Bookbased Emotion and Anxiety Reduction (BEAR)
Bookbased Emotion and Anxiety Reduction: A Children's Storybook Intervention to Reduce Preoperative Fear, a Single-center Prospective Randomized Controlled Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Background and Rationale:
Many children experience significant anxiety before scheduled surgical procedures. Literature indicates that up to 60% of pediatric patients exhibit substantial preoperative anxiety. This fear is primarily driven by an unfamiliar hospital environment, separation from parents, anticipation of pain, and a lack of understanding regarding the upcoming procedures. High levels of preoperative anxiety can complicate the clinical workflow, increase patient stress, elevate post-operative pain perception, and lead to negative postoperative behavioral changes. This study investigates whether a specially designed, age-appropriate children's book can effectively reduce preoperative anxiety. The educational book utilizes pictures and simplified language to explain the processes of anesthesia and surgery in a child-friendly manner.
Study Design and Objectives: This is a randomized controlled trial aiming to evaluate the efficacy of an educational children's book as a low-threshold intervention to mitigate preoperative anxiety in pediatric patients. The primary objective is to assess whether introducing this book during home preparation significantly decreases anxiety scores compared to standard care.
Participant Enrollment and Randomization: The study aims to enroll a total of 50 pediatric patients. Eligible participants are children aged 4 to 10 years scheduled for elective surgery (inguinal, umbilical, or ventral hernia repair) at the Inselspital Bern. Upon enrollment, participants will be randomly allocated into one of two parallel groups:
Intervention Group: Participants receive the specialized children's book for preoperative preparation at home.
Control Group: Participants receive standard preoperative preparation without the educational book.
Data Collection and Outcomes: Children's anxiety levels will be measured using an established, validated observational scale. Assessments will take place at two time points: during the initial preliminary outpatient examination (baseline) and on the day of surgery prior to the induction of anesthesia. Secondary outcomes and confounding variables will also be recorded, including:
The child's level of cooperation during the induction of anesthesia. The total dosage of anesthetic medication required. Parental anxiety levels, measured via a brief self-reported questionnaire.
Risk Assessment: Participation in this study carries minimal risk. The intervention consists solely of providing an educational book and observing standard clinical and behavioral outcomes. No additional medical interventions, invasive procedures, or alterations to the standard surgical protocol are involved.
Significance: If the intervention proves successful, this educational tool could be implemented into routine clinical practice to improve preoperative preparation and emotional well-being for pediatric surgical patients
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Viktoria A Pfeifle, Dr.med.
- Telefonnummer: 0041316643495
- E-mail: viktoria.pfeifle@insel.ch
Undersøgelse Kontakt Backup
- Navn: Alexander Fuchs, PD Dr. med.
- Telefonnummer: 0041316322384
- E-mail: alexander.fuchs@insel.ch
Studiesteder
-
-
Canton of Bern
-
Bern, Canton of Bern, Schweiz, 3010
- Children's Hospital, Inselspital, University Hospital Bern
-
Kontakt:
- Alexander Fuchs, PD Dr. med.
- Telefonnummer: 0041316322384
- E-mail: alexander.fuchs@insel.ch
-
Kontakt:
- Viktoria A Pfeifle, Dr. med.
- Telefonnummer: 0041316643495
- E-mail: viktoria.pfeifle@insel.ch
-
Ledende efterforsker:
- Viktoria A Pfeifle, Dr.med.
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Children aged 4 to 10 years at the time of surgery
- Scheduled for elective surgical intervention (inguinal hernia, umbilical hernia, epigastric or supraumbilical hernia)
- Understanding of the German language
- Written informed consent obtained from at least one parent or legal guardian
Exclusion Criteria:
- Emergency surgical procedures
- History of previous surgery
- Less than 7 days between randomization and surgical procedure
- Known developmental delay, cognitive impairment, or psychiatric disorder that may interfere with anxiety assessment
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Reading the book
Children receive a book preoperatively that they read together with their parents
|
A book that has been especially designed for this study, a children's story, that could prepare children before undergoing surgery will be handed out to the children and their caregivers.
They should read it before surgery.
|
|
Aktiv komparator: Standard care
Children do not receive the book preoperatively
|
Children do not receive this book
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
modified Yale Preoperative Anxiety Scale
Tidsramme: perioperative
|
Preoperative anxiety level on the day of surgery, measured using the modified Yale Preoperative Anxiety Scale (mYPAS), assessed prior to induction of anesthesia before administration of any sedative premedication. The mYPAS Scale ranges from 23,33 (minimum) to 100 (maximum), with higher scores indicating greater preoperative anxiety. The scale comprises 22 items across 5 behavioral categories (activity, vocalization, emotional expressivity, state of apparent arousal, use of parents). |
perioperative
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Baseline modified Yale Preoperative Anxiety Scale
Tidsramme: Baseline
|
Baseline preoperative anxiety level measured using the modified Yale Preoperative Anxiety (mYPAS) scale prior to any study-related intervention.
The mYPAS Scale ranges from 23,33 (minimum) to 100 (maximum), with higher scores indicating greater preoperative anxiety.
The scale comprises 22 items across 5 behavioral categories (activity, vocalization, emotional expressivity, state of apparent arousal, use of parents).
|
Baseline
|
|
Anesthetic medication
Tidsramme: perioperative
|
Amount of anesthetic medication used for induction of anesthesia, recorded from the anesthesia record.
The amount of anesthetic medication used for induction will be analyzed descriptively and exploratorily; no causal inference is planned.
|
perioperative
|
|
Demographics
Tidsramme: Baseline
|
Exploratory associations between preoperative anxiety and Age, Sex, Type of surgical procedure.
|
Baseline
|
|
Postoperative delirium
Tidsramme: perioperative
|
Incidence of Postoperative delirium will be assessed in the post-anesthesia care unit using the Pediatric Anesthesia Emergence Delirium (PAED) scale by trained clinical staff and analyzed exploratorily.
The PAED scale ranges from 0 (minimum) to 20 (maximum).
Higher total scores indicate more severe emergence delirium.
|
perioperative
|
|
Parental anxiety
Tidsramme: Baseline
|
Parental anxiety assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) prior to intervention.
The GAD-7 is a validated questionnaire widely used to quantify anxiety symptoms in adults.
The GAD-7 ranges from 0 (minimum) to 21 (maximum).
The higher the score, the more anxiety.
|
Baseline
|
|
Child compliance during induction (Induction Compliance Checklist)
Tidsramme: perioperative
|
Child compliance during anesthesia induction, assessed using the Induction Compliance Checklist (ICC), a behavioral compliance scale during induction of anesthesia.
This observational measure captures negative or non-compliant behaviors during anesthesia induction and provides complementary information on perioperative distress and cooperation.
The Induction Compliance Checklist ranges from 0 (minimum) to 10 (maximum).
Higher scores indicate poorer compliance during induction.
Lower scores indicate better cooperation.
|
perioperative
|
|
Parental educational level and age
Tidsramme: Baseline
|
Age of the parents and parental educational level, categorized according to the Swiss education system (primary, secondary I, secondary II, tertiary)
|
Baseline
|
|
Acceptability of the book intervention using a questionnaire
Tidsramme: postoperative
|
Acceptability of the intervention assessed descriptively using parental feedback by using a questionnaire.
|
postoperative
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: Thomas Riva, Prof. Dr. med., Department of Anaesthesiology and Pain Medicine, Inselspital Bern, University Hospital, University of Bern
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- BEAR-trial
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .