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

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

Background: Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is 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.

anesthesia, child, general [*psychology], preoperative care, tooth extraction, video games [psychology]
1155-5645
157-166
Huntington, Corinne
d0a856b1-b300-4a6b-a6aa-37d8b6dbbcf1
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Donaldson, Ana Nora
1c5e63f7-01a1-4966-8472-167443d71b21
Newton, Jonathan Timothy
c6d0a8ce-3318-47b3-8009-7e58b0b8a19d
Reynolds, Patricia A.
9464d071-4194-48f0-8154-584514c55682
Alharatani, Reham
4be24174-ced5-479b-8d15-ca853f7cc84a
Hosey, Marie Therese
22678fa4-e2fe-4fa2-9ab0-ed8d944f28b8
Huntington, Corinne
d0a856b1-b300-4a6b-a6aa-37d8b6dbbcf1
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Donaldson, Ana Nora
1c5e63f7-01a1-4966-8472-167443d71b21
Newton, Jonathan Timothy
c6d0a8ce-3318-47b3-8009-7e58b0b8a19d
Reynolds, Patricia A.
9464d071-4194-48f0-8154-584514c55682
Alharatani, Reham
4be24174-ced5-479b-8d15-ca853f7cc84a
Hosey, Marie Therese
22678fa4-e2fe-4fa2-9ab0-ed8d944f28b8

Huntington, Corinne, Liossi, Christina, Donaldson, Ana Nora, Newton, Jonathan Timothy, Reynolds, Patricia A., Alharatani, Reham and Hosey, Marie Therese (2018) On-line preparatory information for children and their families undergoing dental extractions under general anesthesia: A phase III randomized controlled trial Paediatric Anaesthesia, 28, (2), pp. 157-166. (doi:10.1111/pan.13307).

Record type: Article

Abstract

Background: Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is 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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More information

Accepted/In Press date: 26 November 2017
e-pub ahead of print date: 27 December 2017
Published date: 18 January 2018
Keywords: anesthesia, child, general [*psychology], preoperative care, tooth extraction, video games [psychology]

Identifiers

Local EPrints ID: 417623
URI: https://eprints.soton.ac.uk/id/eprint/417623
ISSN: 1155-5645
PURE UUID: 9815a841-b0be-41ae-9f5b-be22a2b19297

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Date deposited: 07 Feb 2018 17:30
Last modified: 07 Feb 2018 17:30

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Contributors

Author: Corinne Huntington
Author: Ana Nora Donaldson
Author: Jonathan Timothy Newton
Author: Patricia A. Reynolds
Author: Reham Alharatani
Author: Marie Therese Hosey

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