Management Of Anxiety In Children Research Articles

The Management of Procedure-Induced Anxiety in Children

The Management of Procedure-Induced Anxiety in Children

Virtual reality for intravenous placement in the emergency department-a randomized controlled trial.

This study sought to determine whether adding virtual reality (VR) was superior to standard of care alone in facilitating reduction in pain and anxiety among children who underwent intravenous catheterization in the emergency department (ED). Sixty-six children aged 6-16 years who needed intravenous placement received VR, or standard of care in the ED (videos, television, iPad, child life specialist). Outcome measures included change in pain score, level of anxiety, patient and parent satisfaction (pain and anxiety), number of trials, and procedure time. Compared with controls, the intervention group had similar age, sex, number of trials, and anesthetic use. Time of procedure was shorter in the VR group (median 5 min) but this was not statistically significant compared with 7 min for the control group. Pain in the intervention group was lower, even before the procedure. Difference in pain (before and after) and anxiety (after the procedure) were similar in both groups. Satisfaction from anxiety management was higher for the VR group (p < 0.007) and children rated VR significantly more "fun" (p < 0.024).Conclusion: VR was an effective distraction tool and increased satisfaction from anxiety management for this common pediatric procedure, and should be incorporated in management of anxiety in children in the ED setting.Trial registration: clinicaltrials.gov ID NCT03681730, https://clinicaltrials.gov/ct2/show/NCT03681730 What is Known: • Virtual reality is an evolving computer technology that shows some promise in the areas of acute and chronic pain management due to its ability to create effective distraction. What is New: • We report that among children in the emergency setting with intravenous catheterization, satisfaction from the use of VR for anxiety management should support implementation of VR systems for this procedure.

Effectiveness of distraction techniques in the management of anxious children - A randomized controlled pilot trial.

The aim was to evaluate and compare the effectiveness of two distraction techniques, magic trick and mobile dental game with tell-show-do (TSD) in the management of anxious children. Two hundred and thirty children aged 4-5 years were screened for their baseline anxiety using the Chotta Bheem-Chutki scale. A double-blinded randomized control trial was conducted among 60 children with high anxiety scores. They were randomly divided into three groups. Group 1 received a magic trick distraction technique. Group 2 received a mobile dental game distraction technique. Group 3, the control group received TSD. Readiness to accept the dental treatment and postoperative anxiety scores were recorded. Statistically significant reduction in the anxiety level was seen in children who received magic (P = 0.001), mobile dental game (P < 0.001), and TSD technique (P < 0.001). Based on the readiness to accept dental treatment, there was a statistically significant difference between the three groups (P = 0.025). The children in the mobile group were found to accept the treatment faster compared to the magic and TSD groups. All three techniques were equally effective in reducing the anxiety of children. The mobile dental game was superior to magic trick and TSD in terms of children's readiness to accept dental treatment.

Investigating the Effect of OrangeAroma on Anxiety in School-Age Children with Diabetes: A Randomized Clinical Trial

This study aimed to determine the effect of orange essence aromatherapy on anxiety in school-age children with diabetes, as anxiety reduction would be expected to have a positive impact on health in this population. This clinical trial enrolled 60 children with diabetes, who were randomized to either the experimental or the control group (30 in each group). For the children in the experimental group, two drops of orange essence were poured on to a strip of gauze inside an open box, which was then held at a 5-cm distance from the child's nose. The children were then asked to breathe deeply for a span of 2 minutes. The control group received only routine care for diabetes. Data were collected using the Spielberger State-Trait Anxiety Inventoryand the Revised Children's Manifest Anxiety Scale. Data were analyzed using SPSS version 19 to perform descriptive and analytical statistical tests. No significant difference was observed between children's anxiety inthe experimental and control groups (P>.05) prior to the use of orange essence aromatherapy. After the therapeutic intervention, the anxiety of the experimental group significantly decreased compared to that before the intervention (P<.05). Orange aromatherapy, which is nonpharmacological and non-invasive, may be a useful complementary medical treatment for the management of anxiety in children with diabetes.

Effectiveness of Distraction Techniques in The Management of Anxious Children in the Dental Operatory

Aims and objectives: To investigate the effect of distraction with a mobile phone video game in comparison with video viewing on the behavior of children undergoing local anesthesia injection during dental extraction and the treatment satisfaction as reported by children and pediatric dentists. Materials and methods: 30 children in the age group of 4-8 years with Frankel's behavior rating score of 2 who required local anesthesia for dental extraction were selected. There were two study groups; group 1 playing video game on the mobile phone and group 2 viewing videos of patient's favorite cartoon character on mobile phone as means of distraction during the preoperative period and during the course of the dental procedure. The level of anxiety of the patient and the pediatric dentist's satisfaction with the patient's behavior during the treatment were noted. Results: Mobile phone video games were found to be more effective for distracting kids in the dental operatory than viewing videos. Preoperative anxiety was found to be highly reduced with this method of distraction. Conclusion: A cartoon video or video game on a mobile phone can be offered to most children as they are easy to implement, portable, and effective method to reduce anxiety in the preoperative area and during injection of local anesthesia for dental extraction. These techniques of distraction also reduce operatory stress on the pediatric dentist.

Preoperative Anxiety in Preschool Children-Observational Study

Objectives: Pediatric preoperative anxiety (PPOA) has been a concerning matter for the past decades with a high prevalence and several adverse outcomes branching into social, developmental, behavioral and perioperative fields. The management of anxious children is a priority for minimizing PPOA of the upmost importance. The aim of the study was to assess the levels of preoperative anxiety and their relation to a group of selected variables in a pediatric population being submitted to ambulatory surgery under general anesthesia. Methods: Children’s anxiety was assessed using the modified Yale Preoperative Anxiety Scale-Short Version at the preoperative holding area (Time 1) and at the operation room during induction of anesthesia (Time 2). A cutoff value of 30 was used to differentiate anxious children from non-anxious children (scores ≤ 30). Results: 67 children were included in the study. 9 (13.4%) were anxious children at T1 and 24 (35.8%) at T2. A gender difference was not present (p=0.634 for T1, p=0.303 for T2), but the boys presented higher scores at both times and tend to have a significant increase from T1 to T2 (p=0.049). An overall change in the anxiety status from T1 to T2 does not tend to occur (p=0.01). Younger children tend to have higher scores although not statistically significant. No statistical significant difference was found between the remaining variables. Conclusions: The prevalence of anxious children presented is lower than the estimated worldwide and reveals both the result of correct practices and best use of resources. However, the scarcity of national studies exploring this topic renders an indication to implement similar future studies, with larger samples and further studying of the potential predisposing and contributing variables. The never-ending purpose should be to institute more customized programs for minimizing PPOA by means of multimodal combinations of anxiolytic practices.

Comparative efficacy and acceptability of psychotherapies for acute anxiety disorders in children and adolescents: study protocol for a network meta-analysis

IntroductionAnxiety disorders are associated with significant public health burden in young individuals. Cognitive-behavioural therapy (CBT) is the most commonly used psychotherapy for anxiety disorders in children and adolescents, but previous...

Undergraduates' perceptions of the value of practical inhalation sedation experience in a UK dental school.

This was to establish the level and reported value of paediatric IHS experience from the perspective of final year undergraduates and to evaluate whether those students with more experience expressed feeling better-prepared for future practice and more likely to undertake further postgraduate education in IHS. All final year students were invited to complete an anonymous questionnaire designed to elicit undergraduate perceptions of IHS using visual analogue scales and free-text questions. A response rate of 77 % was achieved. Results revealed that only 21 % of participants reported acting as operator sedationist in ten or more IHS cases. Thus, the majority of undergraduates' did not meet the recommended quantity of practical IHS experiences, as outlined by the British Dental Sedation Teachers Group. In general, students felt on the value of IHS in the management of anxious children and expressed a desire to undertake further postgraduate education in conscious sedation. However, those students with more experience of practical IHS expressed feeling better able to describe the IHS experience with patients and parents, and were more satisfied with the quality of teaching. Furthermore free-text comments revealed that, regardless of experience, students wished to gain more experience of the practical administration of IHS. There is a need to increase the provision of IHS training within an undergraduate curriculum, in addition to improving the accessibility of postgraduate sedation courses.

Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients.

The aim of this study was to evaluate and compare audio and audiovisual distraction aids in management of anxious pediatric dental patients of different age groups and to study children's response to sequential dental visits with the use of distraction aids. This study was conducted on two age groups, that is, 4-6 years and 6-8 years with 30 patients in each age group on their first dental visit. The children of both the age groups were divided into 3 subgroups, the control group, audio distraction group, audiovisual distraction group with 10 patients in each subgroup. Each child in all the subgroups had gone through three dental visits. Child anxiety level at each visit was assessed by using a combination of anxiety measuring parameters. The data collected was tabulated and subjected to statistical analysis. Tukey honest significant difference post-hoc test at 0.05% level of significance revealed audiovisual group showed statistically highly significant difference from audio and control group, whereas audio group showed the statistically significant difference from the control group. Audiovisual distraction was found to be a more effective mode of distraction in the management of anxious children in both the age groups when compared to audio distraction. In both the age groups, a significant effect of the visit type was also observed.

Overview of paediatric dental sedation: 1. current UK guidelines

The use of conscious sedation in paediatric dentistry is very beneficial for the management of anxious children. It is essential that it is provided according to national guidelines in a safe and effective manner. Dentists carrying out conscious sedation in children must be aware of current national guidance and the most appropriate techniques to use.

Effects of Cognitive-Behavioral Therapy on Anxiety in Children with Autism Spectrum Disorders: A Randomized Controlled Trial

We compared the effects of a 16-week Cognitive-Behavioral Therapy (CBT) program and a Social Recreational (SR) program on anxiety in children with Autism Spectrum Disorders (ASD). Seventy children (9-16 years old) were randomly assigned to either of the programs (n (CBT) = 36; n (SR) = 34). Measures on child's anxiety using the Spence Child Anxiety Scale--Child (SCAS-C) and the Clinical Global Impression-Severity scale (CGI--S) were administered at pre-, post-treatment, and follow-ups (3- and 6-month). Children in both programs showed significantly lower levels of generalized anxiety and total anxiety symptoms at 6-month follow-up on SCAS-C. Clinician ratings on the CGI-S demonstrated an increase in the percentage of participants rated as "Normal" and "Borderline" for both programs. Findings from the present study suggest factors such as regular sessions in a structured setting, consistent therapists, social exposure and the use of autism-friendly strategies are important components of an effective framework in the management of anxiety in children and adolescents with ASD.

Effectiveness of music distraction in the management of anxious pediatric dental patients

Management of Anxious Children in dental office still remains a challenge in day to day pediatric dental practice. The effect of different behavior management procedures in managing anxious children is well documented, for example distraction. This study is an attempt to evaluate the effect of music (audio) distraction in reducing the anxiety using Venham's picture test.

Behaviour management of anxious children

Children with dental anxiety may refuse treatment, which can lead to dental emergencies. Shannu Bhatia and Barbara Chadwick review a number of ways in which to manage the anxious child, and the role of the dental nurse.

Anxiety Disorders During Childhood and Adolescence: Origins and Treatment

The present review summarizes our current knowledge of the development and management of anxiety in children and adolescents. Consideration is given to limitations of this knowledge and directions for future research. The review begins with coverage of the development and demographic correlates of anxiety in young people and then moves to systematic discussion of some of the key etiological factors, including genetics, temperament, parenting, and individual experiences. The second part of the review describes current treatment strategies and efficacy as well as factors thought to influence treatment outcome, including treatment features, child factors, and parent factors. The review concludes with brief coverage of some more recent developments in treatment including alternative models of delivery and prevention strategies.

The Management of Preoperative Anxiety in Children: An Update

The Management of Preoperative Anxiety in Children: An Update

Childhood anxiety disorders: lessons from the literature.

Studies of childhood anxiety disorders have increased in recent years, but the clinical implications of the work are sometimes difficult to discern. This paper reviews salient findings (related to the assessment and management of anxious children) published in the last 5 years. The high comorbidity among disorders, the occurrence of different disorders in the same child over time, recent changes in diagnostic categories, the availability of new anxiety measures, and poor correspondence between parent and child reports of symptoms all underscore the need for thorough assessment. Increasing evidence supports cognitive-behavioural treatments for anxiety disorders, alone or in combination with pharmacotherapy. Other important aspects of management suggested by developmental studies of anxious children include psychoeducation about constitutional factors in the development of anxiety, interventions to address parental anxiety, parenting advice regarding behaviour management and reduction of family conflict, and treatment of child impairment to decrease the risk of depression. Questions requiring further research are identified.