The effect of an educational pre‐operative DVD on parents’ and children's outcomes after a same‐day surgery: a randomized controlled trial

Abstract

The effect of an educational pre-operative DVD on parents' and children's outcomes after a sameday surgery: a randomized controlled trial. Journal of Advanced Nursing 73(3), 599-611. doi: 10.1111/jan.13161 Abstract Aims. To examine the effect of a pre-operative DVD on parents' knowledge, participation and anxiety and on children's distress, pain, analgesic requirements and length of recovery after same-day surgery. Background. Very few parents are adequately prepared to participate in their child's care during a same-day surgery. An educational DVD was developed to educate parents on how to actively support their child in the recovery room. Design. Single-blind, post-test randomized controlled trial. Study is registered at ClinicalTrials.gov NCT02766452. Methods. Between September 2011-September 2012, 123 parent-child dyads where the child underwent an ENT or dental same-day surgery were recruited in a Canadian paediatric hospital. Dyads were randomly assigned to either the intervention (DVD and standard preparation) or control group (standard preparation). Parents and children were videotaped in the recovery room where parental participation and anxiety and children's distress were measured. Data on parents' knowledge, children's postoperative pain, analgesic requirements and length of recovery were measured. Independent and paired t-tests, chi square and repeated measures ANOVA were used to analyse the data. Results. Parents in the intervention group gained greater knowledge of and used more positive reinforcement and distraction and relaxation methods than those in the control group. Children's postoperative pain in the day-care surgery unit was significantly lower among the intervention group compared with the control group. Conclusion. A pre-operative DVD can increase parents' participation in the recovery room and decrease children's postoperative pain.

<p>Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review</p>

“… 32 , 37 , 38 , 49 , 53 , 54 , 57 , 58 , 59 , 63 , 70 , 71 , 79 , 81 , 91 , 93 , 94 , 103 , 105 , 108 Prevention of anxiety was a secondary outcome of interest in a further nine (10%) studies. 22 , 23 , 25 , 47 , 50 , 55 , 69 , 73 , 80 Of the studies including anxiety prevention as the primary outcome, nine studies (47%) were focused on adult patients; 32 , 38 , 53 , 57 , 59 , 71 , 81 , 94 , 105 nine were focused on pediatric patients, 37 , 49 , 54 , 63 , 79 , 91 , 93 , 103 , 108 (with four of these also including caregivers as a sub-population, 37 , 49 , 54 , 108 and another focused on adolescents 37 ); one study concentrated solely on caregiver (parent) anxiety. 70 The interventions of interest included music; 32 , 58 , 59 , 71 , 103 education (including videos); 37 ,…”

“…32,37,38,49,53,54,57,58,59,63,70,71,79,81,91,93,94,103,105,108 Prevention of anxiety was a secondary outcome of interest in a further nine (10%) studies. 22,23,25,47,50,55,69,73,80 Of the studies including anxiety prevention as the primary outcome, nine studies (47%) were focused on adult patients; 32,38,53,57,59,71,81,94,105 nine were focused on pediatric patients, 37,49,54,63,79,91,93,103,108 (with four of these also including caregivers as a sub-population, 37,49,54,…”

“…67 Three studies were interested in adult patient knowledge, 67,80,106 two on parental knowledge. 23,107 Other Clinical Outcomes A wide variety of other clinical practices were investigated as primary outcomes in the identified RCTs (Supplementary file 3). 25,27,28,30,33,45,47,52,60,68,75,77,78,95,101,102…”

Supporting paediatric patients: Parental presence in the anaesthetic journey

“…The preoperative visit would de-escalate these fears in a non-threatening way by familiarising the child with the equipment. The introduction of a preoperative visit can assist parents and child with levels of anxiety 35 . Not all institutions facilitate preoperative visits to the operating room; however, this activity could be encouraged if it is evidenced and supported by leaders to be best practice.…”

“…Depending on the child, they may be able to be held by the parent for induction 8 . This informal visit and the role of the parent is vitally important and will benefit the child and parent as it familiarises them with the forthcoming scenarios and environment under the guide of the family-centred care model 35 .…”