The effect of music on preprocedure anxiety in Hong Kong Chinese day patients

Aims and objectives. To identify the effect of music on preprocedure anxiety levels of Hong Kong Chinese patients undergoing day procedures in a local community based hospital. Design. Pre and post‐test quasi experimental design with non‐random assignment. Method. A total of 113 participants were assigned to the control group or intervention group depending on the day of their procedure. Participants’ anxiety levels were measured objectively by comparing their vital signs and subjectively by the Spielberger State Trait Anxiety Scale. Participants’ physiological parameters (blood pressure, pulse and respiration) and State Trait Anxiety Scale were measured at two time periods. The control group undertook the usual relaxing activities provided in the waiting room compared with the intervention group who listened to music of their own choice in reclining chairs while waiting for the procedure. Results. The physiological parameters for both the control and intervention groups dropped significantly during the waiting period, however, only the intervention group had a significant reduction in reported anxiety levels. Conclusions. These results suggest that providing self‐selected music to day procedure patients in the preprocedure period assists in the reduction of physiological parameters and anxiety, yet, a relaxing environment can assist in the reduction of physiological parameters. Relevance to clinical practice. The administration of self‐selected music to day procedure patients in the preprocedure period can be effective in the reduction of physiological parameters and anxiety.     

癫痫患儿家长焦虑、抑郁现状调查及其影响因素分析

目的:了解癫痫患儿家长的焦虑、抑郁现状并分析其影响因素。方法:采用一般情况问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)对2011年5-10月在某儿童医院神经内科就诊或住院的癫痫患儿父亲或母亲共104名进行问卷调查。结果:癫痫患儿家长SAS总得分为(49.41±6.99)分;SDS总得分为(59.68±8.47)分;家长学历和服药疗程知识是家长焦虑的影响因素,家长学历是家长抑郁的影响因素。结论:癫痫患儿家长存在焦虑和抑郁的心理问题,家长学历和服药疗程知识是其焦虑或抑郁的影响因素,可以通过加强对家长进行健康教育、改善患儿治疗效果来改善癫痫患儿家长的心理状况。     

Levels of anxiety in parents in the 24 hr before and after their child's surgery: A descriptive study

Aims and objectives

To (i) investigate pre‐ and postoperative anxiety levels in parents of surgical patients; (ii) identify factors that affect parental anxiety; and (iii) analyse assistance provided and overall parental satisfaction to assess whether and how this aspect can impact their anxiety level.

Background

Surgery as an event generates anxiety in children and their parents. Children who are anxious before surgery are likely to develop more postoperative psychological and physiological complications than those who are not. The role parents play in influencing emotional states of their children has been well demonstrated. However, specific national programmes aimed at helping parents develop new models for coping are relatively inexistent in Italy.

Study design

Longitudinal study.

Methods

One hundred and one parents of children undergoing surgery at a healthcare facility in Padua, Italy, completed the Italian version of the State‐Trait Anxiety Inventory Form Y questionnaire. They also answered questions about their parents' socio‐demographic situation, the amount and quality of preoperative information received, assistance provided and their overall satisfaction with this information.

Results

The preoperative level of anxiety in parents who were interviewed was higher than Italian normative data, especially in Pediatric Cardiac Surgery and Pediatric Urology departments. Mothers had a significantly higher level of anxiety than fathers. Communicating possible complications of surgical procedures increased anxiety, while providing information about pre‐ and postsurgery nutrition and pain management and providing local anaesthetic on children decreased parental anxiety. Parents expressed a sufficiently high level of satisfaction although they defined the hospital environment as uncomfortable.

Conclusions

Aspects of care that can make hospitalisation less traumatic for parents are as follows: greater support, involving them in the treatment process, improving hospital department admission procedures and providing thorough preoperative information.

Relevance to clinical practice

Healthcare professionals are encouraged to pay attention to communication modalities providing detailed information to parents.     

唇腭裂患儿父母心理状况研究现状

介绍了唇腭裂患儿父母心理健康状况及其对患儿的影响，并阐述了影响唇腭裂患儿父母的心理因素及心理干预措施。     

Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery

The purpose of this study was to examine the effects of therapeutic play on outcomes of children undergoing day surgery. Two hundred and three children admitted for day surgery were invited to participate in a randomized controlled trial. The experimental group received therapeutic play; the control group received routine information preparation. Children in the experimental group reported significantly lower state anxiety scores in pre- and postoperative periods and exhibited fewer negative emotions at induction of anesthesia than children in the control group. No significant differences were found between the two groups in postoperative pain. The study provides some evidence that therapeutic play is effective in pre- as opposed to postsurgical management of children.     

围术期患儿家长焦虑现状及护理干预研究

综述围术期患儿家长焦虑现状及护理干预研究,认为围术期患儿家长的焦虑现状与家长年龄、文化程度等的相关性有待进一步研究,改善家长焦虑情绪的干预措施的有效性需临床实践证明。     

Anxiety and quality of recovery in day surgery: A questionnaire study using Hospital Anxiety and Depression Scale and Quality of Recovery Score

The aims of this study were (i) to examine the association between preoperative and postoperative anxiety, and (ii) to examine the association between preoperative anxiety and postoperative recovery, following day surgery under general anaesthesia. Day surgery has become more commonplace owing to advances in pharmacology, anaesthetic and surgical techniques, as it has recognized benefits, such as lower costs and reduced incidence of infection. Recent years have seen increased complexity of day surgery undertaken on a broader range of patients, but with reduced pre-surgery contact with the hospital environment. These recent service changes might have had an effect on the preparation of patients for day surgery, and this in turn might have affected their postoperative recovery. This pilot study used survey methods to examine potential associations between preoperative and postoperative anxiety, and between preoperative anxiety and postoperative recovery. Data were collected in 2008 from a convenience sample of 54 day surgery patients. The instruments used were the Hospital Anxiety and Depression Scale (HADS) and the Quality of Recovery Score (QoR-40). There was a statistically significant relationship between preoperative and postoperative anxiety (χ(2) =11.899, d.f.=1, P=0.001). The T-test showed a statistically significant difference in the mean scores for QoR-40 score for gender, and for the postoperative anxiety and QoR-40. A relationship between preoperative anxiety and postoperative recovery was not shown. Although challenging to implement in view of restricted timescales, appraisal and revision of pre-assessment processes to incorporate an anxiety measurement tool, such as the HADS, should be considered.     

颅脑肿瘤患儿家属术前焦虑状况与需求的调查

目的 探讨神经外科颅脑肿瘤患儿家属术前焦虑状况及相关需求,及时满足患儿家属的心理需求,为护理服务提供依据.方法 采用Zung焦虑自评量表和自设问卷对114例住院患儿家属术前焦虑状况及需求进行调查,并对结果进行分析.结果 颅脑肿瘤患儿家属术前焦虑水平高于国内常模(P<0.01);56.14%的患儿家属术前存在焦虑情绪;母亲焦虑得分高于父亲(P<0.01),焦虑得分与家属的年龄、学历、职业无关(P>0.05).术前患儿家属需求主要包括:了解患儿的病情、肿瘤能否全部切除、手术危险性和预后等疾病相关内容.结论 护士应针对患儿家属的不同需求进行心理干预,以减轻其焦虑程度.     

白血病患儿及其父母的疾病承受力对其健康教育效果的影响

[目的]了解白血病患儿及其父母的疾病承受力对其健康教育效果的影响,探讨护士在患儿及其父母获取疾病知识的过程中所起的作用。[方法]应用自行设计的一般资料和健康知识调查问卷,对30例住院白血病患儿父母进行调查。[结果]白血病患儿父母的疾病知识的水平较高,受患儿对疾病承受力的影响(P<0.05)。[结论]患儿及其父母的心理状况对健康教育效果具有较大的影响。     

Burdened parents sharing their concerns for their children with the doctor. The impact of trust in general practice: a qualitative study

Abstract

Objective: The aim of this study was to recognise the preconditions experienced by general practitioners (GPs) in addressing the children’s needs when ill and substance abusing parents consult for their own health problems.

Design: Qualitative analysis of 38 case stories told by GPs in focus group interviews.

Setting: Focus group interviews of four continuing medical education groups for GPs in western Norway.

Subjects: 27 GPs (nine females) with at least 5 years’ experiences in general practice.

Results: Different aspects of the GPs’ perceived mandate of trust from the parents was a precondition for the children’s situation to be addressed. In some case stories the participants took an open mandate from the parent for granted, while in others they assumed that the parent did not want to discuss their family situation. Sometimes the participants had faith that by continuing with their ordinary GP tasks, they might obtain a more open mandate of trust. Their evaluation of the mandate of trust seemed to impact on how the GP could adopt a mediating role between the parents and various support agencies, thus supporting children who were at risk.

Discussion/conclusion: The children most at risk may remain invisible in GPs’ encounters with their parents, possibly because their parent’s health problems and overall situation overshadow the children’s situation. The mandate of trust from burdened parents to GPs can be a fruitful concept in understanding the interaction regarding the welfare of the parent’s children. Negotiating the mandate of trust with parents by explicitly addressing trust and having an ongoing discussion about the mandate and its limits might be an option to secure the children support if necessary.

• KEY POINTS

• Offering children of burdened parents information and support can be crucial for health promotion and illness prevention.

• A general practitioner’s (GP’s) evaluation of the trust parents have in them can determine the extent of support children receive.

• Depending on the parents’ level of trust, GPs may take a mediating role between support services and parents for the benefit of the children.

• A negotiation concerning the trust parents have in the GP may open up possibilities for GPs to offer children necessary support.

     

A geriatric day hospital in Hong Kong: An analysis of activities and costs

A survey of the activities of a geriatric day hospital in Hong Kong was carried out. It revealed that alternative modalities of hospital-based treatment were impractical and difficult to organize. Most patients and their carers were satisfied with the day hospital service, and the main area for improvement was in transportation. Costs of day hospital treatment were also calculated, and were found to be cheaper than an equivalent period of in-patient rehabilitation or out-patient therapy.     

Use of perioperative dialogues with children undergoing day surgery

Title. Use of perioperative dialogues with children undergoing day surgery Aim. This paper is a report of a study to explore what it means for children to attend hospital for day surgery. Background. Hospitalization is a major stressor for children. Fear of separation, unfamiliar routines, anaesthetic/operation expectations/experiences and pain and needles are sources of children’s negative reactions. Method. A grounded theory study was carried out during 2005–2006 with 15 boys and five girls (aged 6–9 years) scheduled for elective day surgery. Data were collected using tape‐recorded interviews that included a perioperative dialogue, participant observations and pre‐ and postoperative drawings. Findings. A conceptual model was generated on the basis of the core category ‘enduring inflicted hospital distress’, showing that the main problem for children having day surgery is that they are forced into an unpredictable and distressful situation. Pre‐operatively, the children do not know what to expect, as described in the category ‘facing an unknown reality’. Additional categories show that they perceive a ‘breaking away from daily routines’ and that they are ‘trying to gain control’ over the situation. During the perioperative period, the categories ‘losing control’ and ‘co‐operating despite fear and pain’ are present and intertwined. Post‐operatively, the categories ‘breathing a sigh of relief’ and ‘regaining normality in life’ emerged. Conclusion. The perioperative dialogue used in our study, if translated into clinical practice, might therefore minimize distress and prepare children for the ‘unknown’ stressor that hospital care often presents. Further research is needed to compare anxiety and stress levels in children undergoing day surgery involving the perioperative dialogue and those having ‘traditional’ anaesthetic care.     

The effect of music on preoperative anxiety in day surgery

AIM: This paper reports a study to test the hypothesis that day surgery patients who listen to music during their preoperative wait will have statistically significantly lower levels of anxiety than patients who receive routine care. BACKGROUND: Although previous day surgery research suggests that music effectively reduces preoperative anxiety, methodological issues limit the generalizability of results. METHODS: In early 2004, a randomized controlled trial design was conducted to assess anxiety before and after listening to patient preferred music. Participants were allocated to an intervention (n=60), placebo (n=60) or control group (n=60). Pre- and post-test measures of anxiety were carried out using the State-Trait Anxiety Inventory. RESULTS: Music statistically significantly reduced the state anxiety level of the music (intervention) group. No relationships were found between socio-demographic or clinical variables such as gender or type of surgery. CONCLUSION: The findings support the use of music as an independent nursing intervention for preoperative anxiety in patients having day surgery.     

个性化健康教育对哮喘患儿父母生活质量的影响

目的探讨社区个性化健康教育对哮喘患儿父母生活质量的影响。方法采用随机数字表法,将101名哮喘患儿及家长分为干预组52名和对照组49名。对照组采用传统授课和发放儿童哮喘知识宣教手册,干预组在此基础上实施个性化健康教育,即在传统授课的基础上加入家庭哮喘应对行动计划的书写及行动目标的拟定。采用儿童照护者生活质量问卷(paediatric asthma caregiver’s quality of life questionnaire,PACQLQ)测评干预前后两组患儿父母PACQLQ得分的差异。结果干预1个月后,干预组患儿父母PACQLQ总分、活动受限和情感功能维度得分均高于对照组和干预前,组间和组内比较,差异具有统计学意义(均P<0.001)。结论个性化健康教育提高了哮喘患儿父母的生活质量。     

The health of children with cerebral palsy and stress in their parents

Title.  The health of children with cerebral palsy and stress in their parents.
Aim.  This paper is a report of a study conducted to describe the health of children with cerebral palsy and investigate predictors of stress in their parents.
Background.  Children with severe cerebral palsy tend to have poorer health than their able-bodied peers, and their parents are more likely to be stressed and have poorer health.
Method.  A cross-sectional survey with home visits using standard questionnaires was administered to parents in 2004–05. A total of 102/199 (51%) children and parents participated. The children were compared with a normative sample.
Results.  Children with cerebral palsy had poorer physical health, and 79% of parents reported that their child had moderate to severe pain. Their poorer health, in comparison with the normal sample and measured by the Child Health Questionnaire, was related to feeding problems and seizures, general health perceptions to intellectual and feeding impairment, and family activities with severe motor, intellectual and feeding impairment. Poorer psychological well-being on the hyperactivity domain of the Strengths & Difficulties Questionnaire was related to feeding difficulties, on the prosocial domain to more severe forms of all child impairments, and on the social impairment scale to intellectual impairment. Children with psychological problems had statistically significantly increased odds (OR = 7·2, 95% CIs 2·6–20·3) of having parents with high stress.
Conclusion.  Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support.     

尿毒症儿童父母教养压力调查与分析

目的 调查尿毒症儿童父母教养压力水平,为开展心理干预和社会支持提供科学依据.方法 采取教养压力指标简表对49例尿毒症儿童父母和50例正常儿童父母的教养压力进行调查.结果 尿毒症儿童父亲与母亲教养压力总分和各维度得分均高于正常儿童父母(P<0.01);尿毒症儿童母亲在教养压力总分和亲职愁苦、困难儿童维度得分高于父亲(...