEC), Bologna, Italy.
出版信息
Braz J Anesthesiol. 2024 Sep-Oct;74(5):844533. doi: 10.1016/j.bjane.2024.844533. Epub 2024 Jun 26.
BACKGROUND
Preoperative anxiety in children causes negative postoperative outcomes. Parental presence at induction is a non-pharmacological strategy for relieving anxiety; nevertheless, it is not always possible or effective, namely when parents are overly anxious. Parental presence via video has been demonstrated to be useful in other contexts (divorce, criminal court). This study reports the feasibility of a randomized controlled trial to investigate the effect of video parental presence and parental coaching at induction on preoperative anxiety.
METHODS
The study was a randomized, 2 × 2 factorial design trial examining parental presence (virtual vs. physical) and coaching (provided vs. not provided). Feasibility was assessed by enrollment rate, attrition rate, compliance, and staff satisfaction with virtual method with the NASA-Task Load Index (NASA-TLX) and System Usability Scale (SUS). For the children's anxiety and postoperative outcomes, the modified Yale Preoperative Anxiety Scale (mYPAS) and Post-Hospitalization Behavioral Questionnaire (PHBQ) were used. Parental anxiety was evaluated with the State-Trait Anxiety Inventory (STAI) questionnaire.
RESULTS
A total of 41 parent/patient dyads were recruited. The enrollment rate was 32.2%, the attrition rate 25.5%. Compliance was 87.8% for parents and 85% for staff. The SUS was 67.5/100 and 63.5/100 and NASA-TLX was 29.2 (21.5-36.8) and 27.6 (8.2-3.7) for the anesthesiologists and induction nurses, respectively. No statistically significant difference was found in mYPAS, PHBQ and STAI.
CONCLUSION
A randomized controlled trial to explore virtual parental presence effect on preoperative anxiety is feasible. Further studies are needed to investigate its role and the role of parent coaching in reducing preoperative anxiety.
背景
儿童术前焦虑会导致负面的术后结果。诱导期父母陪伴是一种缓解焦虑的非药物策略；然而，这并不总是可行或有效的，尤其是当父母过度焦虑时。视频形式的父母陪伴在其他情境（离婚、刑事法庭）中已被证明是有用的。本研究报告了一项随机对照试验的可行性，该试验旨在研究诱导期视频形式的父母陪伴及父母指导对术前焦虑的影响。
方法
该研究为一项随机、2×2析因设计试验，考察父母陪伴（虚拟陪伴与实际陪伴）和指导（提供指导与不提供指导）。通过入组率、损耗率、依从性以及工作人员使用美国国家航空航天局任务负荷指数（NASA-TLX）和系统可用性量表（SUS）对虚拟方法的满意度来评估可行性。对于儿童的焦虑和术后结果，使用改良耶鲁术前焦虑量表（mYPAS）和出院后行为问卷（PHBQ）。用状态-特质焦虑量表（STAI）问卷评估父母的焦虑。
结果
共招募了41对父母/患者二元组。入组率为32.2%，损耗率为25.5%。父母的依从率为87.8%，工作人员的依从率为85%。麻醉医生和诱导护士的SUS分别为67.5/100和63.5/100，NASA-TLX分别为29.2（21.5 - 36.8）和27.6（8.2 - 3.7）。在mYPAS、PHBQ和STAI中未发现统计学上的显著差异。
结论
探索虚拟父母陪伴对术前焦虑影响的随机对照试验是可行的。需要进一步研究来调查其作用以及父母指导在减轻术前焦虑中的作用。
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