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Published on: January 17, 2011
Developing anxiety-reduction procedures for a ventilator-dependent pediatric patient
W J Warzak1, L E Engel, L G Bischoff
1University of Nebraska Medical Center/Meyer Rehabilitation Institute, Omaha 68198.
Insights
For ventilator-dependent children, information alone may not reduce anxiety during care. Combining relaxation and cognitive distraction effectively decreased anxiety behaviors in a young patient.
Area of Science:
- Pediatric Psychology
- Behavioral Interventions
- Respiratory Care
Background:
- Anxiety behaviors can complicate daily tracheostomy care and ventilator maintenance for pediatric patients.
- Effective anxiety reduction strategies are crucial for improving patient compliance and care quality.
Observation:
- A multiple-baseline design assessed information-only versus combined relaxation and cognitive distraction techniques.
- An eight-year-old ventilator-dependent boy was the participant, with interventions applied across ventilator and tracheostomy procedures.
Findings:
- The information-only strategy did not alter the patient's anxiety behaviors.
- Implementing cognitive distraction and relaxation techniques led to significant decreases in heart rate, mouth noises, and demands.
- Behavioral improvements were sustained at a one-year follow-up.
Implications:
- Information alone is insufficient for managing anxiety in some ventilator-dependent children.
- Combined relaxation and cognitive distraction offer a promising approach for anxiety reduction in this population.
- Further research should explore tailored anxiety management protocols for pediatric respiratory care.
Abstract:
This study evaluated two strategies to reduce anxiety behaviors which interfered with the daily tracheostomy care and ventilator maintenance of an eight-year-old ventilator-dependent boy. A multiple-baseline design (across ventilator and tracheostomy procedures) was used to evaluate the effectiveness of an information-only procedure and combined relaxation and cognitive distraction procedures. Partial-interval recording was used to measure heart rate, disruptive mouth noises, and demands and complaints to staff members. The patient's behavior did not change during a no-intervention baseline or during the information-only condition. Cognitive distraction and relaxation procedures were introduced, first during ventilator checks and then during tracheostomy care; corresponding decreases in heart rate, mouth noises, and demands and complaints were noted. Gains were maintained at one year follow-up. Results suggest that information alone may not effectively reduce anxiety behaviors for some ventilator-dependent patients unless additional anxiety-reduction procedures are implemented.
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