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Tablet-Based Intervention for Reducing Children's Preoperative Anxiety: A Pilot Study
Cheryl H T Chow1, Ryan J Van Lieshout, Louis A Schmidt
1Departments of *Psychology, Neuroscience & Behaviour, †Psychiatry and Behavioural Neurosciences, ‡Anesthesia, McMaster University, Hamilton, ON, Canada.
Insights
This pilot study found that the Story-Telling Medicine (STM) tablet application is a feasible and acceptable way to reduce children's preoperative anxiety. STM significantly lowered anxiety scores in children undergoing surgery compared to usual care.
Area of Science:
- Pediatric Surgery
- Child Psychology
- Health Technology
Background:
- Preoperative anxiety is a common issue in children undergoing surgery.
- Effective interventions are needed to manage this anxiety.
- Tablet-based applications offer a novel approach to patient care.
Purpose of the Study:
- To assess the feasibility and acceptability of the Story-Telling Medicine (STM) application.
- To evaluate the effectiveness of STM in reducing preoperative anxiety in children.
- To compare STM combined with usual care (UC) against UC alone.
Main Methods:
- A pilot study involving 100 children (aged 7-13) undergoing outpatient surgery.
- Three waves of study: Waves 1 & 2 focused on feasibility, Wave 3 on acceptability and efficacy.
- Wave 3 randomly assigned 40 children to STM+UC or UC, measuring anxiety via CPMAS at multiple time points.
Main Results:
- Feasibility of recruitment and data collection was confirmed, with protocol modifications addressing attrition.
- Children receiving STM+UC showed significantly greater reductions in preoperative anxiety (CPMAS scores) compared to the UC group.
- Statistical significance was achieved (p = .015) with a notable confidence interval.
Conclusions:
- Story-Telling Medicine (STM) is a feasible and acceptable intervention for reducing pediatric preoperative anxiety.
- The findings support further investigation of STM in a larger randomized controlled trial.
- STM shows promise as a tool in busy pediatric operative settings.
Objectives:
To examine the feasibility, acceptability, and effects of a novel tablet-based application, Story-Telling Medicine (STM), in reducing children's preoperative anxiety.
Methods:
Children (N = 100) aged 7 to 13 years who were undergoing outpatient surgery were recruited from a local children's hospital. This study comprised 3 waves: Waves 1 (n = 30) and 2 (n = 30) examined feasibility, and Wave 3 (n = 40) examined the acceptability of STM and compared its effect on preoperative anxiety to Usual Care (UC). In Wave 3, children were randomly allocated to receive STM+UC or UC. A change in preoperative anxiety was measured using the Children's Perioperative Multidimensional Anxiety Scale (CPMAS) 7 to 14 days before surgery (T1), on the day of surgery (T2), and 1 month postoperatively (T3).
Results:
Wave 1 demonstrated the feasibility of participant recruitment and data collection procedures but identified challenges with attrition at T2 and T3. Wave 2 piloted a modified protocol that addressed attrition and increased the feasibility of follow-up. In Wave 3, children in the STM+UC demonstrated greater reductions in CPMAS compared with the UC group (ΔM = 119.90, SE = 46.36, t(27) = 2.59, p = .015; 95% confidence interval = 24.78-215.02).
Conclusion:
This pilot study provides preliminary evidence that STM is a feasible and acceptable intervention for reducing children's preoperative anxiety in a busy pediatric operative setting and supports the investigation of a full-scale randomized controlled trial.
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