Virtual parental presence with coaching for reducing preoperative anxiety in children: a feasibility and pilot randomized controlled trial
Presença virtual dos pais com coaching para redução da ansiedade pré-operatória em crianças: uma viabilidade e um ensaio piloto randomizado controlado
Clyde T. Matava, Martina Bordini, Ben O’ Sullivan, Gabriela Alcaraz Garcia-Tejedor, Nan Gai, Guy Petroz, Conor Mc Donnell, Fahad Alam, Katie Brazel, Monica Caldeira-Kulbakas
Abstract
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.
Keywords
Resumo
Introdução
A ansiedade pré-operatória em crianças causa resultados pós-operatórios negativos. A presença dos pais na indução é uma estratégia não farmacológica para aliviar a ansiedade; no entanto, nem sempre é possível ou eficaz, nomeadamente quando os pais estão excessivamente ansiosos. A presença dos pais através de vídeo demonstrou ser útil noutros contextos (divórcio, tribunal criminal). Este estudo relata a viabilidade de um ensaio clínico randomizado para investigar o efeito da presença parental por vídeo e do treinamento parental na indução na ansiedade pré-operatória.
Métodos
O estudo foi um ensaio clínico randomizado, fatorial 2 × 2, examinando a presença dos pais (virtual vs. física) e treinamento (fornecido vs. não fornecido). A viabilidade foi avaliada pela taxa de matrícula, taxa de desgaste, conformidade e satisfação da equipe com o método virtual com o Índice de Carga de Tarefas da NASA (NASA-TLX) e a Escala de Usabilidade do Sistema (SUS). Para a ansiedade das crianças e os resultados pós-operatórios, foram utilizados a Escala de Ansiedade Pré-operatória de Yale modificada (mYPAS) e o Questionário Comportamental Pós-Hospitalização (PHBQ). A ansiedade dos pais foi avaliada com o questionário State-Trait Anxiety Inventory (STAI).
Resultados
Um total de 41 pares pais/pacientes foram recrutados. A taxa de adesão foi de 32,2%, a taxa de evasão de 25,5%. A conformidade foi de 87,8% para os pais e 85% para os funcionários. O SUS foi 67,5/100 e 63,5/100 e o NASA-TLX foi 29,2 (21,5–36,8) e 27,6 (8,2–3,7) para os anestesiologistas e enfermeiros de indução, respectivamente. Nenhuma diferença estatisticamente significativa foi encontrada em mYPAS, PHBQ e STAI.
Conclusão
Um ensaio clínico randomizado para explorar o efeito da presença virtual dos pais na ansiedade pré-operatória é viável. Mais estudos são necessários para investigar o seu papel e o papel do treinamento parental na redução da ansiedade pré-operatória.
Palavras-chave
Referências
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Submetido em:
28/11/2023
Aceito em:
08/06/2024
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