- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01878747
Healthcare Provider Behavior and Children's Perioperative Distress
The goal of this randomized trial is to examine the effectiveness of a Provider Tailored Intervention for Perioperative Stress (P-TIPS) in preventing high anxiety and improving the recovery process in children undergoing surgery. Four hospitals and all Healthcare Providers (HCP) in it will be randomized to either a P-TIPS Group, who will receive the newly developed intervention, or a Control Group who will receive a 2-hour seminar on the management of preoperative anxiety and postoperative pain and otherwise will provide standard care. The aims of this study are to:
PRIMARY AIM
1. Determine if P-TIPS is more effective than standard care for preventing high preoperative anxiety among children undergoing anesthesia and surgery. The primary outcome will be observational anxiety in the operating room settings as measured by m-YPAS (modified-Yale Preoperative Anxiety Scale).
SECONDARY AIMS
- Examine the impact of P-TIPS on surgical recovery parameters such as postoperative pain, recovery room stay, nausea and vomiting, emergence delirium and maladaptive behavioral changes as measured by the PAED, and PHBQ
- Determine if the use of P-TIPS results in higher satisfaction and lower anxiety scores in the parents.as measured by the STAIs, STAIt and Parent Satisfaction questionnaires
- Determine if HCP in P-TIPS group display more desired behaviors and less undesired behaviors as compared to control group and whether these behaviors mediate the child and parent-level outcomes.These behaviors will be measured using the m-PCAMPIS
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The proposed clustered randomized trial of four children's hospitals: CHOC Children's (CHOC), Children's Hospital Los Angeles (CHLA), Lucile Packard Children's Hospital at Stanford, The Children's Hospital, Denver. At each hospital approximately 20 anesthesia and nursing health care providers (HCP) will examine the effectiveness of a Provider Tailored Intervention for Perioperative Stress (P-TIPS) aimed at preventing high anxiety and improving the recovery process in children undergoing surgery via modifying adults' behavior. Each hospital and all HCP in it will be randomized to either a P-TIPS Group, who will receive the newly developed intervention, or a Control Group who will receive a 2-hour seminar on the management of preoperative anxiety and postoperative pain and otherwise will provide standard care. Objective measures of children's preoperative anxiety and postoperative recovery, as well as adherence measures of HCP will be collected prior and during the experimental period.
HCP in the Intervention group will learn that the use of behaviors as such distraction and medical reinterpretation directs the child's attention towards more enjoyable topics or reframes the procedure into something less threatening, which in turn diverts the child's attention away from their own distress or fear. Conversely, although HCPs often use reassurance and empathy to help soothe children, the education that HCPs receive from P-TIPS will explain that these emotion-focused comments seem to direct children's attention to their own distress and frightening aspects of the medical procedure. HCPs will also learn the intricacies of implementing these strategies and ways to adjust their behavior to effectively keep children engaged in coping related behaviors.
Child's anxiety m-YPAS during induction is assessed at two points, a) entering the operating room and b) introduction of the anesthesia mask to the child. Once in the OR, the child's blood pressure and heart rate is also assessed. A total of 10 child-parent dyad interactions per HCP are collected for the baseline assessment phase. HCP behavior during induction is also videotaped by research assistants and coded later using the P-CAMPIS measure. Also, parents and children answer baseline questionnaires aimed at capturing demographics, anxiety, health beliefs. Postoperative analgesic consumption, behavioral and recovery measures are also collected.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Nova Scotia
-
Halifax, Nova Scotia, Canada, B3K6R8
- IWK Health Center
-
-
-
-
California
-
Los Angeles, California, United States, 90027-6062
- Children's Hospital Los Angeles
-
Menlo Park, California, United States, 94025-3434
- Stanford University
-
Orange, California, United States, 92868
- CHOC Children's Hospital
-
-
Colorado
-
Aurora, Colorado, United States, 30602-7411
- Children's Hospital Colorado
-
-
Georgia
-
Athens, Georgia, United States, 30602-7411
- Boyd Graduate Studies Research Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
INCLUSION CRITERIA:
Children:
- Children who are scheduled to undergo outpatient T&A
- Children whose health status is American Society of Anesthesiologists (ASA) physical status I-III will be recruited for this study
- Only children who are in the normal range of development will be recruited for this study
Parents: Parents of children who are enrolled in the study.
Healthcare Provider:
- Anesthesia care providers in the four study hospitals
- Nurses who provide preoperative nursing care to children who are about to undergo surgery in the four study hospitals
EXCLUSION CRITERIA
Children:
- Patients with health status defined by ASA status IV-V
- Patients who are taking psychotropic medications that affect emotion modulation
- Patients who are taking medications such as erythromycin that interfere with the metabolism of midazolam
- Patients born before 36 weeks gestational age are considered premature and will not be included in this study
- Patients with a positive sleep study and patients who have any indication to be admitted postoperatively (e.g. positive sleep study)
- Patients with a positive sleep study indicating sleep apnea will also be excluded from this study.
Parents:
- Parents who refuse to be part of the study
- Parents who don't speak English if the health care providers involved with that child-parent dyad don't speak the language that is spoken by the parent and child
Healthcare Providers:
- Anesthesiologists who refuse to be part of the study
- Nurses who refuse to be part of the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: P-TIPS group
Provider Tailored Intervention for Perioperative Stress (P-TIPS) aims at reducing preoperative anxiety in children via modifying adults' behavior.P-TIPS program is developed from the proximal-distal theory that suggested that in acute procedural settings specific adult behaviors directly affect children's distress and coping behaviors.
|
Provider Tailored Intervention for Perioperative Stress (P-TIPS) is developed based on the proximal-distal theory that suggested that in acute procedural settings specific adult behaviors directly affect children's distress and coping behaviors.
P-TIPS aims at reducing preoperative anxiety in children via modifying adults' behavior.
Other Names:
|
No Intervention: Control Group
Subjects in this group will not be trained with the P-TIPS method.
They will receive a 2-hour seminar on the management of preoperative anxiety and postoperative pain and otherwise will provide standard care to patients.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Child's anxiety in the operating room settings.
Time Frame: 1 day
|
m-YPAS (modified-Yale Preoperative Anxiety Scale)
|
1 day
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Impact of the intervention on the child's recovery parameters including emergence delirium, systolic pressure, diastolic pressure, heart rate recordings, and analgesic consumption.
Time Frame: 2 weeks
|
2 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Zeev N. Kain, MD, MBA, UC Irvine Medical Center, Dept. of Anesthesiology and Perioperative Care
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- UCIANES02
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Pain, Postoperative
-
Dr. Negrin University HospitalCompletedPostoperative Pain, Acute | Postoperative Pain, ChronicSpain
-
Ankara City Hospital BilkentRecruitingPostoperative Pain | Postoperative Pain, Acute | Postoperative Pain, Chronic | SternotomyTurkey
-
Atatürk Chest Diseases and Chest Surgery Training...RecruitingPostoperative Pain | Postoperative Pain, Acute | Postoperative Pain, Chronic | VATSTurkey
-
Atatürk Chest Diseases and Chest Surgery Training...RecruitingPostoperative Pain | Thoracotomy | Postoperative Pain, Acute | Postoperative Pain, ChronicTurkey
-
Aydin Adnan Menderes UniversityCompleted
-
Aydin Adnan Menderes UniversityCompletedAcute Postoperative Pain | Chronic Postoperative PainTurkey
-
Maimonides Medical CenterCompletedPOSTOPERATIVE PAINUnited States
-
University Hospital, AntwerpUnknown
-
VA Office of Research and DevelopmentRecruitingTotal Knee Arthroplasty (Postoperative Pain) | Total Hip Arthroplasty (Postoperative Pain)United States
-
VA Office of Research and DevelopmentCompletedTotal Knee Arthroplasty (Postoperative Pain) | Total Hip Arthroplasty(Postoperative Pain)United States
Clinical Trials on Provider Tailored Intervention for Perioperative Stress
-
Duke UniversityNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other collaboratorsCompletedOsteoarthritisUnited States
-
Indiana UniversityNational Cancer Institute (NCI); National Institute of Nursing Research (NINR)Completed
-
University of Colorado, DenverNational Cancer Institute (NCI); Kaiser PermanenteCompleted
-
University of North Carolina, Chapel HillPatient-Centered Outcomes Research Institute; Children's Hospital of Philadelphia and other collaboratorsRecruitingA Comparison of Two Brief Suicide Prevention Interventions Tailored for Youth on the Autism SpectrumSuicidal Ideation | Suicide | Autism Spectrum Disorder | Suicidal and Self-injurious BehaviorUnited States
-
University of North Carolina, Chapel HillCompletedHIV Infections | Acquired Immunodeficiency SyndromeUnited States
-
Fox Chase Cancer CenterNational Cancer Institute (NCI)CompletedSkin NeoplasmsUnited States
-
The Miriam HospitalCompleted
-
The Miriam HospitalNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Recruiting
-
University of California, IrvineEunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedPain | Anxiety | Postoperative BehaviorUnited States
-
University of Rochester NCORP Research BaseNational Cancer Institute (NCI)RecruitingMalignant Solid NeoplasmUnited States