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数字图画书对接受心导管插入术的幼儿及其家庭照顾者的影响:一项随机对照试验。

Effects of Digital Picture Books on Young Children Undergoing Cardiac Catheterisation and Their Family Caregivers: A Randomised Controlled Trial.

作者信息

Zheng Changhua, Li Chengyang, Zhuang Lingdan, Chen YueXiu, Wu Yong, Hu Rong

机构信息

The School of Nursing, Fujian Medical University, Fuzhou, China.

Department of Cardiology Nursing, Fujian Medical University Union Hospital, Fuzhou, China.

出版信息

J Adv Nurs. 2025 Apr;81(4):2125-2135. doi: 10.1111/jan.16447. Epub 2024 Sep 11.

Abstract

AIM

To assess the impact of digital picture books on preoperative anxiety, pain and sleep quality in young children undergoing cardiac catheterisation and the anxiety of their family caregivers.

DESIGN

A randomised, single-blinded, two-arm, parallel-group controlled trial.

METHODS

Participants are young children aged 2-7 years with congenital heart disease scheduled for cardiac catheterisation and their family caregivers. They were enrolled at Fujian Medical University Union Hospital between September 2022 and July 2023. They were randomised to either a control group receiving usual care or an intervention group receiving digital picture book sessions. Anxiety and pain levels were assessed using standardised scales, and sleep quality was measured using actigraphy.

RESULTS

The study included 64 pairs of young children and family caregivers. Digital picture books significantly reduced preoperative anxiety and bandage removal pain in children and anxiety in family caregivers. However, there was no statistical difference in sleep quality between the intervention group and the control group.

CONCLUSIONS

Digital picture books prove to be an effective intervention for reducing anxiety and pain in paediatric cardiac catheterisation patients and anxiety of their family caregivers. The intervention did not affect sleep quality, suggesting the need for additional strategies to address this aspect of the hospital experience.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study demonstrated the effectiveness of digitally illustrated books in reducing preoperative anxiety and pain in young children and anxiety in family caregivers. Digital picture books offer a creative and engaging way to help children and their families cope with the stress and anxiety associated with medical procedures. Further research in this area may lead to the development of more innovative and effective interventions for paediatric patients and their family caregivers.

IMPACT

The study's impact lies in its innovative approach to addressing the psychological and emotional challenges faced by young children and their family caregivers during the stressful experience of cardiac catheterisation. By demonstrating the efficacy of digital picture books in significantly reducing preoperative anxiety and postoperative pain, the research presents a non-pharmacological, accessible and engaging intervention that can be seamlessly integrated into existing healthcare practices. The findings have the potential to transform paediatric care by offering a safe, developmentally appropriate and cost-effective method to support the emotional well-being of children and their families, thereby enhancing the overall patient experience and clinical outcomes. Moreover, the study's emphasis on family caregiver involvement underscores the importance of a holistic approach to care that considers the needs of both the patient and their support system.

PATIENT OR PUBLIC CONTRIBUTION

Children and their family caregivers were invited to provide valuable input which has been critical to the development of the intervention. The participant information sheet and consent form, as well as the consent/recruitment process, were reviewed by a consumer advisor advocate from the pilot study.

REPORTING METHOD

CONSORT.

TRIAL REGISTRATION

Chinese clinical trial registry: ChiCTR2200063973. Registered on 22 September 2022, https://www.chictr.org.cn/showproj.html?proj=132833.

摘要

目的

评估数字绘本对接受心导管插入术的幼儿术前焦虑、疼痛和睡眠质量以及其家庭照顾者焦虑的影响。

设计

一项随机、单盲、双臂、平行组对照试验。

方法

参与者为计划接受心导管插入术的2至7岁先天性心脏病幼儿及其家庭照顾者。他们于2022年9月至2023年7月在福建医科大学附属协和医院入组。他们被随机分为接受常规护理的对照组或接受数字绘本课程的干预组。使用标准化量表评估焦虑和疼痛水平,使用活动记录仪测量睡眠质量。

结果

该研究纳入了64对幼儿和家庭照顾者。数字绘本显著降低了儿童的术前焦虑和绷带拆除时的疼痛以及家庭照顾者的焦虑。然而,干预组和对照组在睡眠质量方面没有统计学差异。

结论

数字绘本被证明是一种有效的干预措施,可减少儿科心导管插入术患者的焦虑和疼痛以及其家庭照顾者的焦虑。该干预措施未影响睡眠质量,这表明需要采取额外策略来解决住院体验的这一方面问题。

对专业和/或患者护理的启示:本研究证明了数字绘本在降低幼儿术前焦虑和疼痛以及家庭照顾者焦虑方面的有效性。数字绘本提供了一种创造性且引人入胜的方式,以帮助儿童及其家庭应对与医疗程序相关的压力和焦虑。该领域的进一步研究可能会为儿科患者及其家庭照顾者开发出更具创新性和有效性的干预措施。

影响

该研究的影响在于其创新方法,以应对幼儿及其家庭照顾者在压力巨大的心导管插入术经历中面临的心理和情感挑战。通过证明数字绘本在显著降低术前焦虑和术后疼痛方面的功效,该研究提出了一种非药物、易于获得且引人入胜的干预措施,可无缝融入现有的医疗保健实践中。这些发现有可能通过提供一种安全、适合发育阶段且具有成本效益的方法来支持儿童及其家庭的情感健康,从而改变儿科护理,进而提升整体患者体验和临床结果。此外,该研究对家庭照顾者参与的强调凸显了全面护理方法的重要性,该方法考虑了患者及其支持系统的需求。

患者或公众贡献

邀请儿童及其家庭照顾者提供了宝贵的意见,这对干预措施的开发至关重要。参与者信息表和同意书以及同意/招募过程由试点研究的消费者顾问倡导者进行了审查。

报告方法

CONSORT。

试验注册

中国临床试验注册中心:ChiCTR2200063973。于2022年9月22日注册,https://www.chictr.org.cn/showproj.html?proj=132833。

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