On-line preparatory information for children and their families undergoing dental extractions under general anesthesia: a phase III randomized controlled trial

Abstract

Background

Family‐centered interactive on‐line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.orgis the new on‐line version of a proven nonweb‐based game for children and parents/caregivers.

Aims

The aim of this study was to evaluate if www.scottga.org improved children's anxiety and families' satisfaction compared with controls.

Methods

In this phase III double‐blind randomized controlled trial, children/parents/caregivers received (i) www.scottga.org, (ii) standard care, or (iii) a placebo hand‐washing game. The intervention and placebo games were available online for home usage and provided again on the ward before surgery. All children were accompanied by parent/caregivers at induction and observed and scored using validated measures. Stratified randomization and generalized linear models were used. An intention‐to‐treat approach was adopted.

Results

Overall, 52/176 children had baseline “psychological disturbance.” Children's anxiety increased preinduction, but there were no differences between groups (Facial Image Scale: video‐standard OR = 1.08, P = .82, 95% CI [0.56, 2.1]; video‐placebo OR = 0.9, P = .77 95% CI [0.46, 1.8]). There were no differences in induction behavior (visual analog scale: video mean = 3.5; standard care mean = 3.5; placebo mean = 3.7: video‐standard OR = 2.0, P = .42, 95% CI [−0.6, 1.3]; video‐placebo OR = 1.53, P = .65, 95% CI [−0.8, 1.1]) or induction anxiety (modified Yale Preoperative Anxiety Scale: video‐standard OR 1.02, P = .97, 95% CI [0.61, 2.6]; video‐placebo OR 1.38, P = .49, 95% CI [0.87, 3.81]). Families favored the intervention regarding the “child handling the visit better” (Treatment Evaluation Inventory: video‐standard OR = 12; 95% CI 4.7‐32; P < .001; video‐placebo OR = 8.2; 95% CI 3‐22; P < .001) and “improving the child's ability to cope” (Treatment Evaluation Inventory: video‐standard OR = 21; 95% CI 8‐56; P < .001 and video‐placebo OR = 13; 95% CI 5‐34; P < .001).

Conclusion

Families believed that a video‐game preparation helped their child's perioperative anxiety, but there were no objective measures of behavioral improvement associated with this intervention.

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