Preparing Children for Anesthesia With an Educational Pop-Up Book

March 11, 2021 updated by: Children's Healthcare of Atlanta

Efficacy of an Educational Pop-Up Book in Preparing Children for Anesthesia: A Randomized Controlled Trial

The study evaluated an educational pop-up book about general anesthesia induction as an interactive, child-focused preoperative education resource for pediatric patients undergoing outpatient surgery. The study's objectives were to evaluate the book as an educational tool and to understand the book's effects on patient and caregiver perceptions of the surgical experience. The study's hypotheses were that preoperative education from the pop-up book, compared to standard care, would more effectively reduce children's fear and expected pain, facilitate more positive views of the procedure and preoperative explanations, encourage adaptive coping strategies, reduce behavioral anxiety at anesthesia induction, and increase caregiver satisfaction with the surgical experience.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

148

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Georgia
      • Duluth, Georgia, United States, 30096-5803
        • Children's Healthcare of Atlanta Satellite Boulevard Outpatient Surgery Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

5 years to 12 years (CHILD)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion criteria:

  • Ages 5-12 (inclusive)
  • Undergoing outpatient medical procedures under general anesthesia with inhalation induction
  • English-speaking
  • Able to provide electronic consent/assent (legal guardian)

Exclusion criteria:

  • Patients with severe developmental disabilities
  • Unable to obtain electronic consent/assent from a legal guardian

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: OTHER
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Pop-Up Book
Patients read an interactive pop-up book about general anesthesia induction in addition to standard consultation with an anesthesia provider.
Other: Pop-Up Book
Patients spent 5-10 minutes reading an illustrated pop-up book that promoted active learning about the process of general anesthesia induction.
NO_INTERVENTION: Standard Care
Patients received standard consultation with an anesthesia provider (standard care).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Observer-Rated Behavioral Anxiety at Anesthesia Induction as assessed by the modified Yale Preoperative Anxiety Scale-Short Form
Time Frame: Baseline anxiety was rated upon initial entry into the preoperative holding area; anxiety at induction was rated while patients received inhalational induction via an anesthesia mask.
Patients' behavioral anxiety at anesthesia induction was assessed relative to baseline using the observer-rated modified Yale Preoperative Anxiety Scale-Short Form. The scale ranges from 22.92-100; higher scores indicate greater anxiety (worse outcomes). Raters were preoperative nurses and circulating nurses blinded to group assignments.
Baseline anxiety was rated upon initial entry into the preoperative holding area; anxiety at induction was rated while patients received inhalational induction via an anesthesia mask.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fear of Anesthesia Induction as assessed by the Children's Fear Scale
Time Frame: Fear was rated after education and before premedication was administered.
Patients self-reported their fear of anesthesia induction using the Children's Fear Scale. The scale ranges from 0-4; higher scores indicate greater fear (worse outcomes).
Fear was rated after education and before premedication was administered.
Expected Pain from the Anesthesia Mask and During Surgery as assessed by the Faces Pain Scale-Revised
Time Frame: Expected pain was rated after education and before premedication was administered.
Patients self-reported how much pain they expected (1) from the anesthesia mask and (2) while asleep for the surgical procedure using the Faces Pain Scale-Revised. The scale ranges from 0-5; higher scores indicate greater expected pain (worse outcomes).
Expected pain was rated after education and before premedication was administered.
Expectations about the Procedure, Attitudes about Anesthesia, and Views of Preoperative Explanations as assessed by a Likert-Scale Questionnaire
Time Frame: The outcomes were rated after education and before premedication was administered.
Patients self-reported their perceptions of the procedure and preoperative explanations (the pop-up book or provider consultation) using a 9-item Likert-scale questionnaire. The questionnaire was scored from 1-5; higher scores indicated more positive views (better outcomes).
The outcomes were rated after education and before premedication was administered.
Self-Reported Coping Strategies for Managing the Stress of Anesthesia Induction
Time Frame: Patients were interviewed after education and before premedication was administered.
In a prospective interview, patients reported coping strategies for managing the stress of anesthesia induction. Greater frequencies of adaptive coping strategies indicated better outcomes.
Patients were interviewed after education and before premedication was administered.
Caregiver Satisfaction with the Surgical Experience as assessed by a Likert-Scale Questionnaire
Time Frame: The questionnaire was administered after the patient underwent anesthesia induction.
Caregivers reported their satisfaction with the surgical experience using a 10-item Likert-scale questionnaire. The questionnaire was scored from 1-5; higher scores indicated more positive views (better outcomes).
The questionnaire was administered after the patient underwent anesthesia induction.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Children's Healthcare of Atlanta

Collaborators

Emory University

Investigators

  • Principal Investigator: Kara K Prickett, MD, Children's Healthcare of Atlanta; Emory University School of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

August 26, 2020

Primary Completion (ACTUAL)

December 18, 2020

Study Completion (ACTUAL)

December 18, 2020

Study Registration Dates

First Submitted

March 9, 2021

First Submitted That Met QC Criteria

March 11, 2021

First Posted (ACTUAL)

March 12, 2021

Study Record Updates

Last Update Posted (ACTUAL)

March 12, 2021

Last Update Submitted That Met QC Criteria

March 11, 2021

Last Verified

March 1, 2021

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • STUDY00000660

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Deidentified individual participant data (including data dictionaries) will be made available to interested researchers, in addition to study protocols, the statistical analysis plan, and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to Dr Kara Prickett [kara.prickett@emory.edu].

IPD Sharing Time Frame

The data will become available after publication.

IPD Sharing Access Criteria

Access will be granted to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to Dr Kara Prickett [kara.prickett@emory.edu].

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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