Pain Clinical Trial
Official title:
The Impact of Comfort Talk on Anxiety Levels and Procedural Experience in a Pediatric Population Undergoing Cardiac Catheterization: A Prospective Randomized Controlled Trial
NCT number | NCT02347748 |
Other study ID # | 1000046792 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | January 2015 |
Est. completion date | September 2018 |
Verified date | July 2019 |
Source | The Hospital for Sick Children |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Background: Pre anaesthesia anxiety in children is a strong predictor of postoperative
behavior challenges and outcomes. In addition, intra-operative stress can precipitate
post-traumatic stress symptomatology. Comfort Talk, consisting of rapport, relaxation, and
reframing of potentially stressful experiences, applied pre-operatively in script form, has
been highly successful in alleviating anxiety and positively affecting procedural outcomes in
adult patients undergoing interventional procedures. No published literature exists
evaluating its' impact in paediatric cardiac catheterization. Purpose: To investigate the
impact of comfort talk on the level of pre-induction anxiety, procedural and recovery
experience, as well as short-term post-procedural behaviour and satisfaction after discharge
in pediatric patients undergoing cardiac catheterization procedures. Design: Prospective
randomized, double blind controlled trial. Participants: 160 children, ages 7-18 years,
having a cardiac catheterization procedure under general anaesthesia. Intervention: Group A
will be read a pre-procedure comfort talk script in the pre-procedure work-up area; Group B
will be read a pre-extubation (before the breathing tube is removed) script ; Group C will be
read a pre-procedure plus a pre-extubation script; Group D will not be read any script. All
groups will be treated according to the standard of care approaches usually provided for
anaesthesia, catheterization, and recovery. Outcomes: We will compare the effect of the
script strategy on preoperative anxiety. Procedural and recovery measurements will include
room time in the catheterization suite, time to discharge from the recovery room; drug use,
vomiting, rebleeds, and cardiorespiratory stability. Postoperative behaviour will be assessed
by questionnaire. Postoperative anxiety and pain will be secondary outcome measures using
queries on 0-10 verbal self-report scales Hypotheses are:
1. Patients being read a preoperative Comfort Talk script will experience less anxiety
prior to anaesthesia induction.
2. The reduction of anxiety prior to induction is associated with better immediate and
short-term recovery outcomes.
3. Patients being read a pre-extubation script will recover better than controls.
4. The combination of a pre-procedure script and a pre-extubation script will have the
greatest positive effect on physical and emotional well-being in the immediate recovery
period and at short term follow-up.
Status | Completed |
Enrollment | 160 |
Est. completion date | September 2018 |
Est. primary completion date | June 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 7 Years to 18 Years |
Eligibility |
Inclusion Criteria: - Scheduled for cardiac catheterization - Procedure performed under general anesthetic - Ability to speak and understand English - No apparent cognitive impairments Exclusion Criteria: - Active dissociative psychiatric disease |
Country | Name | City | State |
---|---|---|---|
Canada | Hospital for Sick Children | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
The Hospital for Sick Children |
Canada,
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* Note: There are 20 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Pre-anesthesia Anxiety | Anxiety is measured by the modified Yale Preoperative Anxiety Scale (mYPAS) immediately upon entry into the operating room and introduction of the anesthesia mask to the child. The mYPAS consists of 22 items in five categories (activity, emotional expressivity, state of arousal, vocalization, and use of parents) and a maximal score of 100. | 3-15 min prior to anesthesia induction | |
Primary | Postoperative Behavior | Measured with the Post Hospitalization Behaviour Questionnaire (PHBQ) | 1 week postoperatively | |
Secondary | Satisfaction with care | CDIU Post Cardiac Catherization follow-up phone survey addressing presence or absence of discomfort, bruising at the cath site, fever, return to normal bodily functions and activity, satisfaction with treatment from and communication with staff. | 24-48 hrs after discharge from the hospital | |
Secondary | Procedure Time | Duration of the cardiac catheterization procedure (1-4 hrs depending on complexity of case) | Duration of the cardiac catheterization procedure (1-4 hrs depending on complexity of case) | |
Secondary | Recovery room time | Measure per recovery room log | within 24 hrs of procedure | |
Secondary | Drug usage during procedure | Amount of anesthesia drugs given in drug units | 1-4 hrs | |
Secondary | Drug usage during recovery | Amount of sedatives and narcotics in drug units | within 24 hrs | |
Secondary | Antiemetics | Amount of antiememtics in drug units | within 28 hrs | |
Secondary | Anesthesia induction behavior | Measured by the Pediatric Anesthesia Behaviour Score (PAB) | within1 hr of anesthesia induction | |
Secondary | Nausea | measured by frequency and severity | within 28 hrs of procedure start | |
Secondary | Rebleeds | counts and severy | within 1 week of procedure | |
Secondary | any pain | 0-10 self-reporting scale | within 28 hrs of arrival | |
Secondary | Self-reported anxiety | 0-10 self-reporting scale | within 28 hrs of arrival |
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