Day-Night Activity in Hospitalized Children after Major Surgery: An Analysis of 2271 Hospital Days

Abstract

Objectives: To characterize the day-night activity patterns of children after major surgery and describe differences in children's activity patterns between the PICU and inpatient floor setting. Study design: In this prospective observational study, we characterized the daytime activity ratio estimate (DARE; ratio between mean daytime activity [08:00-20:00] and mean 24-h activity [00:00-24:00]) for children admitted to the hospital after major surgery. The study sample included 221 infants and children ages 1 day to 17 years admitted to the pediatric intensive care unit (PICU) at a tertiary, academic children's hospital. Subjects were monitored with continuous accelerometry from postoperative day 1 until hospital discharge. NHANES accelerometry data were utilized for normative data to compare DARE in a community sample of U.S. children to hospitalized children. Results: The mean DARE over 2,271 hospital days was 57.8%, with a significant difference between the average DARE during PICU days and inpatient floor days (56% vs. 61%, P <.0001). The average subject DARE ranged from 43% to 73%. In a covariate-adjusted mixed effects model, PICU location, lower age, orthopedic or urologic surgery, and intubation time were associated with decreased DARE. Hospitalized children had significantly lower DARE than NHANES subjects in all age groups studied, with the largest difference in the youngest PICU group analyzed *

Fear of movement in children and adolescents undergoing major surgery: A psychometric evaluation of the Tampa Scale for Kinesiophobia

“…The Actical movement monitor (Respironics, Inc.) is a small, non-invasive, wristwatch-sized device that contains an omnidirectional accelerometer designed to measure physical activity and caloric expenditure on a continuous basis. The movement monitor provides an objective, quantifiable measure of physical movement and has been used in past studies of children in a post-surgical hospital setting (Kudchadkar et al, 2019;Puyau, Adolph, Vohra, Zakeri, & Butte, 2004). The movement monitor was placed on the child's wrist when they arrived in the post-operative care unit after surgery and left in place until they were discharged.…”

Exploration of Disparities in Regions and Specialized Fields of Day Surgery System

“…Many studies from this group analyze patient dissatisfaction, as well as factors that influence their risk level [6][7][8][9]. These studies are significantly heterogenous in their character.…”

“…Experience in performing day surgery in many countries points to the necessity of its own administrative infrastructure in order to ensure coordinated planning and continuity in the performance of day surgery as well as overall optimization. Many foreign studies (e.g., [17,[21][22][23][24][25][26][27][28], and others) have declared an effort to continually expand the day surgery system, both the number of patients operated and the application of more extensive and complex procedures (e.g., [7][8][9]) in patients with higher rates of comorbidity. This creates the preconditions for a more in-depth examination of regional disparities in the development of the number of surgeries performed and the factors that cause them.…”

Family Support System as an Effort to Optimize Coping Mechanism of Preschool Children During Hospitalization

“…It has been proven in several studies that children will feel safe when they are beside their parents, especially when facing invasive procedure (Supartini, 2004). Casey in (Supartini, 2004)suggested that the principle of nursing services to children must focus on children and families, to meet the needs of children and their families (Kudchadkar et al, 2019;Moghaddam et al, 2017). The purpose of this study is to analyze the effect of family support systems on coping mechanisms of preschool children.…”