Anxiety Levels In Children Research Articles

Clinical Validation of a Custom Wearable Patch for Accurate and Comfortable Vital Sign Monitoring in Pediatric Patients

Background/Purpose: Measuring vital signs in pediatric patients requires special consideration and adaptation due to varying anatomy and wide age range. In addition, children's anxiety, uncooperativeness, and high activity levels further complicate measurements, necessitating devices and algorithms designed to minimize the inaccuracies and discomfort. In this work, the performance of a custom wearable patch mounted on the mid-sternum was validated in uncontrolled settings on a cohort including 84 pediatric patients. Methods: Three-minute-long electrocardiogram (ECG), seismocardiogram (SCG) and photoplethysmogram (PPG) signals were acquired using the custom patch. First, pre-processing and signal smoothing algorithms were employed to suppress the out-of-band and motion noise. Two different tasks were then studied: (i) Heart rate (HR) and respiration rate were derived from the ECG, PPG and SCG signals individually. During HR derivation from the SCG, a novel Teager-energy-based HR estimation algorithm was proposed. (ii) Clinical relevance of the SCG signals was shown through mapping the SCG characteristics to body mass index (BMI) and blood pressure values. Results: While the best HR estimation was achieved through the PPG-infrared signal with an absolute error of 2.22.1 bpm, the best respiration estimation was achieved with PPG-Red signal with an error of 2.62.2 breaths/min. On the other hand, regression models resulted in a minimum of 85% confidence interval, revealing that the SCG characteristics indeed have salient correlation with the BMI and blood pressure values. Conclusion: Overall, such a system can potentially be leveraged in clinical practices to achieve more comfortable and accurate measurements.

Challenges Of Obtaining Reliable Eyewitness Testimony from Children and Practical Implications

The reliability of eyewitness testimony provided by children has always been a controversial area in research. This paper addresses the challenges of obtaining reliable eyewitness testimony from children and explores its practical implications. The research background highlights the importance of understanding children's developmental stage, memory and language skills, and how these factors influence their ability to provide accurate testimony. The review explores the different aspects that influence the reliability of children's testimony, including verbal and non-verbal factors, cognitive instructions, and how to build trust. As children have high emotional needs, it is important to provide support while obtaining eyewitness testimony. The final section summarizes the main findings, highlighting the effectiveness of multiple interviews, flexible questioning strategies and the importance of parent and interviewer support. Disadvantages include differences in children's anxiety levels and the need to adapt interview techniques to children. Future research should focus on refining these techniques and studying the impact of different support systems on children from different backgrounds.

Glass ionomer fissure sealants versus fluoride varnish application on children's behaviour: a randomised controlled trial.

Glass ionomer fissure sealant (GIS) and fluoride varnish (NaFV) are two preventive interventions applicable to pre-school children. However, their application effects on young children's behaviour are understudied. The study compared the effects of GIS and NaFV applications on dental anxiety (DA), cooperativeness and pain level in pre-school children when applied to primary second molars in outreach settings. Four hundred and thirteen children were recruited for the study, out of which 228 were allocated to NaFV group whilstand 185 allocated to the GIS group. One calibrated examiner screened and randomly allocated the children into either group. Another calibrated examiner recorded the children's DA level and cooperativeness with Frankl Behaviour Rating Scale (FBRS) and Venham Behaviour Rating Scale (VBRS) throughout the treatment period. Subjects self-reported their pain levels using Wong-Baker Faces Scale (WBFS). Significant difference in postoperative anxiety was found using VBRS, with children in NaFV group having more positive scores post-treatment (p = 0.016). Only the type of preventive interventions significantly affected postoperative DA and patient cooperation (p = 0.032), whereas no other clinical findings and socio-demographic factors significantly influenced the children's behaviour postoperatively. NaFV application is associated with less DA and more cooperative behaviour in pre-school children compared to GIS application although similar pain levels were recorded.

Implementasi Terapi Bermain Plastisin Terhadap Penurunan Tingkat Kecemasan Pada Anak Pre Operasi Sirkumsisi Di Klinik Rathnoe Khitan Ngawi

Introduction: There are both religious and medical reasons for performing circumcision. There are many different approaches to circumcision, but it is still one of the most commonly performed surgical procedures worldwide. Children often experience significant levels of apprehension, fear, and pain before the circumcision procedure. Negative consequences, such as uncooperative circumcision, result from uncontrollable anxiety reactions. Objective: Using plasticine play therapy, this community service project aims to reduce anxiety in adolescent patients who will undergo circumcision surgery. This volunteer activity was conducted at Rathnoe Khitan Ngawi Clinic. Method: Implementing a hands-on plasticine play therapy method, followed by discussion and assessment, was the strategy used. Before and after receiving plasticine play therapy, the children's anxiety levels were assessed. Children at Rathnoe Khitan Ngawi Clinic who were waiting to be circumcised were the beneficiaries of this community service activity. Result: The results of this PkM are the anxiety level of the participants before the implementation of plasticine play therapy, the majority of participants felt moderate anxiety as many as 17 participants (85%), and after the implementation of plasticine play therapy there was a decrease in the anxiety scale to mild as many as 17 participants (85%). Conclusion: Based on the Wilcoxon test, the p-value is 0.001, which means that the p-value <0.05, it is concluded that there is an effect of pre and post implementation of play platisin therapy on reducing anxiety levels in children pre-circumcision surgery at the Rathnoe Khitan Ngawi Clinic.

Mental health among parents and their children with eczema in Hong Kong.

This cross-sectional survey research investigated mental health symptoms and quality of life among Chinese parents and their children with eczema at a paediatric dermatology clinic in Hong Kong from November 2018 to October 2020. Health-related quality of life, eczema severity, and mental health among children with eczema, as well as their parents' mental health, were studied using the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQOL), Nottingham Eczema Severity Score (NESS), Patient-Oriented Eczema Measure (POEM), and the Chinese version of the 21-item Depression, Anxiety, and Stress Scales (DASS-21). In total, 432 children and 380 parents were recruited. Eczema severity (NESS and POEM) and health-related quality of life (CDLQI) were significantly positively associated with parental and child depression, anxiety, and stress levels according to the DASS-21, regardless of sex (children: r=0.28- 0.72, P<0.001 to 0.007; parents: r=0.20-0.52, P<0.001 to 0.034). Maternal depression was marginally positively associated with increased anxiety in boys with eczema (r=0.311; P=0.045). Younger parents had higher risk of developing more anxiety and stress compared with the older parents (adjusted odds ratio [aOR]=-0.342, P=0.014 and aOR=-0.395, P=0.019, respectively). Depression level of parents with primary to secondary education was 58% higher than their counterparts with post-secondary education or above (aOR=-1.579; P=0.007). Depression, anxiety, and stress among children with eczema and their parents were associated with eczema severity and impaired quality of life in those children. These findings regarding impaired mental health in children with eczema and their parents highlight the need to include mental well-being and psychosocial outcomes in future studies and clinical practice.

Enhancing Pediatric Dental Care: The Influence of Virtual Reality.

The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children. The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB. The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety. This study concluded that VR reduced pain and anxiety levels in its passive and active forms.

Oops, we missed a spot: Comparing data substitution methods for non-random missing survey data in a longitudinal study

Imputation methods for missing data may not always be applicable, namely, when the data were completely missing for the whole sample. To estimate the missing data, we compared three missing item substitution methods: (1) mean substitution; (2) last observation carried forward (LOCF); and (3) regression-predicted values. A total of 384 parents reported their 8- to 18-year-old children's anxiety level using the 9-item Screen for Child Anxiety Related Disorders at baseline (Time 1) and two later time points, drawing from a larger longitudinal study (Ontario COVID-19 and Kids' Mental Health Study). We predicted a survey item measured one month after baseline (Time 2) using: (1) the mean value of the rest of the test items; (2) the value of the same item measured at baseline; and (3) the predicted value from the linear regression with all other test items as predictors. Within-Subjects ANOVA results showed a main effect of substitution methods on total score at Time 2. Post-hoc analysis indicated that mean substitution was significantly different from the actual data. Regression-predicted values overestimated the median compared to the actual values, while the LOCF estimation produced comparable means and identical medians. Similar results were found while using other indicators and extending the analysis to a larger 4-month time interval (Time 3), suggesting LOCF is more accurate and reliable than mean substitution or regression-prediction. This study proposes when advanced substitution methods are not applicable, a systematic comparison of alternative methods may help researchers to arrive at a more informed decision in data processing.

SPECIFICITY OF CHILDREN'S SOCIALIZATION IN COMPLETE AND PARENT FAMILIES

The article describes the specifics of the socialization process of children in complete and incomplete families. The research is based on the use of various methods: parental surveys and psychological tests. The main goal was to determine the level of anxiety in children and their individual characteristics influencing the socialization process.The study showed that children from incomplete families are characterized by a higher level of anxiety than children from complete families. During the study of personality traits of children according to R. Kettell's questionnaire, it was found that most children living in incomplete families and for various reasons raised by one parent show significant differences in some traits and behaviour, which may result from the fact that they have an incomplete picture of the family environment, unlike children from complete families. Such traits as emotional stability, normative behaviour and self-control are not characteristic of this category of children.The projective technique "My Family" made it possible to assess the specifics of relations between children and members of complete and incomplete families. Analysis of the research results showed that children with behavioural disorders more often appear in the drawings of children who have experienced a divorce of their parents than children in harmonious interpersonal interaction with their parents. The questionnaire "Analysis of family relations" (Eidemiller, Yustyckis) allowed to diagnose dysfunctions in the system of mutual influence of family members on each other and to detect errors in the parenting style chosen by the parents. Analysis of the answers of complete and incomplete families surveyed using this method and their comparison with the description of parenting styles allows to state that in incomplete families the features of excessively dominant care, excessive protection and excessive indulgence, emotional alienation prevail. Parents who raise their children separately or alone most often choose an "indulgent" parenting style.

Physiological Mechanisms of The Relationship Between Memory, Attention, and Arousal in Children Diagnosed with Autism

Autism is a developmental disorder with an early onset and lifelong duration that impairs social interaction and communication, with the condition being repeatedly diagnosed. To gain scientific knowledge about autism, one must observe these patients, perform a series of investigations and examinations, and finally obtain a general title. The first stage of getting to know children diagnosed with autism is one of the most important conditions for studying their psychology and inner world. Therefore, studying the psychology of children diagnosed with autism is also considered a responsible task for psychologists. The article presents the results of assessing the level of anxiety, stress, depression, attention and memory indicators in children with autism, which is an actual problem in recent times, in different age groups. The studies were conducted at two different locations: the Special Support, Special Training and Rehabilitation Centre (Tatvan district of Bitlis, Turkey) and the Psychological Centre Psychosocial Rehabilitation and Development Centre “PRIM” (Baku, Azerbaijan). Conducting studies in two different regions will reveal whether there is a difference between patients diagnosed with autism. The study examined children diagnosed with autism aged 6-12 years of both sexes (44 in Turkey; 51 in Azerbaijan). The results obtained in the study were compared with normal test limits. Psychological testing was conducted on an individual basis, and for the comprehensive study, the same child was tested repeatedly, with a certain frequency and with special attention. Although more boys than girls were included in the confirmed cases, since the aim was not to study gender differences, care was taken to obtain generalisable results. The attempt to clarify a complex topic such as stress in a broad topic such as autism characterises a very complex situation. Therefore, we have endeavoured to obtain more accurate results through the use of comprehensive tests. The main objective of the research work is to obtain certain results by using comprehensive psychological research methods in determining the level of stress and anxiety in children diagnosed with autism and to study the main characteristics of autism by comparing them with psychological indicators considered within the normal range. The results of studies conducted in Turkey and Azerbaijan showed the presence of low levels of attention and memory processes, behavioural disorders, aggressive and depressive behaviour in all age groups against the background of increased arousal. Children diagnosed with autism exhibit similar symptoms regardless of their geographical location, indicating that this disease has common characteristics regardless of national, racial, religious, and regional peculiarities.

Picture Coloring Play Therapy Affects Pre-School Children's Anxiety Levels During Hospitalization in St. Theresia Room Gunung Maria Tomohon Hospital

Hospitalization can be a distressing experience for children, leading to anxiety due to unfamiliar environments, treatments, and procedures. This study aimed to analyze the effect of coloring picture play therapy on anxiety levels in hospitalized preschool children at St. Theresia Room, Gunung Maria Tomohon Hospital. Using a pre-experimental pre-post test design, 15 preschool children were sampled through non-probability sampling. The Wilcoxon test and the Zung-Self Rating Anxiety Scale (ZSAS) were used for analysis. Results showed a significant effect of coloring picture play therapy on reducing anxiety, with a p-value of 0.001 &lt; α = 0.05. The study concludes that coloring picture play therapy effectively reduces anxiety in hospitalized preschool children.

Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery.

Preschoolers become anxious when they are about to undergo anesthesia and surgery, warranting the development of more appropriate and effective interventions. To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery. One hundred and sixteen preschool-aged children were selected and assigned to the drug (n = 37), intervention (n = 40), and control (n = 39) groups. All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation. The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments. The control group received no intervention. The modified Yale Preoperative Anxiety Scale was used to evaluate the children's anxiety level on the day before surgery (T0), before leaving the preoperative preparation room (T1), when entering the operating room (T2), and at anesthesia induction (T3). Compliance during anesthesia induction (T3) was evaluated using the Induction Compliance Checklist (ICC). Changes in mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) were also recorded at each time point. The anxiety scores of the three groups increased variously at T1 and T2. At T3, both the drug and intervention groups had similar anxiety scores, both of which were lower than those in the control group. At T1 and T2, MAP, HR, and RR of the three groups increased. The drug and control groups had significantly higher MAP and RR than the intervention group at T2. At T3, the MAP, HR, and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group. Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction (T3), both of which were higher than those of the control group. Combining static cartoons with dynamic virtual environments as effective as medication, specifically midazolam, in reducing preoperative anxiety and fear in preschool-aged children. This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

Penerapan Terapi Bermain Boneka Tangan terhadap Tingkat Kecemasan Hospitalisasi pada Anak Usia Prasekolah di RSUD Ir. Soekarno Kabupaten Sukoharjo

Hospitalization anxiety experienced by preschool children causes an increase in anxiety due to actions that cause trauma, children's hand puppets can explore the feelings they are experiencing. Objective: To determine the results of the implementation of hand puppet play therapy on the level of hospitalization anxiety in preschool children at the Ir. Soekarno Sukoharjo Regional Hospital. Method: This study used 2 respondents according to the inclusion and exclusion criteria, the method used pre-test and post-test, by providing hand puppet play therapy for 2 days carried out once a day for 30 minutes. Results: Results of the implementation of hand puppet play on hospitalization anxiety in preschool age children on day 1 of An. A got a score of 37 in the heavy category and An. B got a score of 28 in the heavy category. On the 2nd day on An. A got a score of 25 in the medium category and An. B got a score of 15 in the light category. Where the two patients before application were at a severe anxiety score and experienced a decrease in anxiety scores to moderate and mild. Conclusion: Hand puppet play therapy can reduce anxiety levels in children with hospitality.

Evaluating the Effectiveness of CHRIS'S Birds Assisted Therapy on Dental Anxiety among Pediatric Patients: A Pilot Study.

The heart of childhood nurtures an array of immature emotions. Through this rollercoaster of childhood emotions, from tears to laughter, it is the sole responsibility of a pediatric dentist to help the children navigate through their emotions with their empathetic actions. Whenever a child is anxious or fearful in the dental chair, the child may put forth his emotion through crying or taking up a flight response. Dental caries is a disease that is aggravated when a child refuses to cooperate with dental treatment. The tiny holes in the tooth, when unfilled, may lead to bigger problems, which in turn may lead to tooth loss in future. It is the comprehensive responsibility of the pediatric dentist to support health and emotional development and provide a complete, fulfilling oral rehabilitation to the child patient. The purpose of this study was to determine the anxiety levels of pediatric patients visiting the dental Outpatient Department at a Dental College and Hospital in Kavalkinaru. This study unveils a novel technique wherein birds were used in the form of CHRIS'S Birds Assisted Therapy to reduce anxiety in pediatric dental patients. Results showed that intervention with birds through CHRIS'S Birds Assisted Therapy significantly reduced the anxiety levels in children. Thus, CHRIS'S Birds Assisted Therapy is shown to be a promising method of anxiety control, a key to a successful pediatric dental practice. Joybell C, Kumar K. Evaluating the Effectiveness of CHRIS'S Birds Assisted Therapy on Dental Anxiety among Pediatric Patients: A Pilot Study. Int J Clin Pediatr Dent 2024;17(S-1):S84-S94.

Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study.

Background: The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. Objectives: To examine (1) the impact of CBD-rich cannabis treatment on autistic children's (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. Method: In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children's recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. Results: The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children's overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. Conclusions: The findings of the cannabis treatment's potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.

Push-Pull Mechanism of Attention and Emotion in Children with Attention Deficit Hyperactivity Disorder.

Background/Objectives: While deficits in executive attention and alerting systems in children with attention deficit hyperactivity disorder (ADHD) are well-documented, findings regarding orienting attention in ADHD have been inconsistent. The current study investigated the mechanism of attentional orienting in children with ADHD by examining their attentional bias towards threatening stimuli. Furthermore, we explored the modulating role of anxiety levels in ADHD on this attentional bias. Methods: In Experiment 1, 20 children with ADHD and 26 typically developing children (TDC) performed a continuous performance task that included task-irrelevant distractions consisting of angry faces and neutral places. In Experiment 2, 21 children with ADHD and 25 TDC performed the same task, but with angry and neutral faces as distractors. To measure children's anxiety levels, the State-Trait Anxiety Inventory was administered before each experiment. Results: In Experiment 1, results revealed no attentional bias effects in children with ADHD, whereas TDC exhibited attentional capture effects by both types of distractors. However, in Experiment 2, ADHD children demonstrated an attentional bias towards angry faces, which revealed a significant positive correlation with their trait anxiety levels (r = 0.61, p < 0.05). Further analyses combining all ADHD children showed that trait anxiety levels in Experiment 2 were significantly higher than those in Experiment 1. Finally, a significant positive correlation was found between anxiety levels and attentional bias towards angry faces in all ADHD children (r = 0.36, p < 0.01). Conclusions: Children with ADHD exhibited atypical attentional-orienting effects to threats, and their levels of trait anxiety appeared to modulate such attentional-orienting mechanisms.

Motivation in Preschool Children: The Predictive Effect of Anxiety Level

This study aimed to examine the relationship between motivation levels and anxiety levels of preschool children. Relational Screening Model was used in the research. The sample of the study consists of 48-72 months old children attending kindergartens and nursery classes of official primary schools affiliated with the Ministry of National Education in the central districts of Palandöken and Yakutiye in Erzurum province in the fall semester of the 2023-2024 academic year. The study data were collected using the "Personal Information Form", the "Motivation Scale for Preschool Children" and the "Anxiety in Preschool Children Scale (Teacher Form)". As a result of the study, it was determined that the motivation levels of the children did not differ according to the variables of gender and school type, and the anxiety levels of the children did not differ according to the gender variable (p&gt;0.05), while the anxiety levels of the children differed significantly according to the variables of school type (p

Virtual reality reduces anxiety of children in the plaster room: a randomized controlled trial.

Paediatric fractures are highly prevalent and are most often treated with plaster. The application and removal of plaster is often an anxiety-inducing experience for children. Decreasing the anxiety level may improve the patients' satisfaction and the quality of healthcare. Virtual reality (VR) has proven to effectively distract children and reduce their anxiety in other clinical settings, and it seems to have a similar effect during plaster treatment. This study aims to further investigate the effect of VR on the anxiety level of children with fractures who undergo plaster removal or replacement in the plaster room. A randomized controlled trial was conducted. A total of 255 patients were included, aged five to 17 years, who needed plaster treatment for a fracture of the upper or lower limb. Randomization was stratified for age (five to 11 and 12 to 17 years). The intervention group was distracted with VR goggles and headphones during the plaster treatment, whereas the control group received standard care. As the primary outcome, the post-procedural level of anxiety was measured with the Child Fear Scale (CFS). Secondary outcomes included the children's anxiety reduction (difference between CFS after and CFS before plaster procedure), numerical rating scale (NRS) pain, NRS satisfaction of the children and accompanying parents/guardians, and the children's heart rates during the procedure. An independent-samples t-test and Mann-Whitney U test (depending on the data distribution) were used to analyze the data. The post-procedural CFS was significantly lower (p < 0.001) in the intervention group (proportion of children with no anxiety = 78.6%) than in the control group (56.8%). The anxiety reduction, NRS pain and satisfaction scores, and heart rates showed no significant differences between the control group and the intervention group. Subanalyses showed an increased effect of VR on anxiety levels in young patients, females, upper limb fractures, and those who had had previous plaster treatment. VR effectively reduces the anxiety levels of children in the plaster room, especially in young girls. No statistically significant effects were seen regarding pain, heart rate, or satisfaction scores.

Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial

PurposeThere are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents. DesignA randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators. MethodsPerioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) > 44, STAI (child) > 36, and mYPAS-SF ≥ 30. FindingsNo significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child’s postoperative anxiety. Furthermore, children’s postoperative state anxiety was slightly correlated with postoperative pain. ConclusionsShort-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child.

Utilizing Puzzle Play Therapy for Alleviating Anxiety in Hospitalized Preschool Children

Objective: The aim of this study is to explore the effectiveness of puzzle play therapy in reducing anxiety levels among hospitalized preschool children (aged 3–6 years old) in the Flamboyan Ward at Dr. Moewardi Hospital. Method: Using a descriptive approach, the research adopts a case study design. Results: Both participants demonstrated a reduction in anxiety levels as per the Preschool Anxiety Scale (PAS) assessments conducted before and after the intervention. An. Ab’s anxiety level decreased from 4 (very severe anxiety) to 2 (moderate anxiety), while An. Ak’s anxiety level decreased from 3 (severe anxiety) to 1 (mild anxiety). Conclusion: The findings indicate that puzzle play therapy effectively reduces anxiety levels in preschool children, including those with severe and very severe anxiety levels. The author’s implementation of puzzle play therapy has proven to be successful in alleviating anxiety in children.

Penerapan Metode Clustering Kecemasan Anak Terhadap Bullying

Bullying is a verbal or non-verbal bullying activity through the media (cyber bullying) or directly, carried out by a child or group of children against other children. Aggressive behavior such as bullying among teenagers results in problems such as anxiety. The problem at SMKN 2 Binjai in 2024 is the difficulty of identifying children's anxiety about bullying disorders because there is no strong reference as evidence for cases of bullying carried out by perpetrators against victims. So research is needed to cluster gender, type of bullying and children's anxiety levels, with many parties still not monitoring children's activities enough to see how big the impact is on children who experience bullying. The aim of this research is to determine gender, type of bullying and different levels of anxiety among children who experience bullying. Based on the results of grouping bullying cases using the K-Means algorithm, 3 clusters and 3 iterations were obtained, where cluster 1 contained 9 data. , cluster 2 has 4 data and cluster 3 has 7 data, so it can be concluded that bullying cases tend to occur in women who experience types of bullying in the form of cyber and psychological with a mild level of anxiety.