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Home esophageal self-dilatation in children
Summary
Teaching preadolescent children esophageal self-dilatation at home is possible using creative visualization. This innovative program empowers children with esophageal strictures for greater independence and frequent treatment.
Area of Science:
- Pediatric Gastroenterology
- Medical Education
Background:
- Esophageal strictures often require repeated hospital-based dilations.
- Home-based esophageal self-dilatation offers patients greater autonomy and treatment frequency.
Observation:
- An innovative teaching program utilizes creative visualization for preadolescent children undergoing esophageal self-dilatation.
- Children focus on a 2-minute mental image (e.g., video game, song, race) while performing dilatation with a Maloney bougie.
- A nasal breathing technique and encouragement are employed, with initial use of topical lidocaine and oral diazepam for relaxation.
Findings:
- Three children aged 12-13 years with esophageal strictures successfully learned the self-dilatation technique within one week.
- All participants continued home self-dilatation for 4-6 months.
- Teaching was effective both in-hospital by a nurse and as an outpatient by a peer mentor.
Implications:
- Home esophageal self-dilatation is a teachable and effective technique for preadolescent children.
- The program's simplicity allows for potential application to other pediatric self-care tasks, including pain management and feeding tube use.