The effectiveness of web‐based mobile health interventions in paediatric outpatient surgery: A systematic review and meta‐analysis of randomized controlled trials

Abstract

Aims To evaluate the effectiveness of web‐based mobile health interventions on paediatric patients and their parents in the day surgery context, where the primary outcome was children's pre‐operative anxiety and secondary outcomes were postoperative pain and parents’ anxiety and satisfaction with entire course of the day surgery. Design A systematic review and meta‐analysis of randomized controlled trials. Data Sources CENTRAL, CINAHL, Scopus, Ovid MEDLINE, and Web of Science were systematically searched without time limits (up to December 2018). Review Methods Studies were appraised using the Cochrane risk of bias tool. A random effect meta‐analysis of children's pre‐operative anxiety was performed. Results Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web‐based mobile health interventions, including age‐appropriate videos, web‐based game apps, and educational preparation games made for the hospital environment, was examined in pre‐operative settings. A meta‐analysis (N = 560 children) based on six studies found a statistically significant reduction in pre‐operative anxiety measured by the Modified Yale Pre‐operative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction. Conclusion Web‐based mobile health interventions can reduce children's pre‐operative anxiety and increase parental satisfaction. Web‐based mobile health interventions could be considered as non‐pharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children's postoperative pain and parental anxiety using similar interventions. Impact Web‐based mobile health interventions reduce children´s pre‐operative anxiety and could therefore be considered as non‐pharmacological distraction tools for children in nursing.

Telematic Intervention based on the Play Specialist Approach in the Covid-19 Era: Benefits for Parents of Children with Clinical Conditions

“…Moreover, the TPS group perceives higher social support and lower children's emotional and behavioural problems. Given that covid-19 post-lockdown months may have constituted a risk factor for Italian parents' health and may increase parental burnout in vulnerable families, these findings respond to the scientific debate over the positive effects of web-based interventions to support pediatric patients [12,13,14,15,16,17,18,45]. These data align with recent research demonstrating the association between parents' and children's wellbeing during covid-19 outbreak in Italy [1].…”

“…Covid-19 restrictions have led to adapt the Play Specialist approach for the online environment. In the light of a recent meta-analysis supporting the beneficial effects of a wide range of web-based health interventions in pediatric patients [45], this crisis has represented both a challenge and an opportunity to reshape the Play Specialist approach in the online environment. Specifically, the present study intends to verify whether and how a telematic adaptation of Play Specialist's intervention (TPS) beneficially impacts on families by focusing on variables defining parental wellbeing (i.e., parental burnout, anxiety, stress, depression, perceived social support).…”

Parental Experiences of the Pediatric Day Surgery Pathway and the Needs for a Digital Gaming Solution: Qualitative Study

“…In the study by Carlsson and Henningsson [ 47 ], the researchers realized that visiting the operation room might not reduce parents’ or children’s anxiety in surgery care situations. This finding is contradicted by the study of Rantala et al [ 18 ], who argued based on a recent meta-analysis that web-based interventions (eg, educational web-based programs or age-appropriate streamed videos) could be used to reduce children’s anxieties [ 18 ]. In another study by Rantala et al [ 23 ], health specialists observed that a digital gaming solution (developed for a hospital environment, including virtual visits to the hospital for different surgeries) would help families and children to be better oriented to an upcoming treatment.…”

“…According to the previous meta-analysis, digital gaming solutions can reduce children’s preoperative anxiety and increase parental satisfaction [ 18 ]. In addition, digital gaming solutions can be considered as nonpharmacological distraction tools for children.…”

“…In addition, digital gaming solutions can be considered as nonpharmacological distraction tools for children. Parents’ experiences may help care providers to deliver more effective, family-centered care that responds to parents’ needs throughout the day surgery pathway [ 18 ]. Family-centered care considers the individual needs of parents and children [ 19 ] and emphasizes the role of written information intended to reduce parental anxiety and stress regarding day surgeries [ 20 , 21 ].…”