Pramila Maharjan1,2, Dustin Murdock3, Nicholas Tielemans3, Nancy Goodall1,2, Beverley Temple4, Nicole Askin5, Kristy Wittmeier1,6,7. 1. Physiotherapy Department, Health Sciences Centre Winnipeg-Shared Health, Winnipeg, MB R3A 1R9, Canada. 2. Orthopedic Technology Services, Health Sciences Centre Winnipeg-Shared Health, Winnipeg, MB R3A 1R9, Canada. 3. Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R33 0T6, Canada. 4. College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2M6, Canada. 5. WRHA Virtual Library, University of Manitoba, Winnipeg, MB R3E 3P5, Canada. 6. Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada. 7. Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada.
Abstract
BACKGROUND: Cast removal can be a distressing experience for a child. This scoping review aims to provide a comprehensive review of interventions designed to reduce anxiety and improve the child's and family's experience of pediatric cast removal. METHODS: A scoping review was conducted (Medline, Embase, PsycINFO, CINAHL, Scopus, grey literature sources). INCLUSION CRITERIA: studies published January 1975-October 2019 with a primary focus on pediatric patients undergoing cast removal/cast room procedures. Screening, full text review, data extraction, and quality appraisal were conducted in duplicate. RESULTS: 974 unique articles and 1 video were screened. Nine articles (eight unique studies) with a total of 763 participants were included. Interventions included the following, alone or in combination: noise reduction, electronic device use, preparatory information, music therapy, play therapy, and child life specialist-directed intervention. Heart rate was used as a primary (88%) or secondary (12%) outcome measure across studies. Each study reported some positive effect of the intervention, however effects varied by age, outcome measure, and measurement timing. Studies scored low on outcome measure validity and blinding as assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials. CONCLUSION: Various methods have been tested to improve the pediatric cast removal experience. Results are promising, however the variation in observed effectiveness suggests a need for the use of consistent and valid outcome measures. In addition, future research and quality improvement projects should evaluate interventions that are tailored to a child's age and child/family preference.
BACKGROUND:Cast removal can be a distressing experience for a child. This scoping review aims to provide a comprehensive review of interventions designed to reduce anxiety and improve the child's and family's experience of pediatric cast removal. METHODS: A scoping review was conducted (Medline, Embase, PsycINFO, CINAHL, Scopus, grey literature sources). INCLUSION CRITERIA: studies published January 1975-October 2019 with a primary focus on pediatric patients undergoing cast removal/cast room procedures. Screening, full text review, data extraction, and quality appraisal were conducted in duplicate. RESULTS: 974 unique articles and 1 video were screened. Nine articles (eight unique studies) with a total of 763 participants were included. Interventions included the following, alone or in combination: noise reduction, electronic device use, preparatory information, music therapy, play therapy, and child life specialist-directed intervention. Heart rate was used as a primary (88%) or secondary (12%) outcome measure across studies. Each study reported some positive effect of the intervention, however effects varied by age, outcome measure, and measurement timing. Studies scored low on outcome measure validity and blinding as assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials. CONCLUSION: Various methods have been tested to improve the pediatric cast removal experience. Results are promising, however the variation in observed effectiveness suggests a need for the use of consistent and valid outcome measures. In addition, future research and quality improvement projects should evaluate interventions that are tailored to a child's age and child/family preference.
Authors: Tammy C Hoffmann; Paul P Glasziou; Isabelle Boutron; Ruairidh Milne; Rafael Perera; David Moher; Douglas G Altman; Virginia Barbour; Helen Macdonald; Marie Johnston; Sarah E Lamb; Mary Dixon-Woods; Peter McCulloch; Jeremy C Wyatt; An-Wen Chan; Susan Michie Journal: BMJ Date: 2014-03-07
Authors: Juan Pablo Domecq; Gabriela Prutsky; Tarig Elraiyah; Zhen Wang; Mohammed Nabhan; Nathan Shippee; Juan Pablo Brito; Kasey Boehmer; Rim Hasan; Belal Firwana; Patricia Erwin; David Eton; Jeff Sloan; Victor Montori; Noor Asi; Abd Moain Abu Dabrh; Mohammad Hassan Murad Journal: BMC Health Serv Res Date: 2014-02-26 Impact factor: 2.655
Authors: Cho Lee Wong; Wan Yim Ip; Blondi Ming Chau Kwok; Kai Chow Choi; Bobby King Wah Ng; Carmen Wing Han Chan Journal: BMJ Open Date: 2018-07-05 Impact factor: 2.692