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Sosa‐Hernandez L, Vogel N, Frankiewicz K, Reaume C, Drew A, McVey Neufeld S, Thomassin K. Exploring emotions beyond the laboratory: A review of emotional and physiological ecological momentary assessment methods in children and youth. Psychophysiology 2024; 61:e14699. [PMID: 39367539 PMCID: PMC11579238 DOI: 10.1111/psyp.14699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/18/2024] [Accepted: 09/19/2024] [Indexed: 10/06/2024]
Abstract
Recent advancements in methodologies such as ecological momentary assessment (EMA) and ambulatory physiology devices have enhanced our ability to measure emotions experienced in daily life. Despite the feasibility of EMA for assessing children's and youth's emotional self-reports, the feasibility of combining it with physiological measurements in a real-life context has yet to be established. Our scoping review evaluates the feasibility and usability of implementing emotional and physiological EMA in children and youth. Due to the complexities of physiological EMA data, this review also synthesized existing methodological and statistical practices of existing studies. Following the PRISMA-ScR guidelines, we searched and screened PsycINFO, PubMed, and Web of Science electronic databases for studies that assessed children's and youth's subjective emotions and cardiac or electrodermal physiological responses outside the laboratory. Our initial search resulted in 4174 studies, 13 of which were included in our review. Findings showed significant variability in the feasibility of physiological EMA, with physiology device wear-time averaging 58.77% of study periods and data loss due to quality issues ranging from 0.2% to 77% across signals. Compliance for emotional EMA was approximately 60% of study periods when combined with physiological EMA. The review points to a lack of standardized procedures in physiological EMA and suggests a need for guidelines in designing, processing, and analyzing such data collected in real-life contexts. We offer recommendations to enhance participant engagement and develop standard practices for employing physiological EMA with children and youth for emotion, developmental, and psychophysiology researchers.
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Affiliation(s)
| | - Natasha Vogel
- Department of PsychologyUniversity of GuelphGuelphOntarioCanada
| | | | - Chelsea Reaume
- Department of PsychologyUniversity of GuelphGuelphOntarioCanada
| | - Abbey Drew
- Department of PsychologyUniversity of GuelphGuelphOntarioCanada
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Yun R, Caruso TJ. Identification and Treatment of Pediatric Perioperative Anxiety. Anesthesiology 2024; 141:973-983. [PMID: 39163600 DOI: 10.1097/aln.0000000000005105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Affiliation(s)
- Romy Yun
- Romy Yun, M.D.; Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesiology, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California
| | - Thomas J Caruso
- Thomas J. Caruso, M.D., Ph.D.; Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesiology, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California
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Samnakay S, von Ungern-Sternberg BS, Evans D, Sommerfield AC, Hauser ND, Bell E, Khan RN, Sommerfield DL. 3-Dimensional Virtual Reality Versus 2-Dimensional Video for Distraction During the Induction of Anesthesia in Children to Reduce Anxiety: A Randomized Controlled Trial. Anesth Analg 2024:00000539-990000000-00917. [PMID: 39178153 DOI: 10.1213/ane.0000000000007119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2024]
Abstract
BACKGROUND Preoperative anxiety is common in children. It can contribute to negative experiences with anesthetic induction and may cause adverse physiological and psychological effects. Virtual reality (VR) and electronic tablet devices are 2 audiovisual distraction tools that may help to reduce anxiety and enhance the preoperative experience. This study aimed to compare the use of an immersive 3-dimensional (3D) VR to 2-dimensional (2D) video on anxiety in children during induction of general anesthesia. METHODS Two hundred children (4-13 years) undergoing elective or emergency surgery under general anesthesia were enrolled in this randomized, controlled trial. Participants were randomized to use either the 3D VR goggles (intervention) or 2D video tablet (control) during anesthetic induction. Anxiety, the primary outcome, was measured using the modified Yale Preoperative Anxiety Scale Short Form (mYPAS-SF) at 2 time points: in the preoperative holding area before randomization (T1) and during induction of general anesthesia (T2). The primary outcome was analyzed using a linear regression model, including demographic and other covariates, to investigate any differences in anxiety scores. Secondary outcomes included evaluating compliance during the anesthetic induction (Induction Compliance Checklist), emergence of delirium (Cornell Assessment of Pediatric Delirium), perceived usefulness of the device, and child satisfaction. RESULTS Participant characteristics were similar between the 3D VR (n = 98) and 2D video (n = 90) groups, with a mean (±standard deviation) age 8. 8 ± 2.8 years. The median (lower quartile, upper quartile) mYPAS-SF scores for the 3D VR group at the preoperative holding area were 22.9 (22.9, 35.4), then 29.2 (24.0, 41.7) during induction. For the 2D Video group, the scores were 27.1 (22.9, 35.4) and then 30.2 (22.9, 41.1). No significant difference was observed in the increase in mYPAS-SF scores between groups (P = .672). Children in the 3D VR group were less likely to be rated as having a perfect induction (P = .039). There was no evidence of a difference between the groups in emergence delirium. Both devices were rated highly for usefulness and patient satisfaction. Children preferred VR, while anesthesiologists and parents felt the 2D was more useful. CONCLUSIONS This randomized controlled trial demonstrated that preoperative anxiety was equally low and induction compliance high with both 3D VR and 2D video distraction in children with parental presence during anesthetic induction.
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Affiliation(s)
- Sarah Samnakay
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Britta S von Ungern-Sternberg
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Daisy Evans
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- School of Physics, Mathematics and Computing, The University of Western Australia, Perth, Western Australia, Australia
| | - Aine C Sommerfield
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Neil D Hauser
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Emily Bell
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - R Nazim Khan
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- Department of Mathematics and Statistics, The University of Western Australia, Perth, Western Australia, Australia
| | - David L Sommerfield
- From the Perioperative Medicine Team, Perioperative Care Program, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
- Institute for Paediatric Perioperative Excellence, The University of Western Australia, Perth, Western Australia, Australia
- Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Western Australia, Australia
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Goel S, Mihandoust S, Joseph A, Markowitz J, Gonzales A, Browning M. Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:183-199. [PMID: 38166516 DOI: 10.1177/19375867231220398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
OBJECTIVE To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces. BACKGROUND Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted. METHODS This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient's journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants' perceptions about four spaces-waiting, preprocedure, procedure, and recovery. RESULTS Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups. CONCLUSIONS Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.
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Affiliation(s)
- Swati Goel
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Sahar Mihandoust
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Jonathan Markowitz
- Prisma Health, School of Medicine, University of South Carolina, Greenville, SC, USA
| | - Alec Gonzales
- Department of Industrial Engineering, Clemson University, SC, USA
| | - Matthew Browning
- Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, SC, USA
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Lööf G, Lönnqvist P. Role of information and preparation for improvement of pediatric perioperative care. Paediatr Anaesth 2022; 32:600-608. [PMID: 35167154 PMCID: PMC9311830 DOI: 10.1111/pan.14419] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
The perioperative period is a significant and stressful experience that may cause negative consequences in children, both in a short-term and long-term perspective. Despite a wide base of evidence stating the importance of adequate preparation to reduce anxiety, improve coping, cooperation and enhance recovery, many children continue to report that they feel unprepared for their perioperative experience. To secure children's right to request and need for preparation, the content, format, and availability of existing programs need to be scrutinized. Preparation programs in perioperative care must change from simply providing information to embracing the importance of children's need to process the information provided in order to learn and understand. Interactive web-based technology can function as a significant resource for preparation of children for perioperative procedures. By changing perspective from children's need for information to their need for learning and by developing preparation programs including adequate educational principles, web-based technology can be used to its fullest advantage as a healthcare learning and preparation resource.
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Affiliation(s)
- Gunilla Lööf
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Learning, Informatics, Management and EthicsKarolinska InstitutetStockholmSweden
| | - Per‐Arne Lönnqvist
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
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