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Healthcare provider and parent behavior and children's coping and distress at anesthesia induction
Jill MacLaren Chorney1, Carrie Torrey, Ronald Blount
1Department of Anesthesiology, University of California, Irvine, Orange, CA, USA. jill.chorney@iwk.nshealth.ca
Insights
Adult behaviors significantly impact children's distress and coping during anesthesia induction. Emotion-focused actions increase distress, while distraction aids coping, suggesting trainable interventions for better pediatric patient experiences.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Healthcare Provider Communication
Background:
- Limited research exists on how specific healthcare provider and parent behaviors influence children's distress and coping during anesthesia induction.
- Understanding these interactions is crucial for improving the pediatric perioperative experience.
Purpose of the Study:
- To evaluate the impact of specific anesthesiologist, nurse, and parent behaviors on children's distress and coping during anesthesia induction.
- To identify which adult behaviors are associated with increased or decreased child distress and coping.
Main Methods:
- Analysis of digital video data from 293 children (aged 2-10 years) undergoing anesthesia induction with parental presence.
- Systematic coding of anesthesiologist, nurse, and parent behaviors, along with children's distress and coping, using the Revised Preoperative Child-Adult Medical Procedure Interaction Scale.
- Utilized specialized coding software for precise behavioral analysis.
Main Results:
- Anesthesiologists and parents exhibited higher rates of most observed behaviors compared to nurses.
- Emotion-focused adult behaviors (e.g., empathy, reassurance) correlated positively with children's distress and negatively with coping.
- Distracting adult behaviors (e.g., humor, distracting talk) showed the inverse relationship: negatively related to distress and positively to coping.
- Medical reinterpretation by anesthesiologists positively influenced child coping, whereas the same parental behavior increased child distress.
Conclusions:
- Evidence confirms a significant relationship between adult behaviors and children's distress and coping during anesthesia induction.
- Identified adult behaviors are trainable, indicating potential for interventions to modify physician and parent conduct.
- Future studies can investigate the efficacy of modifying these behaviors to improve child outcomes during anesthesia induction.
Background:
To date, no study has evaluated the impact of specific healthcare provider and parent behaviors on children's distress and coping during anesthesia induction.
Method:
Extensive digital video data were collected on 293 two- to ten-yr-old children undergoing anesthesia induction with a parent present. Anesthesiologist, nurse, and parent behavior and children's distress and coping were coded using the Revised Preoperative Child-Adult Medical Procedure Interaction Scale administered using specialized coding software.
Results:
Anesthesiologists and parents engaged in higher rates of most behaviors than nurses. Overall, adult emotion-focused behavior such as empathy and reassurance was significantly positively related to children's distress and negatively related to children's coping behaviors. Adult distracting behavior such as humor and distracting talk showed the opposite pattern. Medical reinterpretation by anesthesiologists was significantly positively related to children's coping behaviors, but the same behavior by parents was significantly positively related to children's distress.
Conclusions:
The data presented here provide evidence for a relation between adult behaviors and children's distress and coping at anesthesia induction. These behaviors are trainable, and hence it is possible to test whether modifying physician behavior can influence child behavior in future studies.
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