Anxiety
Conditions
Brief summary
Children undergoing anesthesia are often very frightened by the experience. This can lead to bed wetting, nightmares and stranger anxiety that can last for weeks. Moreover, this can influence their future experiences with anesthesia and surgery. The investigators believe the presence of a parent via video might work better as parental fear is not transferred to the child. The investigators also believe that parents who are coached on how to assist their child during anesthesia will have a better impact. As such the investigators are carrying out this study to assess whether parents who are coached and are present in either video or physical form will be more effective in reducing anxiety at induction of anesthesia.
Detailed description
The investigators' goal in this study is to investigate the effects of virtual parental presence and coaching of parents on anxiety in children at induction of anesthesia. The primary hypothesis is virtual parental presence during induction of anesthesia is superior to physical parental presence during induction of anesthesia in reducing anxiety in children at induction of anesthesia. The secondary hypothesis is that the coaching of parents modulates the effect of physical or video parental presence at induction anesthesia on children's anxiety.
Interventions
BEHAVIORALcoaching
Parent learns what to say verbally to soothe child
BEHAVIORALvirtual
Parent is present via an internet pad (iPad)
BEHAVIORALphysical
Parent is present in the operating room
BEHAVIORALno coaching
Parent does not learn what to say verbally to soothe child
Sponsors
The Hospital for Sick Children
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Months to 12 Years
Healthy volunteers
No
Inclusion criteria
1. Children from ages 18 months to 12 years old 2. American Society of Anesthesiologists physical status I, II or III 3. No previous exposure to anesthesia or surgery 4. Same Day surgery 5. English speaking parents and child
Exclusion criteria
1. Children with developmental delay 2. Children with psychological / emotional disorders 3. Children with language barrier 4. Previous anesthetic or surgical experience 5. Children whose eyes will be closed following surgery 6. Children on sedative or psychoactive medication 7. History of allergy to medications in our study 8. Children with expected difficult intubation 9. Children presenting for emergency surgery 10. Family history or personal history of malignant hyperthermia / risk of malignant hyperthermia 11. Consent not obtained or withdrawal of consent 12. Children who are violent during induction of anesthesia 13. Cancellation of surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety in children | Day of surgery, immediately following consent | measured using the modified Yale Preoperative Anxiety Scale (mYPAS) |
| Change in child anxiety | Day of surgery, immediately preceding surgery | measured using the modified Yale Preoperative Anxiety Scale (mYPAS) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parental anxiety | Day of surgery, immediately following consent | measured using the State-Trait Anxiety Inventory (STAI) |
| Change in parental anxiety | Day of surgery, immediately preceding surgery | measured using the State-Trait Anxiety Inventory (STAI) |
| Parental satisfaction | Day of surgery, five minutes after surgery has commenced | measured using The Hospital for Sick Children satisfaction questionnaire |
| Anesthesiologist satisfaction with task load | Day of surgery, immediately following surgery | measured using the NASA Task Load Index (NASA-TLX) |
| Induction compliance | Day of surgery, immediately preceding surgery | measured using the Induction Compliance Checklist |
| Induction nurse satisfaction with task load | Day of surgery, immediately following surgery | measured using the NASA Task Load Index (NASA-TLX) |
| Induction nurse satisfaction with technology usability | Day of surgery, immediately following surgery | measured using the System Usability Scale (SUS) |
| Anesthetic requirements | Day of surgery, intra-operatively | measurement includes recording dose of anesthetic(s) used |
| Post-hospitalization negative behaviours | Two to three days after surgery | measured using the Posthospitalization Behaviour Questionnaire (PHBQ) |
| Anesthesiologist satisfaction with technology usability | Day of surgery, immediately following surgery | measured using the System Usability Scale (SUS) |
| Child temperament | Day of surgery, immediately following consent | measured using the Emotionality Activity Sociability Impulsivity Instrument of Child Temperament (EASI) |
Countries
Canada
Outcome results
None listed