Interventions and methods to prepare, educate or familiarise children and young people for radiological procedures: a scoping review

Bray, Lucy; Booth, Lisa; Gray, Victoria; Maden, Michelle; Thompson, Jill; Saron, Holly

doi:10.1186/s13244-022-01278-5

Cited by 5 publications

(1 citation statement)

References 62 publications

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“…Given these disadvantages, different strategies have been explored and have shown success in reducing anxiety and the need for sedation among children who undergo MR exams, including animal-assisted therapy, the use of audiovisual systems, behavioral desensitization programs, among others [3,[15][16][17][18][19][20][21][22][23][24]. For example, the use of animal-assisted therapy as a non-pharmacological intervention involving the child sitting next to a dog, petting it, and playing with it under the coach's supervision reduced anxiety and prevented the use of sedation for MR exams [17].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Patient-Centered Communication on Children’s Anxiety and Use of Anesthesia for MR

Castro

Ramos

Carvalho

2022

IJERPH

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Background: The aim of this study was to inspect the influence of patient-centered communication (PCC) with 4- to 10-year-old children on the use of anesthesia for magnetic resonance imaging exams (MRs). Methods: A total of thirty children received the PCC and pre-simulated the exam with an MR toy. Another 30 children received routine information about the MR and pre-simulated the exam with the toy. Anesthesia use in these two groups was additionally compared with a previously existing group of children (n = 30) who had received only routine information about the exam (CG). Children’s anxiety was assessed with a self-report question plus heartbeat frequency. Children’s satisfaction was assessed through several questions. The analyses were based on group comparisons and regression. Results: A total of two children (7%) in the PCC + simulation group used sedation compared with 14 (47%) in the simulation group and 21 (70%) in the CG. Differences between the PCC + simulation and the other two groups were significant (p < 0.001), although not between the simulation and the CG. The decrease in anxiety was significantly greater (self-reported p < 0.001; heart rate p < 0.05) and satisfaction was higher (p = 0.001) in the PCC + simulation, when compared with the simulation group. Reduced anxiety was associated with less anesthesia use (OR 1.39; CI 1.07–1.79; p = 0.013). Conclusions: PCC + simulation was more effective than simulation and routine practice in decreasing children’s anxiety, increasing satisfaction, and reducing the use of anesthesia for MRs.

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Section: Introductionmentioning

confidence: 99%

The Influence of Patient-Centered Communication on Children’s Anxiety and Use of Anesthesia for MR

Castro

Ramos

Carvalho

2022

IJERPH

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Developing rights-based standards for children having tests, treatments, examinations and interventions: using a collaborative, multi-phased, multi-method and multi-stakeholder approach to build consensus

Bray,

Carter,

Kiernan

et al. 2023

Eur J Pediatr

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Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020–2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child. What is Known:• Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care.• Professionals report uncertainty and tensions in applying evidence-based practice to children’s procedural care. What is New:• This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives.• The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.

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Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis

Thestrup,

Hybschmann,

Madsen

et al. 2023

Hospital Pediatrics

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CONTEXT: Nonpharmacological strategies are increasingly used in pediatric procedures, but in pediatric MRI, sedation and general anesthesia are still commonly required. OBJECTIVES: To evaluate the effectiveness of nonpharmacological interventions in reducing use of sedation and general anesthesia in pediatric patients undergoing MRI, and to investigate effects on scan time, image quality, and anxiety. DATA SOURCES: We searched Ovid Medline, CINAHL, Embase, and CENTRAL from inception through October 10, 2022. STUDY SELECTION: We included randomized controlled trials and quasi-experimental designs comparing the effect of a nonpharmacological intervention with standard care on use of sedation or general anesthesia, scan time, image quality, or child and parental anxiety among infants (<2 years), children, and adolescents (2–18 years) undergoing MRI. DATA EXTRACTION: Standardized instruments were used to extract data and assess study quality. RESULTS: Forty-six studies were eligible for the systematic review. Limited to studies on children and adolescents, the meta-analysis included 20 studies with 33 873 patients. Intervention versus comparator analysis showed that nonpharmacological interventions were associated with reduced need for sedation and general anesthesia in the randomized control trials (risk ratio, 0.68; 95% confidence interval, 0.48–0.95; l2 = 35%) and nonrandomized studies (risk ratio, 0.58; 95% confidence interval, 0.51–0.66; l2 = 91%). The effect was largest among children aged 3 to 10 years when compared with older children and adolescents aged 11 to 18 years. LIMITATIONS: There was substantial heterogeneity among nonrandomized studies. CONCLUSIONS: Nonpharmacological interventions must be considered as standard procedure in infants, children, and adolescents undergoing MRI.

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Interventions and methods to prepare, educate or familiarise children and young people for radiological procedures: a scoping review

Cited by 5 publications

References 62 publications

The Influence of Patient-Centered Communication on Children’s Anxiety and Use of Anesthesia for MR

The Influence of Patient-Centered Communication on Children’s Anxiety and Use of Anesthesia for MR

Developing rights-based standards for children having tests, treatments, examinations and interventions: using a collaborative, multi-phased, multi-method and multi-stakeholder approach to build consensus

Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis

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