Wong-Baker Faces Rating Scale Research Articles

Virtual reality use in pediatric patients for orthopedic clinical procedures: A randomized prospective trial of efficacy.

Distraction therapy use such as virtual reality is novel in the pediatric orthopedic field. In this study, we use subjective and objective metrics to evaluate virtual reality efficacy to reduce anxiety and pain in a pediatric orthopedic cohort. A prospective randomized controlled trial included patients between age 5 and 17 years, presenting to a tertiary care pediatric orthopedic clinic. Parallel groups underwent orthopedic procedures in clinic, utilizing immersive and interactive virtual reality distraction therapies versus standard of care. Procedures included cast application, cast removal, bone pin removal, and fracture reduction. All preprocedure parameters were similar between the groups. Primary outcome was the difference between maximum procedural heart rate and baseline. Secondary outcomes included Wong Baker FACES Rating Scale (Wong & Baker, 1988, Oklahoma, USA) for pain and Visual Analog Scale scores for anxiety. Ninety-five patients (66 M, 29 F) underwent 59 cast removals, 26 cast applications, 7 percutaneous pin removals, and 3 fracture reductions. Average patient age in the virtual reality and control cohorts was 10.1 (5-17) and 10.6 (5-17), respectively. Average change in maximum heart rate in the virtual reality and control groups was 10.6 ± 10.1 versus 18.4 ± 11.0 (p = 0.00048). The virtual reality group demonstrated trends toward lower perceived anxiety (1.7 ± 2.8 versus 2.9 ± 3.6, p = 0.0666) when compared to controls. This level 1 study is the first to utilize objective biometric measurements to evaluate use of interactive virtual reality during multiple types of pediatric orthopedic procedures in the clinical setting. The findings suggest that an interactive and immersive virtual reality experience can be effective in reducing pain and anxiety. Level 1, Randomized Controlled Trial.

PENGARUH HERBAL COMPRES BALL TERHADAP PENURUNAN NYERI OTOT PADA LANSIA

ABSTRACT
 
 Muscle pain is an unpleasant emotional and sensory experience associated with the risk of actual or potential damage. The results of a direct survey at the Palembang City Regional Social Home showed that the majority of elderly people experienced muscle pain. One non-pharmacological therapy to reduce the scale of muscle pain is Herbal Compress Ball therapy, the effect of which comes from heat conduction which can increase regional blood flow to the pain area, the analgesic effect comes from herbal ingredients and aromatherapy essential oils provide a relaxing effect. This study aims to determine the effect of the Herbal Compress Ball on reducing muscle pain in the elderly. The measuring tool used is an observation sheet with a muscle pain scale used is the Wong-Baker FACES Rating Scale, divided into no pain, mild pain, moderate pain, controlled severe pain, and uncontrolled severe pain. The design of this research is an experimental one-group pre-post test design. The sampling technique is purposive sampling with a sample size of 15 respondents. Data analysis was carried out using the Wilcoxon sign rank test, and the p value = 0.000 (p < 0.05). This research shows that there is an effect of Herbal Compress Ball on reducing muscle pain in the elderly in social institutions in the Palembang city area. It is hoped that future researchers can complete this research by adding a control group and comparing the effectiveness of the Herbal Compress Ball between the intervention group and the control group.

Quality of Life in Children With Achondroplasia Undergoing Paired Limb Lengthening With an External Fixator and Modified Distraction Control: Observational Nonrandomized Study.

Transosseous distraction osteosynthesis is prioritized in orthopedic care for children with achondroplasia. However, difficulties encountered during treatment and rehabilitation directly impact patients' quality of life. Using rod external fixators within a semicircular frame for osteosynthesis is less traumatic compared to spoke circular devices. Their straightforward assembly and mounting on the limb segment can help significantly reduce treatment duration, thereby improving children's quality of life during treatment and rehabilitation. This study aimed to conduct a comparative analysis of the quality of life (measured by postoperative pain syndrome, physical activity, and emotional state) among children with achondroplasia undergoing paired limb lengthening using either an external fixator with modified distraction control or a circular multiaxial system developed by the authors. This was an observational, prospective, nonrandomized, and longitudinal study with historical control. The study group consisted of 14 patients ranging from 5 to 15 (mean 7.6, SD 2.3) years old with a genetically confirmed diagnosis of achondroplasia. All patients underwent paired limb lengthening with a rod external fixator and a modified distraction control developed by the authors. A total of 28 limb segments, among them 4 (14%) humeri, 8 (29%) femurs, and 16 (57%) tibias, were lengthened in 1 round. Unpublished data from the previous study served as the control group, comprising 9 patients (18 limb segments) of the same age group (mean age at surgery 8.6, SD 2.3 years), who underwent limb lengthening surgery using a circular multiaxial system-2 (11%) humeri, 6 (33%) femurs, and 10 (56%) tibias. The Wong-Baker Faces Rating Scale was used to measure pain symptoms, while the Russified Pediatric Quality of Life (PedsQL) v4.0 questionnaire assessed quality of life. During the latent phase (7 to 10 days after surgery), a more pronounced decrease in the indicators of physical activity and emotional state on the PedsQL v4.0 questionnaire was noted in the control group (mean 52.4, SD 4.8 versus mean 52.8, SD 5.5 points according to children's responses and their parents' responses, respectively) compared to the experimental group (mean 59.5, SD 6.8 points and mean 61.33, SD 6.5 points according to the children's responses and their parents' responses, respectively). The differences between the groups were statistically significant (P<.05 for children's responses and P<.01 for parents' responses). Importantly, 6 months after surgery, these quality-of-life indicators, as reported by children in the experimental group, averaged 70.25 (SS 4.8) points. Similarly, their parents reported a mean of 70.54 (SD 4.2) points. In the control group, the corresponding values were 69.64 (SD 5.6) and 69.35 (SD 6.2), respectively. There was no statistically significant difference between the groups. The external fixator with modified distraction control developed by the authors provides a higher standard of living compared with the circular multiaxial system during the latency phase.

Efektivitas Senam Hamil terhadap Penurunan Nyeri Punggung pada Kehamilan Trimester III di RSUD Ciawi

Pain in the lower back is a common musculoskeletal problem during pregnancy with the prevalence of pregnant women in Indonesia being 4.8%, while for West Java it is 5.3%. One way to improve health during pregnancy is to do light exercise such as pregnancy exercise. Pregnancy exercise is able to release endorphins in the body, where the function of endorphins is as a sedative and can reduce back pain in pregnant women. This study aims to determine the effectiveness of pregnancy exercise on reducing back pain in third trimester pregnant women at Ciawi Hospital. This quasi-experimental study used a one group pretest and posttest design. The population totaling 20 respondents. The instrument used in this study was the Wong Baker FACES Rating Scale for pain measurement. Pregnancy exercise is done for 1 month to reduce back pain in pregnant women. From the results of the study, a significant value of paired sample t-test was obtained, a significant value of 0.002 &lt; 0.05, meaning that there was a change in back pain in third trimester pregnant women at Ciawi Hospital in 2021 before and after pregnancy exercise. There are significant results on changes in pain in back pain in third trimester pregnant women at Ciawi Hospital in 2021 before and after pregnancy exercise. It is hoped that health workers, especially midwives, can work together to increase education about back pain and the benefits of pregnancy exercise, so that pregnant women have awareness to do pregnancy exercise.

The effect of parental presence and dental anxiety on children's fear during dental procedures: A randomized trial.

Objective: To evaluate the effect of anxiety of parent accompanying child on child's anxiety during treatment. Methods: The study included two groups: one group with 80 children whose parents were anxious, and the other group with 80 children with non-anxious parents, totaling 160 children. Each group was further randomized into subgroups, with and without parents accompanying their children. The children's heart rates were measured using a portable pulse oximeter during the treatment. The child's perception was measured using the Wong-Baker Faces Rating Scale, and another pediatric dentist rated child's behavior using the Frankl scale based on the treatment video that was limited to the child's appearance. Results: The highest pulse rates were observed in children accompanied by an anxious parent (p < .001). Values on the Wong-Baker scale did not differ according to parental anxiety and parental presence (p > .05). According to the dentist, the presence of parents negatively affected the anxiety of the child (p = .025), while the effect of parents' anxiety was not statistically significant (p = .514). Conclusions: The anxiety of parent accompanying the child affects child's anxiety. Parents with high anxiety appeared to negatively affect their children's behavior.

The effect of parental presence on the child's perception and co-operation during dental treatment.

This was to study the influence of parental presence during dental treatment on children's behaviour and perception. Parents of 100 patients (mean age 7±2.2 years) who visited the Postgraduate Paediatric Dental Clinic were randomly divided into two equal groups during one familiarisation and two treatment sessions: (1) parent present in the surgery/operatory and (2) parent absent (with their child observed through a window). Both an independent paediatric dentist and the parent rated the child's behaviour using the Venham scale. The child's perception was measured using the Wong-Baker Faces Rating Scale (FPRS) at the end of every session. Statistical analysis was performed with the IBM Statistics SPSS 22.0 (p<0.05). Comparisons between variables were performed with the Mann-Whitney U, Wilcoxon and Friedman's tests. According to the paediatric dentist's rating, children's behaviour was worse when the parent was absent, with a significant difference only for the second restorative treatment session (p=0.011). There was no difference on parents' rating child behaviour scores between the two groups. There was no difference of children's own perception between the two groups, except for any increased discomfort found at the second treatment (p=0.021) when the parent was present. In both groups, the dentist rated lower Venham scores (better child behaviour), than parents did (presence: p=0.001, absence: p=0.038). Children recorded worse scores than both parents and the paediatric dentist. The only significant finding lay in the antithesis of how children perceived their last treatment session and how the dentist rated children's behaviour regarding parental presence. Parents' scores of their child's behaviour were unrelated to parental presence.

Randomized comparative trial of cervical block protocols for pain management during hysteroscopic removal of polyps and myomas.

PurposeTo evaluate the efficacy of two cervical block protocols for pain management during hysteroscopic removal of intrauterine polyps and myomas using the MyoSure® device.Patients and methodsThis was a randomized, comparative treatment trial conducted by five private Obstetrics and Gynecology practices in the USA. Forty premenopausal women aged 18 years and older were randomized to receive either a combination para/intracervical block protocol of 37 cc local anesthetic administered at six injections sites in association with the application of topic 1% lidocaine gel, or an intracervical block protocol of 22 cc local anesthetic administered at three injections sites without topical anesthetic, for pain management during hysteroscopic removal of intrauterine polyps and/or a single type 0 or type 1 submucosal myoma ≤3 cm. The main outcomes were a composite measure of procedure-related pain and pain during the postoperative recovery period, assessed by the Wong-Baker Faces Rating Scale (0= no pain to 10= maximum pain). The lesion characteristics, procedure time, and adverse events were summarized.ResultsA total of 17 polyps and eight myomas were removed in the para/intracervical block group, with diameters of 1.3±0.5 cm and 1.8±0.8 cm, respectively. In the intracervical block group, 25 polyps with a mean diameter of 1.2±0.7 cm and 7 myomas with a mean diameter of 1.9±0.9 cm were removed. The mean tissue resection time was 1.2±2.0 minutes and 1.2±1.4 minutes for the para/intracervical and intracervical block groups, respectively. The mean composite procedure-related pain score was low for both cervical block protocols, 1.3±1.4 in the para/intracervical block group vs 2.1±1.5 in the intracervical block group. During the postoperative recovery period, the mean pain scores were 0.3±0.7 vs 1.2±1.7 for the para/intracervical and intracervical block groups, respectively. There were no serious adverse events.ConclusionThe MyoSure procedure for removal of polyps and myomas was well tolerated, with low pain scores reported for both the para/intracervical and intracervical block protocols.

The Effect of Preintervention Preparation on Pain and Anxiety Related to Peripheral Cannulation Procedures in Children

This study was performed to determine the effect of several preintervention preparation practices on pain and anxiety related to the peripheral cannulation procedure in children ages 9-12 years. The study included 60 Turkish children (28 female, 32 male, randomly selected by lot), 30 of whom were included in the intervention group and 30 of whom were included in the control group. The children's demographic data were collected by a data collection form prepared by the researcher. The children in the intervention group read the training manual before peripheral cannulation, and the procedure was demonstrated on a teddy bear. Their level of pain was assessed using the Wong-Baker Faces Rating Scale, and their level of anxiety was determined by the Spielberger State-Trait Anxiety Inventory for Children, before and during the procedure in both groups. Results showed that while anxiety and pain scores increased during the actual procedure compared to the preparatory procedure in the control group (anxiety t = −4.957, pain Za = −4.048), anxiety and pain scores decreased during the actual procedure in the intervention group compared to the preparatory procedure (anxiety t = 7.896, pain t = 6.196). When the pain and anxiety scores were examined, it was found that both anxiety and pain scores in the intervention group were significantly lower than in the control group. In conclusion, children in this study experienced pain and situational anxiety during peripheral cannulation, and this pain can be reduced by preparing the child in advance of the procedure. It is suggested that children should be informed about and able to practice the procedure on a toy or model before peripheral cannulation. Preparation of the children to painful procedures in accordance with their cognitive development can reduce anxiety and pain.

Influence of parental presence on the child’s perception of, and behaviour, during dental treatment

To analyse the influence of the presence of the parent in the dental operatory on their child's behaviour during dental treatment. This study was a randomised controlled trial performed in a secondary paediatric dental care clinic. The child's perception of the dental treatment and its behaviour during treatment according to the parent and dentist were compared with parental presence in the operatory as independent variable. Age and dental anxiety were also calculated as co-variable. The child's perception of the treatment was assessed using the Wong-Baker Faces Rating Scale. The behaviour of the child according to parent and dentist was measured using Venham`s (modified) clinical rating of anxiety and cooperative behaviour. Statistical analysis was performed using Mann Whitney U tests and Independent Samples T Test. 90 children participated (50% girls, mean age 6.21 years old, SD ± 1.56). During the habituation session child's behaviour was better according to the dentist when the parents were not present in the operatory during treatment (p<0.01). There were no significant differences in a child's perception of the treatment in relation to parental presence or absence. Dentally anxious children behaved better according to the parent (treatment session 2) and the dentist (habituation session and treatment session 2) when the parent was not present in the operatory (p<0.05). Relying on a child's perception of dental treatment, a made no difference whether the child was treated with or without the parent(s) in the dental operatory. For anxious children it was mainly the dentist who was aware of the disadvantages of the parental presence.

A randomized controlled trial of an at‐home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery

To determine whether the implementation of at-home psychological preparation programme for children and family prior to surgery can reduce anxiety for Japanese preschool children undergoing herniorrhaphy and their caregivers assessed as an appropriate outpatient care. Patients were randomly assigned to either of two groups: the usual care group or the at-home preparation group. Both two groups viewed a patient-educational video for herniorrhaphy once as outpatients with other patients prior to hospitalization. The control group later underwent surgery without any further preparation. The experimental group watched the same educational video at home again with an auxiliary booklet prior to hospitalization. Children's anxiety was measured by the Wong-Baker FACES Rating Scale (FACES Rating Scale), while caregivers' anxiety was measured by the Spielberger's State Trait Anxiety Inventory (STAI). Both outcomes were measured repeatedly from pre-intervention to 1 month after surgery. Of the eligible 161 patients participating, 158 (98.1%) were randomly assigned to the control group (n = 81) and the experimental group (n = 77), and 144 (89.4%) completed the study. The experimental group gained more information and knowledge about surgery from parents and showed significantly lower scores than the controls for FACES and STAI. A specially designed at-home preparation programme as an outpatient care is effective to encourage parent-child verbal interaction concerning surgery and reduce both children and caregivers' anxiety associated with surgery.

Comparative Effects of Chlorhexidine Gluconate and Povidone Iodine Mouthwashes to Chemotherapy-Induced Oral Mucositis in Children with Acute Lymphoblastic Leukemia

Oral mucositis is one of a common, debilitating complication of cancer chemotherapy. Mucositis causes severe pain and distress, and may limit the tolerability of chemotherapy. The aim of this study was to compare the efficacy of chlorhexidine gluconate and povidone iodine mouthwashes on oral mucositis in children receiving chemotherapy for acute lymphoblastic leukemia (ALL). A total of 18 children age 2 to 10 years were participating in a clinical trial with pre-post test design and single blinded system. Subjects were divided into three groups, using chlorhexidine gluconate, povidone iodine, and alkaline saline as a control group, respectively. Clinical measurements to assess mucositis and pain were performed using General Mucositis Scale from WHO and Wong-Baker Faces Rating Scale, respectively. Children in all groups received daily oral hygiene instructions, and were examined daily until the mucositis heals. Data were analyzed by ANOVA and Newman-Keuls methods with significance value p=0.05. The results showed that mucositis and its related pain were disappeared after 5 to 7 days, 8 to 14 days, and 13 to 14 days using chlorhexidine gluconate, povidone iodine, and alkaline saline (control), respectively. It is concluded that chlorhexidine gluconate was more effective on the healing of oral mucositis than povidone iodine.

Ketorolac vs Chlorpromazine in the Treatment of Acute Migraine Without Aura

Many treatments for acute migraine exist. Chlorpromazine is effective but has serious side effects. Ketorolac has only rare side effects. To compare intramuscular ketorolac troinethamine with intravenous chlorpromazine hydrochloride in treating acute migraine. We performed a prospective, randomized, double-blind trial comparing the clinical effectiveness of 60 mg of intramuscular ketorolac tromethamine with 25 mg of intravenous chlorpromazine hydrochloride in patients with acute migraine headache seen in the emergency department. Pain intensity, quantitated using the Wong-Baker Faces Rating Scale, was measured every 30 minutes for 2 hours in the emergency department. Patients returned pain scores at 6, 12, 24, and 48 hours by mail. Fifteen patients were entered into each treatment arm. No differences were seen between the mean pain scores or the mean change in pain scores. The ketorolac group mean (+/- SEM) pain score decreased from 4.07 +/- 0.18 to 0.73 +/- 0.3 in 2 hours. The chlorpromazine group pain score decreased from 4.47 +/- 0.17 to 0.87 +/- 0.4. Two of the 3 nonresponders responded to the alternate group's treatment. No side effects were seen. Using 60 mg of intramuscular ketorolac tromethamine is as effective as 25 mg of intravenous chlorpromazine hydrochloride in the treatment of acute migraine headache. Patients who do not respond to one of these medications may respond to the other.