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Le May S, Wu W, Francoeur M, Dodin P, Doyon-Trottier E, Hung N, Guingo E, Vu AK, Sylfra A, Lessard L, Cara-Slavich S, DeKoven K. Topical anesthetics for needle-related pain in adults and children (TOPIC): a mini-review. Front Pain Res (Lausanne) 2024; 4:1350578. [PMID: 38259980 PMCID: PMC10800406 DOI: 10.3389/fpain.2023.1350578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Healthcare professionals (HCP) perform various needle procedures that can be distressing and painful for children and adults. Even though many strategies have been proven effective in reducing distress and pain, topical anesthetic use before needle procedures is uncommon. However, there are limited studies in the existing literature comparing specifically liposomal lidocaine and tetracaine hydrochloride topical creams. Source This systematic review analyzed studies on the use of two anesthetic creams, Liposomal Lidocaine (Maxilene®) and Tetracaine hydrochloride (Ametop™), in children and adults undergoing a needle-related procedure. Databases searched: PubMed, CINAHL, ClinicalTrials. Only randomized controlled trials (RCT) and Controlled Clinical Trials (CCT) studies were included. Cochrane Collaboration's Risk of Bias assessment tool was used. Strictly minimally invasive procedures were included to standardize different skin needle interventions. Principal findings Only one study with 60 participants was available to be included in this review. No statistically significant difference was found in the mean pain score among both interventions. The outcomes of self-reported distress during cannulation and on HCP satisfaction were not reported. However, physiological characteristics associated with stress/anxiety and on cannulation success rate were reported and did not show statistical significance. Conclusion Little to no evidence regarding the most efficient cream between liposomal lidocaine and tetracaine hydrochloride for pain management during needle-related procedures was found. Further studies, particularly RCT with larger sample sizes and standardized outcome measures, are needed to confirm the relative efficacy of either anesthetic cream.
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Affiliation(s)
- Sylvie Le May
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, QC, Canada
| | - Wenjia Wu
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Faculty of Dental Medicine, University of Montreal, Montreal, QC, Canada
- Department of Dental Medicine, CHU Sainte-Justine, Montreal, QC, Canada
| | - Maxime Francoeur
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Philippe Dodin
- Medical Librairies, Direction de l’enseignement, CHU Sainte-Justine, Montreal, QC, Canada
| | - Evelyne Doyon-Trottier
- Emergency Department, CHU Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Nicole Hung
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Estelle Guingo
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Creation and New Medias, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, QC, Canada
| | - An Kateri Vu
- Faculty of Dental Medicine, University of Montreal, Montreal, QC, Canada
| | - Annie Sylfra
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Laurence Lessard
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Stephany Cara-Slavich
- Institut TransMedTech, CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Kathryn DeKoven
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Anesthesiology, CHU Sainte-Justine, Montreal, QC, Canada
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Ali S, Yukseloglu A, Ross CJ, Rosychuk RJ, Drendel AL, Manaloor R, Johnson DW, Le May S, Carleton B. Effects of pharmacogenetic profiles on pediatric pain relief and adverse events with ibuprofen and oxycodone. Pain Rep 2023; 8:e1113. [PMID: 38027465 PMCID: PMC10659733 DOI: 10.1097/pr9.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/27/2023] [Accepted: 08/10/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Individual genetic variation may influence clinical effects for pain medications. Effects of CYP2C9, CYP3A4, and CYP2D6 polymorphisms on clinical effectiveness and safety for ibuprofen and oxycodone were studied. Objective Primary objectives were to AU2 evaluate if allelic variations would affect clinical effectiveness and adverse events (AEs) occurrence. Methods This pragmatic prospective, observational cohort included children aged 4 to 16 years who were seen in a pediatric emergency department with an acute fracture and prescribed ibuprofen or oxycodone for at-home pain management. Saliva samples were obtained for genotyping of allelic variants, and daily telephone follow-up was conducted for 3 days. Pain was measured using the Faces Pain Scale-Revised. Results We included 210 children (n = 140 ibuprofen and n = 70 oxycodone); mean age was 11.1 (±SD 3.5) years, 33.8% were female. Median pain reduction on day 1 was similar between groups [ibuprofen 4 (IQR 2,4) and oxycodone 4 (IQR 2,6), P = 0.69]. Over the 3 days, the oxycodone group experienced more AE than the ibuprofen group (78.3% vs 53.2%, P < 0.001). Those with a CYP2C9*2 reduced function allele experienced less adverse events with ibuprofen compared with those with a normal functioning allele CYP2C9*1 (P = 0.003). Neither CYP3A4 variants nor CYP2D6 phenotype classification affected clinical effect or AE. Conclusion Although pain relief was similar, children receiving oxycodone experienced more AE, overall, than those receiving ibuprofen. For children receiving ibuprofen or oxycodone, pain relief was not affected by genetic variations in CYP2C9 or CYP3A4/CYP2D6, respectively. For children receiving ibuprofen, the presence of CYP2C9*2 was associated with less adverse events.
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Affiliation(s)
- Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry and Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, Canada
| | - Aran Yukseloglu
- Department of Pediatrics, Faculty of Medicine & Dentistry and Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, Canada
| | - Colin J. Ross
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Rhonda J. Rosychuk
- Department of Pediatrics, Faculty of Medicine & Dentistry and Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, Canada
| | - Amy L. Drendel
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robin Manaloor
- Department of Anaesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - David W. Johnson
- Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, CHU Sainte-Justine Research Centre, Montreal, QC, Canada
| | - Bruce Carleton
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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3
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Wu W, Le May S, Hung N, Fortin O, Genest C, Francoeur M, Guingo E, St-Arneault K, Sylfra A, Vu AK, Carmel J, Lessard L, Cara-Slavich S, De Koven K, Paquette J, Hoffman H, Asselin ME. Effects of a Virtual Reality Game on Children's Anxiety During Dental Procedures (VR-TOOTH): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49956. [PMID: 37948113 PMCID: PMC10674143 DOI: 10.2196/49956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Dental fear and anxiety (DFA) is a condition that affects approximately one-quarter of children and adolescents. It is a significant cause for pediatric patients to avoid dental care later in adulthood. Lack of patient cooperation due to DFA can create an environment of stress, often obligating dentists to end appointments prematurely and consider alternative pharmacological treatment options. Virtual reality (VR) use during dental care, providing an immersive experience through sensory stimuli, is potentially an additional nonpharmacologic tool to better manage DFA in children with special health care needs (SHCN) undergoing dental procedures. OBJECTIVE This pilot study aims to assess the feasibility and acceptability of VR immersion as a tool to reduce DFA in pediatric special needs patients undergoing dental procedures. The study also aims to gain insight on parent and health care provider perspectives on the use of VR during dental appointments. METHODS This pilot randomized controlled trial study will follow a parallel design including 2 groups: a control group (clinic's standard care using a wall TV) and an experimental group (using a VR game). We will randomize 20 participants to either group. Recruitment will be carried out at the dental clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary-quaternary care center that mostly serves pediatric patients with SHCN. The primary outcome will be patient recruitment rates and completion rates of planned procedures. DFA in children will be assessed using both an observation-based proxy assessment with the Venham Anxiety and Behavior Rating Scale and physiological assessments using parameters such as change in heart rate and levels of salivary alpha-amylase as a stress biomarker before and 10 minutes after the procedure. Sociodemographic characteristics, measures of the levels of parent and health care professional satisfaction, occurrence of side effects, and any deviation from normal procedure length will also be collected. Descriptive statistics, nonparametric tests, and effect sizes will be used for demographic and clinical variables and to present parent and health care professional satisfaction levels as well as procedural time. RESULTS This study will be conducted from May 2023 to May 2024, with results expected to be available in December 2024. CONCLUSIONS The pilot study will provide insight on the feasibility and acceptability of VR use in clinical dentistry to reduce DFA for pediatric patients with SHCN. This study will guide future research on VR use in pediatric dentistry and can serve as a framework for a larger randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT05898100; https://classic.clinicaltrials.gov/ct2/show/NCT05898100. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49956.
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Affiliation(s)
- Wenjia Wu
- Department of Dental Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Sylvie Le May
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Nicole Hung
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Olivier Fortin
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Trauma Studies Centre, Le Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Maxime Francoeur
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Estelle Guingo
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Université du Québec en Abitibi-Témiscamingue, Quebec, QC, Canada
| | - Kate St-Arneault
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Annie Sylfra
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - An Kateri Vu
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Janick Carmel
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Laurence Lessard
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Stephany Cara-Slavich
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Katheryn De Koven
- Department of Anesthesia, Centre Hospitalier Universitaire St-Justine Hospital, Montreal, QC, Canada
| | - Julie Paquette
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | | | - Marie-Eve Asselin
- Department of Dental Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
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Flores A, Hoffman HG, Navarro-Haro MV, Garcia-Palacios A, Atzori B, Le May S, Alhalabi W, Sampaio M, Fontenot MR, Mason KP. Using Immersive Virtual Reality Distraction to Reduce Fear and Anxiety before Surgery. Healthcare (Basel) 2023; 11:2697. [PMID: 37830734 PMCID: PMC10572694 DOI: 10.3390/healthcare11192697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
Presurgical anxiety is very common and is often treated with sedatives. Minimizing or avoiding sedation reduces the risk of sedation-related adverse events. Reducing sedation can increase early cognitive recovery and reduce time to discharge after surgery. The current case study is the first to explore the use of interactive eye-tracked VR as a nonpharmacologic anxiolytic customized for physically immobilized presurgery patients. Method: A 44-year-old female patient presenting for gallbladder surgery participated. Using a within-subject repeated measures design (treatment order randomized), the participant received no VR during one portion of her preoperative wait and interactive eye-tracked virtual reality during an equivalent portion of time in the presurgery room. After each condition (no VR vs. VR), the participant provided subjective 0-10 ratings and state-trait short form Y anxiety measures of the amount of anxiety and fear she experienced during that condition. Results: As predicted, compared to treatment as usual (no VR), the patient reported having 67% lower presurgical anxiety during VR. She also experienced "strong fear" (8 out of 10) during no VR vs. "no fear" (0 out of 10) during VR. She reported a strong sense of presence during VR and zero nausea. She liked VR, she had fun during VR, and she recommended VR to future patients during pre-op. Interactive VR distraction with eye tracking was an effective nonpharmacologic technique for reducing anticipatory fear and anxiety prior to surgery. The results add to existing evidence that supports the use of VR in perioperative settings. VR technology has recently become affordable and more user friendly, increasing the potential for widespread dissemination into medical practice. Although case studies are scientifically inconclusive by nature, they help identify new directions for future larger, carefully controlled studies. VR sedation is a promising non-drug fear and anxiety management technique meriting further investigation.
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Affiliation(s)
- Araceli Flores
- Ben Taub Hospital Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
- William Beaumont Army Medical Center, Fort Bliss, TX 79918, USA
- El Paso VA Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, El Paso, TX 79930, USA
| | - Hunter G. Hoffman
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Maria Vicenta Navarro-Haro
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón (IISA), 50009 Zaragoza, Spain
| | - Azucena Garcia-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, 12006 Castelló de la Plana, Spain;
| | - Barbara Atzori
- Department of Health Sciences, University of Florence, 50121 Florence, Italy;
| | - Sylvie Le May
- Centre de Recherche du CHU Sainte-Justine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de Recherche de l’Institut, Universitaire en Santé Mentale de Montréal (CRIUSMM), Montreal, QC H1N 3M5, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC H1N 3M5, Canada
| | - Wadee Alhalabi
- Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Computer Science, Dar Alhekma University, Jeddah 21589, Saudi Arabia
| | - Mariana Sampaio
- Department of Social Work, Catholic University of Portugal, 1649-023 Lisboa, Portugal;
- Department of Psychology, University of Coimbra, 1649-023 Lisboa, Portugal
| | - Miles R. Fontenot
- Department of Anesthesiology & Pain Medicine, School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Keira P. Mason
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children’s Hospital, Boston, MA 02115, USA;
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5
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Sidhu K, Kim D, Lebel D, Alshammari A, Photopoulos G, Duarte MP, Provost M, Nielsen C, Oitment C, Cowley R, Dumas E, Dea N, Versteeg A, Eltit F, Rampersaud YR, Dandurand C, Grassner L, Alduwaisan A, Kennedy C, Christie S, Toobaie A, Algarni N, El-Mughayyar D, Pahuta M, Grassner L, Pelletier-Roy R, Bak AB, Singh S, Abbas A, Abbas A, Abbas A, Ajisebutu A, Aldahamsheh O, Martin S, Baron N, Basiratzadeh S, Beresford-Cleary N, Good C, Thomson A, Bhatt F, Bhatt F, Good C, Thomson A, Blake N, Briand MM, Shah V, Chen T, Cherry A, Rocos B, Cherry A, Chua R, Chua R, Cotter T, Coyle MJ, Dandurand C, Dandurand C, Dandurand C, Dauphinee E, Dionne A, El Bojairami I, Duarte MP, Duarte MP, Elahi MT, Ellingwood N, Ells B, Fallah N, Fernandes R, Fernandes R, Fleury C, Flórez-Jiménez S, Li P, Gennari A, Georgiopoulos M, Greene R, Yu C, Werthmann N, Hakimjavadi R, Hakimjavadi R, Heard B, Hutchison C, Kemna C, Kennedy C, Laflamme M, Laskin J, MacLean M, Mac-Thiong JM, Manson N, Manson N, Manson N, Urquhart J, Kuepper E, Pahuta M, Pahuta M, Parker E, Persad A, Phan K, Rachevitz M, Ridha B, Dhaliwal P, Sakoto S, Sarraj M, Sarraj M, Hache P, Singh S, Slosar P, Sun M, Sundararajan K, Sundararajan K, Thornley P, Thornley P, Thornley P, Thornley P, Thorogood N, Toobaie A, Belhouari S, Olotu O, Du JT, Saleh I, Varga A, Varshney V, Versteeg A, Visnjevac O, Wang Z, Wasim A, Wasim A, Wu J, Filezio M, Singh V, Ferri-de-Barros F, Dermott J, Lebel D, Machida M, Bath N, Levin D, Campbell F, Koyle M, Isaac L, Ruskin D, Brennenstuh S, Stinson J, Navarro-Ramirez R, Rabau O, Ouellet JA, Hurry J, Brooks J, Fitzgerald R, Louer C, Murphy J, Shaw KA, Smit K, El-Hawary R, Joncas J, Parent S, Duval M, Chèmaly O, Brassard F, Mac-Thiong JM, Barchi S, Labelle H, Beauséjour M, Ishimo MC, Joncas J, Labelle H, Le May S, Lewis L, Arnold K, Oitment C, Jentzsch T, Lewis S, Rienmuller A, Jentzsch T, Yashuv HS, Martin A, Nielsen C, Berven S, Ludwig T, Coyle M, Asmussen M, Edwards B, Nicholls F, Bigney E, Fleury C, El-Mughayyar D, Cherry A, Vanderwint A, Richardson E, Kerr J, McPhee R, Abraham E, Manson N, Attabib N, Small C, Couture J, Goulet J, Bédard S, Lebel K, LaRue B, Investigators CSORN, Gal R, Verlaan JJ, Charest-Morin R, Fisher CG, Wessels H, Verkooijen L, Ng T, Gokaslan Z, Fisher C, Dea N, Charest-Morin R, Urquhart J, Glennie A, Fisher C, Bailey C, Mcintosh G, Fisher C, Paquet J, Abraham E, Bailey C, Weber M, Johnson M, Nataraj A, Glennie A, Attabib N, Kelly A, Hall H, Rampersaud R, Manson N, Phan P, Thomas K, Dea N, Thomé C, Kögl N, Vo AK, Kramer JLK, Petr O, Visva S, Phan K, Nguyen-Luu T, Stratton A, Kingwell S, Wai E, Phan P, Puskas D, Pahuta M, Marion T, Greene R, Kehler S, Rockwood K, Urquhart J, Thornley P, Rasoulinejad P, Glennie A, Rampersaud R, Manson N, Abraham E, Fisher C, Charest-Morin R, Paquette S, Gélinas-Phaneuf N, Thomas K, Dea N, Dvorak M, Kwon B, Street J, Ailon T, Christie S, Bailey C, McIntosh G, Dea N, Charest-Morin R, Adams T, Bigney E, Cunningham E, Richardson E, Vandewint A, Attabib N, Abraham E, Manson N, Small C, LeRoux A, Kolyvas G, Investigators CSORN, Hebert J, Jiang E, Fisk F, Taliaferro K, Stukas S, Cooper J, Gill J, Fallah N, Skinnider MA, Belanger L, Ritchie L, Tsang A, Dong K, Streijger F, Street J, Paquette S, Ailon T, Dea N, Charest-Morin R, Fisher CG, Dvorak MF, Wellington C, Kwon BK, Dionne A, Richard-Denis A, Briand MM, Bourassa-Moreau É, Mac-Thiong JM, Moghaddamjou A, Fehlings MG, Nadeau M, Fisher C, Toor J, Larouche J, Finkelstein J, Whyne C, Yee A, Toor J, Du JT, Versteeg A, Yee N, Finkelstein J, Abouali J, Nousiainen MT, Kreder H, Whyne C, Larouche J, Toor J, Lewis S, Finkelstein J, Larouche J, Yee A, Whyne C, Dhaliwal P, Hasan M, Berrington N, Johnson M, Burger L, Nicholls F, Evaniew N, Cobetto N, Aubin CE, Larson AN, Cheng Y, Fourney D, Hakimjavadi R, Michalowski W, Viktor H, Baddour N, Wai E, Stratton A, Kingwell S, Phan P, Dandurand C, Mawhinney G, Reynolds J, Orosz L, Thomson A, Bhatt F, Guth M, Allen B, Boyd D, Grigorian J, Schuler T, Jazini E, Haines C, Orosz L, Bhatt F, Allen B, Sabet A, Schuler T, Haines C, Jazini E, Orosz L, Thomson A, Namian S, Bharara N, Jazini E, Good C, Schuler T, Haines C, Orosz L, Tewari A, Roy R, Good C, Schuler T, Haines C, Jazini E, Orosz L, Thomson A, Bhatt F, Grigorian J, Schuler T, Haines C, Merril J, Roy R, Jazini E, Wang M, Orosz L, Haines C, Jazini E, Bhatt F, Sabet A, Roy R, Schuler T, Good C, Greene R, Schmidt M, Christie S, Richard-Denis A, Le MT, Lim V, Mac-Thiong JM, Gallagher M, Cheung A, Brown J, Chaudhry H, Yee C, McIntosh G, Christie S, Fisher C, Jarzem P, Roy JF, Bouchard J, Yee A, Eseonu K, Ahn H, Cherry A, Rampersaud R, Davidson B, Rabinovitch L, Nielsen C, Jiang F, Vaisman A, Lewis S, Canizares M, Rampersaud R, Investigators CSORN, Avila M, Burket A, Aguilar-Salinas P, Mongrain R, Ouellet J, Driscoll M, Schmidt-Braekling T, Dobransky J, Kreviazuk C, Gofton W, Phan P, Beaule P, Grammatopoulos G, Street J, Fisher C, Jacobs B, Johnson M, Paquet J, Wilson J, Hall H, Bailey CS, Christie S, Nataraj A, Manson N, Phan P, Rampersaud R, Thomas K, Mcintosh G, Rasoulinejad P, Charest-Morin R, Hindi M, Farimani PL, Mashayekhi MS, Ailon T, Boyd M, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Urquhart J, Ailon T, Bailey C, Boyd M, Charest-Morin R, Dea N, Dvorak M, Glennie A, Kwon B, Paquette S, Rampersaud R, Street J, Fisher C, Vandewint A, Bigney E, El-Mughayyar D, Richardson E, Edward A, Manson N, Attabib N, Kolyvas G, Small C, Investigators CSORN, Mac-Thiong JM, Barthélémy D, Lim V, Richard-Denis A, Driscoll M, Aubin CE, Cobetto N, Roy-Beaudry M, Bellefleur C, Turgeon I, Labelle H, Barchi S, Parent S, Joncas J, Parent S, Labelle H, Barchi S, Mac-Thiong JM, Lee W, Phan P, Bigney E, Richardson E, El-Mughayyar D, Vandewint A, Abraham E, Manson N, Small C, Alugo T, Leroux A, Kolyvas G, Investigators CSORN, Attabib N, McIntosh G, Oxner W, Dunning PC, Glennie A, Wang D, Humphreys S, Noonan V, Urquhart J, Siddiqi F, Rasoulinejad P, Bailey C, Urquhart J, Thornley P, Rampersaud R, Glennie A, Rasoulinejad P, Fisher C, Bailey C, Investigators CSORN, Bigney E, Dumas E, El-Mughayyar D, Cherry A, Vanderwint A, Richardson E, Kerr J, McPhee R, Abraham E, Manson N, Attabib N, Small C, Couture J, Goulet J, Bédard S, LaRue B, Investigators CSORN, Macthiong JM, Bourassa-Moreau E, Ogden C, Gallagher M, Cheung A, Huong VT, Tarabay B, Al-Shakfa F, Yuh SJ, Shedid D, Boubez G, Wang Z, Gueziri HE, Santaguida C, Collins DL, Hall A, Alant J, Barry S, Weise L, Glennie A, Oxner B, Etchegary H, Christie S, Carreon L, Glassman S, Brown M, Daniels C, Polly D, Gum J, Gum J, Glassman S, Brown M, Daniels C, Carreon L, Hong HA, Fallah N, Humphreys S, Walden K, Noonan VK, Phan P, Basiratzadeh S, Wai EK, Phan P, Salo P, Krawetz R, Hart D, Bains I, Swamy G, Yang Q, Godoy A, Smith S, Lin C, Nataraj A, Puskas D, Pahuta M, Marion T, Dea N, Waheed Z, Thorogood N, Nightingale T, Noonan V, Touchette C, Duda T, Almojuela A, Bergeron D, Aljoghaiman M, Sader N, Kameda-Smith M, Alant J, Christie S, Hresko MT, Alzakri A, Parent S, Sucato DJ, Lenke LG, Marks M, Labelle H, Pereira P, Charles YP, Krutko A, Santos C, Park Y, Arzoglou V, Park SW, Franke J, Fuentes S, He S, Hosszu T, Varanda P, Mlyavykh S, Vanhauwaert D, Senker W, Franke J, Park Y, Charles YP, Santos C, Arzoglou V, Song Y, He S, Bhagat S, Hong JY, Vanhauwaert D, Senker W, Pereira P, Senker W, Charles YP, Pereira P, Santos C, Park Y, Arzoglou V, Park SW, Bordon G, Fuentes S, Song Y, Vialle E, Bhagat S, Krutko A, Franke J, Thornley P, Rampersaud R, Glennie A, Rasoulinejad P, Abraham E, Ailon T, Charest-Morin R, Dea N, Dvorak M, Gélinas-Phaneuf N, Kwon B, Manson N, Paquette S, Street J, Thomas K, Fisher C, Bailey C, Mishreky A, Hurry J, El-Hawary R, Jiang E, Fisk F, Taliaferro K, Dea N, Investigators CSORN, Al Anazi M, El-Hawary R, Kindrachuk M, Noyes E, Wu A, Fourney D, Pratt M, Wai E, Stratton A, Kingwell S, Wang Z, Phan P, Robarts S, Razmjou H, Yee A, Larouche J, Finkelstein J, Persad A, Huschi Z, Cheng Y, Fourney D, Rossong H, Zhang H, Johnson M, Goytan M, Zarrabian M, Berrington N, Zeiler F, Charles A, Roy-Beaudy, Parent S, Duong L, Marion T, Guha D, Pahuta M, Hache P, Oitment C, Guha D, Pahuta M, Sarraj M, Oitment C, Guha D, Pahuta M, Miyanji F, McAnany S, Cheung A, Dewitt D, Street J, Jurisica I, Perruccio AV, Rampersaud YR, Niu Y, Perruccio AV, Jurisica I, Rampersaud YR, Glennie A, Alahmari A, Al-Jahdali F, Fisher C, Rampersaud R, Urquhart J, Bailey C, Urquhart J, Bailey C, Urquhart J, Rampersaud R, Glennie A, Fisher C, Bailey C, Urquhart J, Rampersaud R, Glennie A, Fisher C, Bailey C, Harback K, Akpinar I, Adjetey C, Tindall D, Chernesky J, Noonan V, Fernandes RJR, Bailey C, Siddiqi F, Rasoulinejad P, Toor J, Abbas A, Brooks H, Larouche J, Abbas A, Bhatia A, Selimovic D, Larouche J, Yee A, Lewis S, Finkelstein J, Toor J, Abbas A, Toor J, Versteeg A, Finkelstein J, Toor J, Abbas A, Ahn H, Larouche J, Finkelstein J, Whyne C, Yee A, Slomp F, Thiessen E, Lastivnyak N, Maclean LS, Ritchie V, Hockley A, Osborn J, Paquette S, Sahjpaul R, Gal R, Charest-Morin R, Verlaan JJ, Wessels H, Fisher CG, Verkooijen L, Pastrak M, Truong VT, Liberman M, Al-Shakfa F, Yuh SJ, Soder SA, Wu J, Sunna T, Renaud-Charest É, Boubez G, Shedid D, Balasuberamaniam P, Shrikumar M, Chen T, Anthony T, Phillips A, Nathens A, Chapman M, Crawford E, Stark R, Schwartz C, Finkelstein J, Small C, Rampersaud R. Canadian Spine SocietyAbstract 57. Radiographic reporting in adolescent idiopathic scoliosis: Is there a discrepancy comparing radiologists’ reports and surgeons’ assessments?Abstract 74. How useful is prereferral spine imaging? A quality improvement projectAbstract 82. Early recovery after surgery, predictors of shorter length of stayAbstract 68. Gliding screws on early-onset scoliosis: a 5-year experienceAbstract 66. Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosisAbstract 16. A dangerous curve: impact of the COVID-19 pandemic on brace treatment in adolescent idiopathic scoliosisAbstract 24. Development of a model of interprofessional support interventions to enhance brace adherence in adolescents with idiopathic scoliosisAbstract 94. Recognizing the importance of self-image in adult spinal deformity: results from the Prospective Evaluation of Elderly Deformity Surgery (PEEDS)Abstract 25. Assessing pain as a primary factor in the surgical treatment of adult spinal deformity surgery in patients over 60 years of ageAbstract 72. Application of the Ames-International Spine Study Group (AMES) radiographic modifiers to an asymptomatic population. Are the thresholds for “normal” appropriate?Abstract 109. Exploring the relationship between cannabis and narcotic use on preoperative health considerations in Canadian thoracolumbar patients: a CSORN studyAbstract 36. Metastatic spine disease: Should patients with short life expectancy be denied surgical care? An international retrospective cohort studyAbstract 91. What do patients expect of palliative treatment for symptomatic spinal metastases? A qualitative studyAbstract 44. Denosumab for giant cell tumours of the spine: molecular predictors of clinical response — a pilot studyAbstract 89. Surgical management and outcomes from “stable” degenerative spondylolisthesis (DS) from the CSORN prospective DS study: What the @#$ % are we doing?Abstract 33. Economic consequences of waiting for lumbar disc herniation surgeryAbstract 108. Motor recovery depends on timing of surgery in patients with lumbar disc herniationAbstract 106. Outcomes following revision decompression for lumbar spinal stenosis when compared to primary decompression: a matched cohort analysis using the Canadian Spine Outcomes and Research Network registryAbstract 64. Patient engagement, remote monitoring and virtual care — a pilot project in rural and remote patients undergoing elective lumbar surgeryAbstract 84. Development of a frailty index from the Canadian Spine Outcomes and Research Network (CSORN) to predict long-term success of surgery for patients with degenerative pathologies of the spineAbstract 102. Posterolateral versus posterior interbody fusion for the management of lumbar degenerative spondylolisthesis: analysis from the CSORN prospective LDS propensity score matched studyAbstract 31. Impact on patient-reported outcomes of ending the posterior construct proximally at C2 versus C3 in degenerative cervical myelopathy patientsAbstract 42. Perioperative factors predict 2-year trajectories of pain and disability following anterior cervical discectomy and fusionAbstract 61. Calculating utilities from the modified Japanese Orthopaedic Association score: a prerequisite for quantifying the value of care for cervical myelopathyAbstract 119. Serum neurofilament light (NF-L) and glial fibrillary acidic protein (GFAP) biomarkers and their association with MRI findings in human acute traumatic spinal cord injuryAbstract 95. The Montreal Acute Classification of Spinal Cord Injury (MAC-SCI): a new tool to detect and characterize spinal cord injury in the trauma patientAbstract 118. Mechanism of injury is associated with neurologic outcomes after cervical sensorimotor complete acute traumatic spinal cord injuryAbstract 13. Patient perspective: diagnosis and prognosis of acute spinal cord injuriesAbstract 136. Predictive analytics to improve dedicated spine trauma operating room resource allocationAbstract 138. Machine learning models to predict surgical resident workload at a level 1 trauma centreAbstract 139. Machine learning to predict duration of surgery and length of stay for single-level discectomy proceduresAbstract 9. Outpatient spinal surgery in ManitobaAbstract 131. Unexpected positive culture in presumed aseptic revision spine surgery: a systematic review and meta-analysisAbstract 50. Lumbar anterior vertebral body tethering: biomechanical assessment of the surgical decision factors influencing the immediate and 2 years postoperative correctionAbstract 145. Does prolonged symptom duration influence surgical outcomes for cervical radiculopathy?Abstract 147. A data-driven cluster analysis approach to create homogenous subgroups for traumatic spine injury: toward improving traditional classificationAbstract 41. The use of neo-adjuvant denosumab in treatment of giant cell tumours of the spineAbstract 5. Complications, revision rates and accuracy of robotic-guided S2 alar-iliac screw placementAbstract 6. Opioid use after spine surgery: How much are we over-prescribing?Abstract 7. Intradiscal injection of autologous bone marrow aspirate concentrate improves low back pain at 1 yearAbstract 8. Augmented reality–assisted spine surgery: an early experience demonstrating safety and accuracy with 218 screwsAbstract 22. Comparison of complications, revision rates and fluoroscopy time using the latest technology in robotic-guided surgery with historical fluoroscopic-guided controlsAbstract 23. Robotic-guided thoracolumbar fusion experience: a multi-surgeon, single-centre study of 628 patients and 3874 robotic-guided screws from 2012 to 2020Abstract 86. A province-wide assessment of the appropriateness of lumbar spine MRIAbstract 134. Concomitant traumatic spinal cord injury and brain injury diagnoses are more frequent and impactful than expectedAbstract 45. Spatial and depth mapping of nascent mineralization on Ti6Al4V surfaces demonstrating hierarchical macro-micro-nanoscale surface featuresAbstract 111. Propensity-matched outcomes comparing lumbar interbody fusion and total disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyAbstract 30. A Canadian-based pilot study of current surgical practice and implant preferences in lumbar fusion surgeryAbstract 32. Local contamination is a major cause of early deep wound infections following open posterior lumbosacral fusionsAbstract 99. Comparing patient preoperative expectations and postoperative expectation fulfillment between minimally invasive versus open fusion surgeryAbstract 146. Outpatient robotic-assisted lumbar spinal fusion using the Mazor X Stealth EditionAbstract 149. Lessons learned from my first 100 robotic-assisted lumbar fusions using the Mazor X Stealth Edition: surgical synergy with MIS, surgical navigation and roboticsAbstract 151. Freehand biomechanical testing for use in lumbar discectomy trainingAbstract 48. Spinal pathology and outcome post-THA: Does segment of arthrodesis matter?Abstract 27. Patient, surgical and institutional factors associated with length of stay in degenerative lumbar spine surgery: national multicentre cohort analysis from the Canadian Spine Outcomes and Research Network (CSORN)Abstract 28. The impact of the increasing proportion of degenerative spine emergency admissionsAbstract 51. Patient’s expectations of surgery for degenerative spondylolisthesis: analysis by site and type of surgery from the Canadian Spine Outcomes and Research Network (CSORN)Abstract 60. The impact of sex on thoracolumbar surgery outcomes in patients with diabetes — a CSORN studyAbstract 81. The impact of older age on rehabilitation outcomes following functional motor-incomplete traumatic spinal cord injuryAbstract 47. Devise and investigate a novel, intramuscular pressure based, muscle activation strategy in a spine stability modelAbstract 17. 3D radiologic outcomes for patients with moderate idiopathic scoliosis curves treated with internal (anterior vertebral growth modulation) versus external bracing: a 2-year observational studyAbstract 18. Is quality of life affected by concomitant isthmic spondylolisthesis when undergoing surgery for adolescent idiopathic scoliosis and nonsurgical management of the spondylolisthesis?Abstract 128. Toward macrostructural and microstructural investigation of the cervical spinal cord through quantitative analysis of T2-weighted and diffusion-weighted imagingAbstract 26. Minimally invasive versus open thoracolumbar spine surgery for patients who have lumbar spinal stenosis and an ASA score of 3 or above: a CSORN studyAbstract 101. Association between surgeon age and outcomes of spine surgery: a population-based retrospective cohort studyAbstract 77. Utilizing machine learning methodology to create a short form of the Multi-Morbidity Index in spinal cord injuryAbstract 70. Ten-year reoperation rate and clinical outcome in patients treated surgically for lumbar spinal stenosisAbstract 105. Assessing the importance of radiographic and clinical parameters when choosing decompression without fusion for LDS: results from the CSORN prospective DS studyAbstract 104. Preoperative cannabis use in Canadian thoracolumbar spine surgery patients: a CSORN studyAbstract 142. Post-traumatic ascending myelitis, about 2 cases, etiologic analysis and treatmentAbstract 55. NanoLOCK surfaces enhance osteoblast activities at the cellular levelAbstract 76. Which scoring system is the most accurate for predicting survival in patients undergoing surgery for spinal metastases from lung cancer?Abstract 11. Pedicle screw insertion using ultrasound-based navigation without intraoperative radiation: feasibility study on porcine cadaversAbstract 85. What barriers prevent patients being discharged from hospital following elective spine surgery?Abstract 15. Propensity-matched comparison of 90-day complications in robotic-assisted versus non-robotic-assisted lumbar fusionAbstract 56. No-tap (2-step) robotic-assisted cortical bone trajectory (RA-CBT) screw insertion is safe and efficient: comparative analysis of 179 patients and 924 RA-CBT screwsAbstract 124. Developing a Web-based application to promote the adoption of a clinical prediction model for independent walking in people with traumatic spinal cord injury — a protocolAbstract 125. Multivariable prediction models for prognostication after traumatic spinal cord injury — a systematic reviewAbstract 148. Expression of blood serum cytokines in the presentation of acute sciaticaAbstract 150. Do patient-reported outcome scores (PROs) correlate with bundled payment plan performance for elective spine surgeries?Abstract 46. Effects of delayed neurosurgery on anxiety, depression and economic burdenAbstract 69. Care close to home — a retrospective analysis of patients undergoing elective lumbar surgery in a rural satellite hospitalAbstract 110. Surgical adverse events for primary tumours of the spine and their impact on prognosis and outcomes: a PTRON studyAbstract 80. Spinal cord stimulation research in the restoration of function for individuals living with spinal cord injuries: a scoping reviewAbstract 132. Workup and management of asymptomatic extracranial traumatic vertebral artery injury: a Canadian Neurosurgery Resident Research Collaborative studyAbstract 12. A surgical treatment algorithm for restoring pelvic balance and health-related quality of life in high-grade lumbosacral spondylolisthesisAbstract 38. Effectiveness of 6 surgical approaches for minimally invasive lumbar interbody fusion: 1-year follow-up results from a global multicentre studyAbstract 39. Clinical outcomes and fusion success in patients with degenerative lumbar disease without spondylolisthesis: comparing anterolateral to posterior MIS approaches from a global multicentre studyAbstract 40. Anterolateral versus posterior approaches to minimally invasive interbody fusion for patients with spondylolisthesis: results at 1-year follow-up from a global multicentre studyAbstract 73. Benefit of minimally invasive lumbar interbody fusion versus traditional interbody fusion versus posterolateral spinal fusion in lumbar degenerative spondylolisthesis: a propensity-matched analysis from the CSORN prospective LDS studyAbstract 67. The effect of fusionless pediatric scoliosis surgery on 3D radiographic spinopelvic alignmentAbstract 62. Calculating utilities from the Neck Disability Index: a prerequisite for quantifying the value of cervical spine careAbstract 63. The psychometric properties of the mJOA for quality-of-life assessments in cervical myelopathyAbstract 59. Low radius of curvature growth friendly implants increases the risk of developing clinically significant proximal junctional kyphosisAbstract 144. Very long–term outcome of single-level minimally invasive lumbar microdiscectomy with a tubular retractorAbstract 112. Metal implant hypersensitivity in patients undergoing spinal surgery: a literature review and case reportAbstract 43. Diagnostic value of the lumbar spinal stenosis (SSHQ) survey in virtual care provided at a tertiary spine programAbstract 54. Is the Calgary Postoperative Pain After Spine Surgery (CAPPS) score correlated with long-term outcomes after lumbar fusion?Abstract 4. Development of a single-entry referral pathway for patients with spinal conditions in Manitoba: a cross-sectional review of impact and potential way forward for Canadian spine programsAbstract 113. Automatization of bone age calculationAbstract 123. An effectiveness and quality-of-life analysis of conservative care versus surgery for moderate and severe cervical myelopathyAbstract 133. Long-term survivorship of cervical spine procedures: a survivorship meta-analysis and meta-regressionAbstract 137. Natural history of degenerative cervical myelopathy: a meta-analysis and neurologic deterioration survival curve synthesisAbstract 14. Does intraoperative vancomycin powder affect postoperative infections in adolescent idiopathic scoliosis?Abstract 37. The clinical impact of nano-surface technology on postoperative opioid consumption in patients undergoing anterior lumbar interbody fusionAbstract 130. Design and implementation of a comprehensive perioperative complex spine communication toolAbstract 87. Stratifying low back pain patients in an inter-professional education and self-management model of care: results of a latent class analysisAbstract 88. Cohort accuracy versus confidence at the patient level: clinical challenges for AI-based prediction of low back pain outcomesAbstract 96. Preoperative disc angle is an important predictor of segmental lordosis after degenerative spondylolisthesis fusionAbstract 97. Preoperative depression, functional and radiographic outcomes after surgery for degenerative lumbar spondylolisthesisAbstract 116. A CSORN study of functional outcomes after surgery for lumbar degenerative spondylolisthesisAbstract 121. A CSORN study of the effect on radiographic alignment outcomes with different surgery type for degenerative lumbar spondylolisthesisAbstract 79. Spinal cord stimulation to restore neurological function: a costing analysisAbstract 107. Biomechanical properties of a novel morselized bone graft cageAbstract 93. Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating roomAbstract 103. Machine learning models can predict subsequent publication of North American Spine Society Annual General Meeting abstractsAbstract 117. The use of primary sacroiliac joint fusion for lower back pain due to sacroiliac joint pathology: a systematic review and meta-analysisAbstract 141. How to make the most of your operative time by optimizing surgical schedulingAbstract 126. Altering physician referral practices remains a challenge: a spine assessment clinic quality improvement studyAbstract 152. Outcomes of workers’ compensation patients undergoing neuromodulation for persistent neuropathic pain conditionsAbstract 90. Expectations of treatment outcomes in patients with spinal metastases: What do we tell our patients? A qualitative studyAbstract 52. Fluoroscopically guided radiofrequency ablation of the superior cluneal nerve: preliminary outcomes data for a minimally invasive approach for treating superior cluneal neuralgiaAbstract 21. Single-stage posterior approach for en bloc resection and spinal reconstruction of T4 Pancoast tumour invading spineAbstract 34. Predictors of sacral ulcers in patients with complete spinal cord injuryAbstract 135. Targeting geographic wait time disparities in Canada: a rapid review of domestic and international strategies to reduce orthopedic wait times in the MaritimesAbstract 143. The influence of coronal plane parameters on patient-reported outcome measures in patients undergoing decompression for lumbar spinal stenosis. Can J Surg 2022. [DOI: 10.1503/cjs.011622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Breakey VR, Gupta A, Johnston DL, Portwine C, Laverdiere C, May SL, Dick B, Hundert A, Nishat F, Killackey T, Nguyen C, Lalloo C, Stinson J. A Pilot Randomized Control Trial of Teens Taking Charge: A Web-based Self-management Program for Adolescents with Cancer. J Pediatr Hematol Oncol Nurs 2022; 39:366-378. [PMID: 35759365 DOI: 10.1177/27527530211068778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: There is a lack of self-management tools for adolescents with cancer (AWC). This study evaluated the feasibility of Teens Taking Charge Cancer, a web-based self-management program. Methods: A pilot randomized control trial (RCT) was conducted across 4 pediatric oncology clinics. AWC (12-18 years) and their caregivers were randomized to either the intervention or control group. All were asked to complete 12 website modules over 12 weeks (at their own pace) and received monthly calls from health coaches. The intervention website was based on cognitive behavioral principals, designed as an interactive self-guided online program, while the control consisted of education and included links to 12 general cancer websites. Outcome assessments occurred at enrollment and 12 weeks post-intervention. The primary outcomes included rate of accrual and retention, adherence to the protocol, acceptability and satisfaction with intervention using questionnaire and semi-structured interviews, adverse events and engagement with the intervention. Results: Eighty-one teen-caregiver dyads were enrolled with a retention rate of 33%. In the intervention group 46% (n = 18) logged in at least once over the 12-week period. A mean of 2.4 of 12 modules (SD 3.0) were completed; and no one completed the program. Thirty-three percent of caregivers in the intervention logged into the website at least once and none completed the full program. Discussion: The results from this pilot study suggest that the current design of the Teens Taking Charge Cancer RCT lacks feasiblity. Future web-based interventions for this group should include additional features to promote uptake and engagement with the program.
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Affiliation(s)
| | - Abha Gupta
- 7315The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada
| | | | - Carol Portwine
- 103398McMaster Children's Hospital, Hamilton, ON, Canada
| | - Caroline Laverdiere
- Department of Pediatrics, 5622University of Montreal, Centre hospitalier universitaire Sainte-Justine (CHU Sainte-Justine), Montréal, QC, Canada
| | - Sylvie Le May
- Faculté des sciences infirmières, Université de Montréal, Montreal, QC, Canada
| | - Bruce Dick
- Department of Anesthesiology & Pain Medicine, Division of Pain and Medicine, 7979University of Alberta, Edmonton, AB, Canada
| | - Amos Hundert
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Fareha Nishat
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Tieghan Killackey
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Cynthia Nguyen
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Chitra Lalloo
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Jennifer Stinson
- 7315The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Le May S, Genest C, Francoeur M, Hung N, Guingo E, Khadra C, Noel M, Paquette J, Roy A. Virtual reality mobility for burn patients (VR-MOBILE): A within-subject-controlled trial protocol. Paediatr Neonatal Pain 2022; 4:192-198. [PMID: 36618513 PMCID: PMC9798042 DOI: 10.1002/pne2.12086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
In the acute phase, burn patients undergo several painful procedures. Pediatric burn care procedures conducted in hydrotherapy have been known to generate severe pain intensity and moderate to high levels of anxiety. Hydrotherapy treatments are done with the use of opioids and benzodiazepines for pain and anxiety. Unfortunately, nonpharmacological methods are rarely combined with pharmacological treatments despite evidence showing that distraction can serve as an effective method for pain management and can potentially decrease analgesic requirements in other painful medical procedures. Virtual reality (VR) is a method that uses distraction to interact within a virtual environment. The use of VR is promising for pain reduction in varying settings. Considering the lack of optimal pain and anxiety management during burn wound care and the positive effect of an immersive distraction for painful procedures, using VR for burn wound care procedures may show promising results. This is a within-subject randomized controlled trial design in which each participant will serve as his/her own control. A minimum of 20 participants, aged 7 to 17 years old undergoing a burn care session, will receive both standard and experimental treatments during the same session in a randomized order. The experimental treatment will consist of combining VR distraction using the video game Dreamland® to the current standard pharmacological care as per unit protocol. The control group will only receive the unit's standard pharmacological care. The mean difference in both pain intensity scores and in anxiety between the two different sequences will be the primary outcomes of this study. This study evaluates the effect of VR on burn wound care. If results from this study show a positive effect of VR compared to standard care, this protocol may provide guidance on how to implement this type of immersive care as part of the tools available for distraction of painful procedures for acute burn victims.
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Affiliation(s)
- Sylvie Le May
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada,Faculty of NursingUniversité de MontréalMontréalQuébecCanada,Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CRIUSMM)MontréalQuébecCanada
| | - Christine Genest
- Faculty of NursingUniversité de MontréalMontréalQuébecCanada,Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CRIUSMM)MontréalQuébecCanada
| | - Maxime Francoeur
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
| | - Nicole Hung
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada,Faculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | - Estelle Guingo
- Department of Creation and NEW MediaUniversité du Québec en Abitibi‐Témiscamingue (UQAT)Rouyn‐NorandaQuébecCanada
| | | | - Melanie Noel
- Department of PsychologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Julie Paquette
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
| | - Andrée‐Anne Roy
- CHU Sainte‐Justine Hospital's Research CentreMontréalQuébecCanada
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Farthing J, Le May S, Gauvin-Lepage J. Developing and Pilot Testing E-Learning Training for Pediatric Nursing Burn Care. J Contin Educ Nurs 2022; 53:232-240. [PMID: 35510919 DOI: 10.3928/00220124-20220414-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Nurses caring for pediatric patients who have burns need to be properly trained to provide optimal care. The aims of this pilot study were to (1) develop a pediatric nursing burn care e-learning training for novice nurses; (2) assess the feasibility and acceptability of this educational intervention; and (3) evaluate the preliminary effects of this intervention on novice nurses' knowledge of pediatric nursing burn care. Method A quasi-experimental, one-group, pre-test-posttest design was used. Results Feasibility was achieved because all of the participants completed the study. A significant difference was observed in the mean knowledge level of the novice nurses from before training to after training (87.7% ± 8.7% vs. 58.6% ± 14.5%; p < .001). The novice nurses' had a mean satisfaction of 95.5% after the intervention. Conclusion This new, evidence-based pediatric nursing burn care e-learning training appeared to be feasible. The novice nurses found it to be satisfactory, and it improved their knowledge regarding pediatric burn care. [J Contin Educ Nurs. 2022;53(5):232-240.].
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Ali S, Gourlay K, Yukseloglu A, Rosychuk RJ, Ortiz S, Watts R, Johnson DW, Carleton B, Le May S, Drendel AL. Quantifying the intensity of adverse events with ibuprofen and oxycodone: an observational cohort study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001428. [PMID: 36053661 PMCID: PMC9131055 DOI: 10.1136/bmjpo-2022-001428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To quantify the frequency and intensity of adverse events (AEs), commonly known as side effects, experienced by children receiving either ibuprofen or oxycodone for pain management following an acute fracture. Secondary objectives were to quantify functional outcome impairment and describe demographic and clinical characteristics associated with AEs. DESIGN Observational cohort study. SETTING Paediatric emergency department. PATIENTS Patients (n=240) aged 4-16 years diagnosed with an acute fracture. INTERVENTION Prescribed either ibuprofen (n=179) or oxycodone (n=61) for pain. MAIN OUTCOME MEASURES Families were called for the first 3 days after discharge to report the presence and intensity of AEs and their child's functional outcomes (ability to eat, sleep, play or attend school). RESULTS On day 1, children using oxycodone were more likely to report any AE (χ2 1=13.5, p<0.001), nausea (χ2 1=17.0, p<0.001), vomiting (χ2 1=11.2, p<0.001), drowsiness (χ2 1=13.7,p<0.001), constipation (χ2 1=8.9, p=0.003) and dizziness (χ2 1=19.1, p<0.001), compared with those using ibuprofen. Children receiving oxycodone reported greater severity of abdominal pain (oxycodone: mean 5.4 SD 3.1; ibuprofen mean 2.5 SD 1.4, F1 13=6.5, p=0.02) on day 1 and worse intensity of constipation (oxycodone: mean 4.9 SD 2.1; ibuprofen mean 3.2 SD 2.2, F1 33=4.5, p=0.04) over all 3 days. Use of oxycodone was associated with an increased odds of experiencing an AE on day 1 (OR=1.31 (95% CI 1.13 to 1.52)). Higher pain scores (OR=1.50 (95% CI 1.12 to 2.01)), lower extremity fracture (OR=1.25 (95% CI 1.07 to 1.47)) and undergoing ED sedation (OR=1.16 (95% CI 1.01 to 1.34)) were associated with missing school. Higher pain scores (OR=1.50 (95% CI 1.14 to 1.97)) and lower extremity fractures (OR=1.23 (95% CI 1.07 to 1.43)) were also associated with less play. CONCLUSIONS Oxycodone is associated with more frequent AEs overall, higher intensity gastrointestinal AEs and greater functional limitations compared with ibuprofen. Lower extremity fractures cause more functional limitations than upper extremity fractures. Clinicians should consider these differences when providing fracture pain care for children.
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Affiliation(s)
- Samina Ali
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada .,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Gourlay
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Aran Yukseloglu
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Rhonda J Rosychuk
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Silvia Ortiz
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Rick Watts
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - David W Johnson
- Department of Pediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bruce Carleton
- Division of Translational Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sylvie Le May
- Faculty of Nursing, Universite de Montreal, Montreal, Quebec, Canada
| | - Amy L Drendel
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Provost M, Beauséjour M, Ishimo MC, Joncas J, Labelle H, Le May S. Development of a model of interprofessional support interventions to enhance brace adherence in adolescents with idiopathic scoliosis: a qualitative study. BMC Musculoskelet Disord 2022; 23:406. [PMID: 35490213 PMCID: PMC9055765 DOI: 10.1186/s12891-022-05359-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/22/2022] [Indexed: 11/14/2022] Open
Abstract
Purpose Brace treatment for adolescent idiopathic scoliosis is recognized as effective if the brace is worn as prescribed (20 to 23 hrs/day). Because of its negative biopsychosocial impact on adolescent patients’ quality of life, brace adherence is a common problem (average bracewear of 12 hrs/day). The purpose of this paper is to develop an interprofessional support intervention model to enhance brace adherence in adolescents with scoliosis. Methods We enrolled 9 health professionals working with braced patients to participate in individual interviews. Interview guides were built following the Information-Motivation-Strategy Model (DiMatteo et al., Health Psychol Rev 6:74-91, 2012) and the Interprofessional Care Competency Framework (Education UoTCfI, Toronto Acad Health Sci Network, 2017). Thematic analysis was performed to identify the most relevant concepts for designing the intervention model. A panel of 5 clinical experts was recruited to review and validate the intervention model. Results Participants suggested educational, motivational, functional, psychological and interprofessional teamwork strategies to improve the support provided to patients and parents and potentially increase brace adherence. Using the emerging themes and their relationships, we designed an Interprofessional Adherence Support (IPAS) intervention model that identifies the actors, activities, structure and intended impacts of the intervention. According to the expert panel, the IPAS model is highly relevant to respond to the brace adherence problem and has potential for implementation in practice. Conclusion We designed an interprofessional support intervention model based on professional perspectives in response to the brace adherence problem in adolescents with scoliosis. Plans for implementation of the IPAS model at our scoliosis clinic are under development and considered essential for improving brace treatment outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05359-w.
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Affiliation(s)
- Myriam Provost
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada.
| | - Marie Beauséjour
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada.,Department of Surgery, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, QC, H3C 3J7, Canada.,Department of Community Health Sciences and Centre de recherche Charles-LeMoyne-Saguenay-Lac-St-Jean sur les innovations de santé, Université de Sherbrooke, 150 Place Charles-LeMoyne - bureau 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Claire Ishimo
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada
| | - Julie Joncas
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada
| | - Hubert Labelle
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada.,Department of Surgery, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, QC, H3C 3J7, Canada
| | - Sylvie Le May
- Sainte-Justine University Health Center, Research Center, 3175 chemin de la Côte-Sainte-Catherine, Office 1.7.19, Montréal, QC, H3T 1C5, Canada.,Faculty of Nursing, Université de Montréal, 2375 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
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Yukseloglu A, Ali S, Drendel A, Carleton B, Ross C, Le May S, Manaloor R, Rosychuk R, Johnson D. 127 Impact of CYP2D6, CYP3A4, and CYP2C9 pharmacogenomic profile on pain relief and adverse events in Canadian children treated with oxycodone and ibuprofen. Paediatr Child Health 2021. [DOI: 10.1093/pch/pxab061.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Primary Subject area
Clinical Pharmacology and Toxicology
Background
Genomic variation impacts drug pharmacokinetics for commonly used children’s pain medications such as oxycodone and ibuprofen. In order to personalize and best treat children’s pain, how cytochrome enzyme polymorphisms for CYP2D6, CYP3A4, and CYP2C9 impact clinical effectiveness and safety for oxycodone and ibuprofen were studied.
Objectives
Primary objectives were to evaluate if allelic variations of CYP2D6, CYP2C9, and CYP3A4 would a) alter clinical effectiveness of ibuprofen and oxycodone for pain relief, and b) impact the occurrence of adverse events. Secondary objectives were to determine the degree to which these genetic and other clinical factors influence analgesic effectiveness and safety.
Design/Methods
This prospective, observational cohort included children aged 4-16 years who were seen in a pediatric emergency department (between June 2010 - July 2014) with an acute fracture and used ibuprofen OR oxycodone for at-home pain management. Saliva samples were obtained prior to discharge, and daily telephone follow-up collected self-reported pain scores, medication use, adverse events, and functional limitations for 3 days. Genotyping identified allelic variants of CYP2D6, CYP3A4, and CYP2C9. Pain was measured using the Faces Pain Scale-Revised. CYP2D6 metabolic phenotypes were determined based on identified variants. Regression analyses were employed to determine relationships between clinical and genomic patient characteristics, pain relief, and adverse events.
Results
We included 210 children (n=140 ibuprofen, n=70 oxycodone); mean age was 11.1 (±3.5) years, 66.2% were male, and 79.5% self-identified as Caucasian. The median pain reduction in the ibuprofen group was 4 (±2.0) and 4 (±3.5) in the oxycodone group on Day 1 (p = 0.69). Adverse events were experienced by 53.2% of the ibuprofen group and 78.3% of the oxycodone group (p < 0.001). CYP2D6 Intermediate Metabolizers had significantly less pain relief using oxycodone than Extensive Metabolizers (p = 0.04). CYP3A4 variants did not significantly impact pain relief or adverse events. Those with the decreased functioning CYP2C9*2 allele experienced less adverse events compared to the normal functioning allele CYP2C9*1 (p = 0.003) when using ibuprofen. Males (p = 0.035) and all children using non-pharmacological pain strategies (p = 0.02) experienced less pain relief with oxycodone.
Conclusion
A better understanding of pharmacogenomic variation could help personalize medication choice. Sex and non-pharmacologic pain management impact pain relief with oxycodone, warranting further study to better understand their relationship with opioid pain relief in children.
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Le May S, Genest C, Hung N, Francoeur M, Guingo E, Paquette J, Fortin O, Guay S. The Effect of Virtual Reality Game Preparation for Children scheduled for MRI (IMAGINE): a Randomized Controlled Trial Protocol (Preprint). JMIR Res Protoc 2021; 11:e30616. [PMID: 35700000 PMCID: PMC9237773 DOI: 10.2196/30616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/06/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background It is known that magnetic resonance imaging (MRI) procedures generate fear and anxiety. Children may become restless during scanning, which results in movement artifacts requiring the MRI procedure to be repeated with sedation. Few studies seem to have looked at the effect of immersive virtual reality (IVR) on anxiety in children scheduled for MRI scans and how to identify which children are more responsive. Objective The aims of this study are 3-fold: develop an algorithm of predictability based on biofeedback, address feasibility and acceptability of preprocedural IVR game preparation for anxiety management during MRI procedures, and examine the efficacy of IVR game preparation compared with usual care for the management of procedural anxiety during MRI scans. Methods This study will have 2 phases. We will first conduct a field test with 10 participants aged 7 to 17 years to develop a predictive algorithm for biofeedback solution and to address the feasibility and acceptability of the research. After the field test, a randomized controlled trial will be completed using a parallel design with 2 groups: an experimental group (preprocedural IVR game preparation) and a usual care group (standard care as per the radiology department’s protocol) in an equal ratio of 49 participants per group for 98 participants. Recruitment will be carried out at a hospital in Quebec, Canada. The experimental group will receive a preprocedural IVR game preparation (IMAGINE) that offers an immersive simulation of the MRI scan. Participants will complete a questionnaire to assess the acceptability, feasibility, and incidence of side effects related to the intervention and the biofeedback device. Data collected will include sociodemographic and clinical characteristics as well as measures of procedure-related anxiety with the French-Canadian version of the State-Trait Anxiety Inventory for Children (score 1-3) and the Children’s Fear Scale (score 0-4). Physiological signs will be noted and include heart rate, skin conductance, hand temperature, and muscle tension. Measures of the level of satisfaction of health care professionals, parents, and participants will also be collected. Analyses will be carried out according to the intention-to-treat principle, with a Cronbach α significance level of .05. Results As of May 10, 2022, no participant was enrolled in the clinical trial. The data collection time frame is projected to be between April 1, 2022, and March 31, 2023. Findings will be disseminated through peer-reviewed publications. Conclusions Our study provides an alternative method for anxiety management to better prepare patients for an awake MRI procedure. The biofeedback will help predict which children are more responsive to this type of intervention. This study will guide future medical practice by providing evidence-based knowledge on a nonpharmacological therapeutic modality for anxiety management in children scheduled for an MRI scan. Trial Registration ClinicalTrials.gov NCT04988516; https://clinicaltrials.gov/ct2/show/NCT04988516 International Registered Report Identifier (IRRID) PRR1-10.2196/30616
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Affiliation(s)
- Sylvie Le May
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Nicole Hung
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Maxime Francoeur
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Estelle Guingo
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Julie Paquette
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Olivier Fortin
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Stéphane Guay
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
- School of Criminology, Université de Montréal, Montreal, QC, Canada
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Power JD, Glennie A, Rogers S, Aziz M, Singh S, Dandurand C, Tauh S, Richard-Denis A, Morris S, Richard-Denis A, Lim V, Mputu PM, Soroceanu A, Sadiq I, Daly C, Dandurand C, Larouche J, Correale M, Sharma A, Charest-Morin R, Lee J, Ajoku U, Moskven E, Asif H, Al-attar ENM, Mishreky A, Rocos B, Rocos B, Rocos B, Srivastava SK, Patgaonkar P, Cummins D, Bednar D, Chan V, Bowker R, Evaniew N, Hathi K, Hall H, Ludwig T, Ludwig T, Truong VT, Passalent L, Wang S, Shaikh N, Pelletier-Roy R, Shen J, Wang Z, Singh S, Machida M, Machida M, Fernandes R, Fernandes R, Marathe N, Kerr J, Magnan MC, Visva S, Jarvis J, Jarvis J, Jentzsch T, Cherry A, Cherry A, Cherry A, Dandurand C, Rampersaud R, Sundararajan K, Levasseur A, Fernandes R, Fernandes R, Fullerton K, Malone H, Daly C, Peloza J, Peloza J, Walden K, Elsemin O, MacLean MA, Rose J, Oppermann M, Ferguson D, Hindi M, Dermott JA, DeVries Z, Lebel D, Ayling O, Singh V, Craig M, Lasswell T, Perruccio AV, Canizares M, McIntosh G, Rampersaud YR, Urquhart J, Koto P, Rasoulinejad P, Sequeira K, Miller T, Watson J, Rosedale R, Gurr K, Siddiqi F, Bailey C, Manson N, Bigney E, Vandewint A, Richardson E, El-Mughayyar D, McPhee R, Abraham E, Weber M, McIntosh G, Kelly A, Santaguida C, Ouellet J, Reindl R, Jarzem P, Lasry O, Dea N, Fisher C, Street J, Boyd M, Charest-Morin R, Rhines L, Boriani S, Charest-Morin R, Gokaslan Z, Gasbarrini A, Saghal A, Laufer II, Lazary A, Bettegowda C, Kawahara N, Clarke M, Rampersaud YR, Reynolds J, Disch A, Chou D, Shin JH, Wei F, Hornicek FJ, Barzilai O, Fisher C, Dea N, Nickel D, Thorpe L, Brown J, Weiler R, Linassi G, Fourney D, Dionne A, Bégin J, Mac-Thiong JM, Yung A, George S, Prevost V, Bauman A, Kozlowski P, Samadi F, Fournier C, Parker L, Dong K, Streijger F, Moore GW, Laule C, Kwon B, Gravel LF, Dionne A, Bourassa-Moreau E, Maurais G, Khoueir P, Mac-Thiong JM, Richard-Denis A, Dionne A, Bourassa-Moreau É, Bégin J, Mac-Thiong JM, Beausejour M, Richard-Denis A, Begin J, Dionne A, Mac-Thiong JM, Scheer J, Protopsaltis T, Gupta M, Passias P, Gum J, Smith J, Bess S, Lafage V, Ames C, Klineberg E, Frederick A, Nicholls F, Lewkonia P, Thomas K, Jacobs B, Swamy G, Miller N, Tanguay R, Soroceanu A, Nevin J, Bourassa-Moreau E, Dvorak M, Fisher C, Paquette S, Kwon B, Dea N, Ailon T, Charest-Morin R, Street J, Hindi M, Kwon B, Dvorak M, Ailon T, Paquette S, Fisher C, Charest-Morin R, Dea N, Street J, Finkelstein J, Bowes J, Ford M, Yee A, Soever L, Rachevitz M, Bigness A, Robertson S, Wilson R, Wong W, Nugent J, Frantzeskos S, Duffy M, Rampersaud R, Marathe N, Agarwal R, Bailey CS, Paquet J, Dea N, Goytan M, McIntosh G, Street J, Fisher C, Jacobs B, Johnson M, Paquet J, Hall H, Bailey C, Christie S, Nataraj A, Manson N, Phan P, Rampersaud R, Thomas K, McIntosh G, Abraham E, Glennie A, Jarzem P, Ahn H, Blanchard J, Hogan G, Kelly A, Charest-Morin R, Tohidi M, Hopman W, Yen D, Parent S, Miyanji F, Murphy J, El-Hawary R, Lebel D, Zeller R, Reda L, Dodds M, Lebel D, Zeller R, Zeller R, Marathe N, Bhosale S, Raj A, Marathe N, Goyal V, Theologis A, Witiw C, Fehlings M, Morash K, Yaszay B, Andras L, Sturm P, Sponseller P, El-Hawary R, Swamy G, Jacobs WB, Bouchard J, Cho R, Manson NA, Rampersaud YR, Paquet J, Bailey CS, Johnson M, Attabib N, Fisher CG, McIntosh G, Thomas KC, Bigney E, Richardson E, Alugo T, El-Mughayyar D, Vandewint A, Manson N, Abraham E, Attabib N, Prostko R, Cheng B, Haring K, Fischer M, Bourget-Murray J, Sridharan S, Frederick A, Johnston K, Edwards B, Nicholls F, Soroceanu A, Bouchard J, Shedid D, Al-Shakfa F, Shen J, Boubez G, Yuh SJ, Wang Z, Sundararajan K, Perruccio A, Coyte P, Bombardier C, Bloom J, Hawke C, Haroon N, Inman R, Rampersaud YR, Hebert J, Abraham E, Vandewint A, Bigney E, Richardson E, El-Mughayyar D, Attabib N, Small C, Manson N, Zhang H, Beresford-Cleary N, Street J, Wilson D, Oxland T, Richard-Denis A, Jean S, Bourassa-Moreau É, Fleury J, Beauchamp-Vien G, Bégin J, Mac-Thiong JM, Boudier-Revéret M, Majdalani C, Truong VT, Wang Z, Shedid D, Najjar A, Yuh SJ, Boubez G, Sebaaly A, McIntosh G, Ailon T, Dea N, Fisher C, Charest-Morin R, Lebel D, Rocos B, Zabjek K, Zeller R, Zabjek K, Rocos B, Lebel D, Zeller R, Gee A, Schneider N, Kanawati A, Schemitsch E, Bailey C, Rasoulinejad P, Zdero R, Schneider N, Gee A, Kanawati A, Zdero R, Bailey C, Rasoulinejad P, Lohkamp LN, Fehlings M, Abraham E, Vandewint A, Bigney E, Hebert J, Richardson E, El-Mughayyar D, Chorney J, El-Hawary R, Manson N, Wai E, Phan P, Kingwell S, Tierney S, Stratton A, AlDuwaisan A, Moravek D, Wai E, Kingwell S, Stratton A, Phan P, Devries Z, Barrowman N, Smit K, Tice A, Devries Z, Barrowman N, Smit K, Tice A, Sundararajan K, Rampersaud YR, Oitment C, Wunder J, Ferguson P, Rampersaud R, Rampersaud R, Rampersaud R, Ailon T, Dvorak M, Kwon B, Paquette S, Charest-Morin R, Dea N, Fisher C, Street J, Bailey C, Casha S, Glennie A, Fox R, McIntosh G, Yee A, Fisher C, Perruccio A, Perruccio A, Rampersaud YR, Mac-Thiong JM, Richard-Denis A, Gee A, Kanawati A, Rasoulinejad P, Zdero R, Bailey C, Gee A, Kanawati A, Rasoulinejad P, Zdero R, Bailey C, Klein G, Emmenegger U, Finkelstein J, Lyons F, Whyne C, Hardisty M, Millgram M, Guyer R, Harel R, Ashkenazi E, Dvorak M, Fisher C, Paquette S, Street J, Dea N, Ailon T, Charest-Morin R, Kwon B, Millgram M, Guyer R, Le Huec JC, Ashkenazi E, Millgram M, Guyer R, Harel R, Kutz S, Ashkenazi E, Parsons J, Bailey CS, Dhaliwal P, Fourney DR, Noonan V, Mac-Thiong JM, Beausejour M, Sassine S, Joncas J, Barchi S, Le May S, Cobetto N, Fortin C, Carl-Éric A, Parent S, Labelle H, Bailey C, Fisher C, Rampersaud R, Glennie A, Manson N, Bigney E, Vandewint A, Hebert J, El-Mughayyar D, Richardson E, Ghallab N, Flood M, Attabib N, Abraham E, Swamy G, Nicholls F, Thomas K, Jacobs WB, Soroceanu A, Evaniew N, Stevens M, Dunning C, Oxner W, Glennie A, Dandurand C, Paquette S, Kwon B, Ailon T, Dvorak M, Dea N, Charest-Morin R, Fisher C, Street J, Kim D, Lebel DE, Jarvis J, Tice A, Smit K, Campbell F, Mashida M, Isaac L, Bath N, Stocki D, Levin D, Koyle M, Ruskin D, Stinson J, Ailon T, Dea N, Fisher C, Evaniew N, Soroceanu A, Nicholls F, Jacobs WB, Thomas K, Cho R, Lewkonia P, Swamy G, Lasry O, Ailon T, Zamani N, Rampersaud R, Rasoulinejad P. 2021 Canadian Spine Society Abstracts. Can J Surg 2021; 64:S1-S36. [PMID: 34296831 PMCID: PMC8410468 DOI: 10.1503/cjs.012621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Aita M, Héon M, Lavallée A, De Clifford Faugère G, Altit G, Le May S, Dorval V, Lippé S, Larone Juneau A, Remmer E, Rennick JE. Nurturing and quiet intervention (NeuroN-QI) on preterm infants' neurodevelopment and maternal stress and anxiety: A pilot randomized clinical trial protocol. J Adv Nurs 2021; 77:3192-3203. [PMID: 33719093 DOI: 10.1111/jan.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Primary objective of this pilot study is to evaluate the feasibility and acceptability of the NeuroN-QI and the study procedures. Secondary objectives are to assess the feasibility and acceptability of the NeuroN-QI by the nurses, assess the nurses' training needs about the components of the NeuroN-QI, and estimate the preliminary effects of the NeuroN-QI on infants' neurodevelopment as well as maternal stress and anxiety at infants' 36 weeks of gestational age. DESIGN A two-group pilot parallel randomized clinical trial stratified by center. METHODS The pilot study will be conducted in two neonatal intensive care units (NICUs). A sample of 24 mother-infant dyads born between 26 and 316/7 gestational age will be randomized into an experimental or control group. Fifty nurses will be recruited. The NeuroN-QI consists of four 2-hour skin-to-skin contact sessions/week with a 15-minute auditory stimulation by mothers with controlled ambient levels of light and noise. A 1-hour quiet period will follow where infants will rest in their incubator/crib with their mother's milk for olfactory stimulation and where the light and noise control will be continued. In the control group, mother-infant dyads will do four skin-to-skin contacts per week and receive standard care. Acceptability and feasibility of the NeuroN-QI in addition to maternal stress and anxiety will be measured through questionnaires, while infants' neurodevelopment will be assessed with Assessment of Preterm Infant Behaviour and General Movement Assessment. CONCLUSIONS This pilot trial will address knowledge gaps and generate evidence in neonatal care by evaluating the feasibility and acceptability of a multi-component developmental care intervention. IMPACT This project is an innovative step towards optimizing the neurodevelopmental trajectory of infants in NICUs and consequently promoting their long-term health outcomes. TRIAL REGISTRATION NCT04593095.
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Affiliation(s)
- Marilyn Aita
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Marjolaine Héon
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Gabriel Altit
- Department of Pediatrics, Division of Neonatology, Montreal Children's Hospital - McGill University Health Center (MUHC), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Sarah Lippé
- CHU Sainte-Justine Research Centre, Montréal, Canada.,Faculty of Arts and Science, Department of Psychology, Université de Montréal, Montréal, Canada
| | | | - Elissa Remmer
- NICU, Montreal Children's Hospital (MCH, MUHC), Montréal, Canada
| | - Janet E Rennick
- Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Department of Nursing, MCH, MUHC, Montréal, Canada
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Le May S, Hupin M, Khadra C, Ballard A, Paquin D, Beaudin M, Bouchard S, Cotes-Turpin C, Noel M, Guingo E, Hoffman HG, Déry J, Hung N, Perreault I. Decreasing Pain and Fear in Medical Procedures with a Pediatric Population (DREAM): A Pilot Randomized Within-Subject Trial. Pain Manag Nurs 2021; 22:191-197. [PMID: 33495093 DOI: 10.1016/j.pmn.2020.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/14/2020] [Accepted: 10/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Many children with injuries, including burns and fractures, experience moderate to severe pain during medical procedures. Recent studies claim that nonpharmacologic pain management using virtual reality (VR) could distract children from procedural pain by engaging multiple senses. AIMS The aims of this pilot randomized clinical trial were to assess the acceptability and feasibility of VR distraction in children with burns or fractures undergoing painful medical procedures, as well as the staff nurses, and assess the preliminary efficacy of VR distraction on pain intensity, pain-related fear, and subsequent recall of both. MATERIALS AND METHOD A within-subject study design, in which participants served as their own control, was used. A total of 20 children from 7 to 17 years old with an injury were recruited at the surgical-trauma outpatient clinics of the Centre hospitalier universitaire Sainte-Justine (CHU Sainte-Justine). Each participant received both standard and experimental treatments through randomized order. Pain (numerical rating scale) and pain-related fear (Children's Fear Scale) measures were taken before the procedure and after each sequence, followed by a measure of children's (graphic rating scale) and nurses' acceptability of the intervention through their satisfaction level. Recall of pain intensity and pain-related fear were assessed 24 hours after the procedure. Wilcoxon signed-rank tests were used, with a significance level at 0.05. RESULTS Results showed that VR distraction was an acceptable and feasible intervention for children and nurses of these outpatient clinics. Preliminary effects showed that, compared to standard of care, children participants reported a significant decrease in pain intensity (p = .023) and pain-related fear (p = .011) during VR as well as less recalled pain-related fear (p = .012) at 24 hours after the procedure. No side effects were reported. CONCLUSION VR is a promising intervention with children undergoing painful procedures because it is immersive and engages multiple senses. It is a low-cost intervention well accepted by children and nursing staff at this clinical site and is easy to implement in daily practice for procedural pain management.
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Affiliation(s)
- Sylvie Le May
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada; CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada.
| | - Mathilde Hupin
- CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada; Department of Surgery, CHU Sainte-Justine, Montreal, QC, Canada
| | - Christelle Khadra
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada; CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada
| | - Ariane Ballard
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada; CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada
| | - David Paquin
- Department of Creation and NEW Media, UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Myriam Beaudin
- CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, UQO Université du Québec en Outaouais, Quebec, Canada
| | - Casey Cotes-Turpin
- Department of Creation and NEW Media, UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Estelle Guingo
- Department of Creation and NEW Media, UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Hunter G Hoffman
- Virtual Reality Research Center, University of Washington, Seattle, Washington, USA
| | - Johanne Déry
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada
| | - Nicole Hung
- CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada
| | - Isabelle Perreault
- CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada
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Osmanlliu E, Trottier ED, Bailey B, Lagacé M, Certain M, Khadra C, Sanchez M, Thériault C, Paquin D, Côtes-Turpin C, Le May S. Distraction in the Emergency department using Virtual reality for INtravenous procedures in Children to Improve comfort (DEVINCI): a pilot pragmatic randomized controlled trial. CAN J EMERG MED 2020; 23:94-102. [PMID: 33683617 DOI: 10.1007/s43678-020-00006-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Intravenous (IV) procedures cause pain and distress in the pediatric emergency department (ED). We studied the feasibility and acceptability of virtual reality distraction for patient comfort during intravenous procedures. METHODS Children were randomized to a control (standard care) or intervention group (standard care + virtual reality). Thresholds for feasibility and acceptability (primary outcomes) were determined through a priori established criteria. The level of procedural pain (principal clinical outcome) and distress, as well as memory of pain at 24 h were collected and reported as medians (Q1, Q3) for each group. RESULTS 63 patients were enrolled, with a high rate of recruitment (78.8%) and game completion (90.3%). Patients, parents and, healthcare providers reported high satisfaction levels. There were no serious adverse events. Five of the 30 patients (16.7%) exposed to virtual reality reported mild side effects. Self-reported procedural pain (verbal numerical rating scale: 3 (1, 6)/10 vs 3 (1, 5.5)/10, p = 0.75) was similar between groups. Further exploratory clinical measures were reported for the intervention and control groups, respectively: self-rated distress during the procedure (Child Fear Scale: 1 (0, 2)/4 vs 2 (0, 3)/4); distress evaluated by proxy during the procedure (Procedure Behavior Check List: 8 (8, 9)/40 vs 10 (8, 15)/40); memory of pain at 24 h (VNRS: 2 (1, 3)/10 vs 4 (2, 6.5)/10). CONCLUSION The addition of virtual reality to standard care is feasible and acceptable for pain and distress management during IV procedures in the pediatric ED. Occasional mild, self-resolving side effects were observed in the intervention group. Self-reported pain during the procedure was similar between groups. CLINICALTRIALS. GOV IDENTIFIER NCT03750578.
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Affiliation(s)
- Esli Osmanlliu
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
| | - Evelyne D Trottier
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Benoit Bailey
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Maryse Lagacé
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.,CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, Canada
| | - Mélanie Certain
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Christelle Khadra
- CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, Canada.,Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Marisol Sanchez
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Corinne Thériault
- Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - David Paquin
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
| | - Casey Côtes-Turpin
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
| | - Sylvie Le May
- CHU Sainte-Justine Research Centre, Université de Montréal, Montréal, Canada.,Faculty of Nursing, Université de Montréal, Montréal, Canada
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Khadra C, Ballard A, Paquin D, Cotes-Turpin C, Hoffman HG, Perreault I, Fortin JS, Bouchard S, Théroux J, Le May S. Corrigendum to 'Effects of a projector-based hybrid virtual reality on pain in young children with burn injuries during hydrotherapy sessions: A within-subject randomized crossover trial'[Burns 46 (2020) 1571-1584]. Burns 2020; 47:1940. [PMID: 34670713 DOI: 10.1016/j.burns.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Christelle Khadra
- University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal (Quebec) H3T 1A8, Canada; CHU Sainte-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal (Quebec) H3T 1C5, Canada
| | - Ariane Ballard
- University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal (Quebec) H3T 1A8, Canada; CHU Sainte-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal (Quebec) H3T 1C5, Canada
| | - David Paquin
- Department in Creation and New Media, Université du Québec en Abitibi-Témiscamingue, Campus Rouyn-Noranda, 445, boul. de l'Université, Rouyn-Noranda (Quebec) J9X 5E4, Canada
| | - Casey Cotes-Turpin
- Department in Creation and New Media, Université du Québec en Abitibi-Témiscamingue, Campus Rouyn-Noranda, 445, boul. de l'Université, Rouyn-Noranda (Quebec) J9X 5E4, Canada
| | - Hunter G Hoffman
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Seattle, WA 98195, USA
| | - Isabelle Perreault
- Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montreal (Quebec) H3T 1C5, Canada
| | - Jean-Simon Fortin
- Emergency Department, Hôpital de Granby, 205 Boulevard Leclerc O, Granby (Quebec) J2G 1T7, Canada
| | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 283, boulevard Alexandre-Taché, Gatineau (Quebec) J9A 1L8, Canada
| | - Jean Théroux
- Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia
| | - Sylvie Le May
- University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal (Quebec) H3T 1A8, Canada; CHU Sainte-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal (Quebec) H3T 1C5, Canada.
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18
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Le May S, Tsimicalis A, Noel M, Rainville P, Khadra C, Ballard A, Guingo E, Cotes-Turpin C, Addab S, Chougui K, Francoeur M, Hung N, Bernstein M, Bouchard S, Parent S, Hupin Debeurme M. Immersive virtual reality vs. non-immersive distraction for pain management of children during bone pins and sutures removal: A randomized clinical trial protocol. J Adv Nurs 2020; 77:439-447. [PMID: 33098330 DOI: 10.1111/jan.14607] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022]
Abstract
AIMS To examine the efficacy of an immersive virtual reality distraction compared with an active non-immersive distraction, such as video games on a tablet, for pain and anxiety management and memory of pain and anxiety in children requiring percutaneous bone pins and/or suture removal procedures. DESIGN Three-centre randomized clinical trial using a parallel design with two groups: experimental and control. METHODS Study to take place in the orthopaedic department of three children hospital of the Montreal region starting in 2019. Children, from 7-17 years old, requiring bone pins and/or suture removal procedures will be recruited. The intervention group (N = 94) will receive a virtual reality game (Dreamland), whereas the control group (N = 94) will receive a tablet with video games. The primary outcomes will be both the mean self-reported pain score measured by the Numerical Rating Scale and mean anxiety score, measured by the Child Fear Scale. Recalls of pain and anxiety will be measured 1 week after the procedure using the same scales. We aim to recruit 188 children to achieve a power of 80% with a significance level (alpha) of 5%. DISCUSSION While multiple pharmacological methods have previously been tested for children, no studies have evaluated the impact of immersive virtual reality distraction for pain and anxiety management in the orthopaedic setting. IMPACT Improved pain management can be achieved using virtual reality during medical procedures for children. This method is innovative, non-pharmacological, adapted to the hospital setting, and user-friendly. TRIAL REGISTRATION NCT03680625, registered on clinicaltrials.gov.
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Affiliation(s)
- Sylvie Le May
- Research Center, CHU Sainte-Justine, Montreal, QC, Canada.,Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada.,Shriners' Hospital for children in Montreal, Montreal, QC, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Pierre Rainville
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | | | - Ariane Ballard
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Estelle Guingo
- UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Casey Cotes-Turpin
- UQAT Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Sofia Addab
- Shriners' Hospital for children in Montreal, Montreal, QC, Canada
| | - Khadidja Chougui
- Shriners' Hospital for children in Montreal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | | | - Nicole Hung
- Research Center, CHU Sainte-Justine, Montreal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Mitchell Bernstein
- Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, QC, Canada
| | | | - Stefan Parent
- Department of Surgery, CHU Sainte-Justine, Montreal, QC, Canada
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Trottier ED, Osmanlliu E, Bailey B, Lagacé M, Sanchez M, Certain M, Khadra C, Thériault C, Paquin D, Cotes Turpin C, Le May S. 80 Distraction in the ED using Virtual reality for Intravenous Needs in Children to Improve comfort -the DEVINCI project: A Pilot RCT. Paediatr Child Health 2020. [DOI: 10.1093/pch/pxaa068.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Venipuncture is a frequent cause of pain and distress in the pediatric emergency department (ED). Healthcare professionals must optimize patient comfort during such procedures, given the associated short- and long-term adverse events. Distraction, which can improve patient experience, remains the most studied psychological intervention. Virtual reality (VR) is a method of immersive distraction that can contribute to the multi-modal management of procedural pain and distress. Its use in the healthcare setting has become more accessible due to the development of more portable and affordable systems.
Objectives
The primary outcome of this study was to determine the feasibility and acceptability of a VR distraction device in the pediatric ED.
The secondary outcomes were to examine the preliminary effects of the addition of VR to standard practice on children’s pain, distress, and memory of pain associated with venipunctures in the pediatric ED.
Design/Methods
This pilot RCT was performed at a tertiary pediatric centre. Children 7-17 years old requiring a venipuncture in the ED were recruited. Participants were randomized to either a control group (standard care) or intervention group (standard care+VR).
A priori feasibility and acceptability criteria were established following expert consensus (nurses/physicians working in the ED):
- 80% of families approached for recruitment consent to participate;
- 80% of recruited patients finish the game as planned (intervention group);
- Mean >7 on the 0-10 satisfaction scale (patients/parents/healthcare providers);
- No serious adverse events.
The principal clinical outcome was the mean level of procedural pain as measured by the verbal numerical rating scale (VNRS). Auto-evaluation of procedural-related distress was performed using the Child Fear Scale (CFS). The level of distress related to the procedure was also evaluated by proxy using the Procedure Behavior Check List (PBCL). Memory of pain was measured at 24h using the VNRS. Side effects were documented.
Results
A total of 63 patients were recruited between December 2018 and April 2019 (one was excluded as the venipuncture was later cancelled).
The results showed feasibility and acceptability of VR in the pediatric ED with:
-79% recruitment rate of eligible families
-90% rate of VR game completion as per protocol (reason for not completing the game: prior headache, wanting to see, VR not working well) and
-overall high mean satisfaction levels.
In addition, there was a significantly higher level of satisfaction among healthcare providers in the intervention group, and 93% of those were willing to use this technology again for the same procedure.
Regarding clinical outcomes, there was no significant difference between groups in self-reported procedural pain, but evaluation of distress by proxy (10/40 vs 13.2/40, p = 0.007) and memory of pain at 24 hours (2.4 vs 4.2, p = 0.027) were significantly lower in the intervention group. Venipuncture was successful on first attempt in 23/31 patients (74%) in the VR group and 15/30 (50%) patients in the control group (p = 0.039). Five of the 31 patients (16%) in the VR group reported side effects, which were mild and self-resolving.
Conclusion
The addition of VR to standard of care for pain and distress management related to venipunctures in the pediatric ED is a feasible and acceptable intervention. Side effects related to VR were few and self-resolving. Both experimental groups were similar with respect to self-reported procedural pain. A lower level of procedural distress, lower memory of pain at 24 hours, and higher venipuncture first attempt success rate were observed in the VR group.
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Boitor M, Ballard A, Emed J, Le May S, Gélinas C. Risk factors for severe opioid-induced respiratory depression in hospitalized adults: A case-control study. Can J Pain 2020; 4:103-110. [PMID: 33987489 PMCID: PMC7951145 DOI: 10.1080/24740527.2020.1714431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Opioids are commonly prescribed to hospitalized adults to promote adequate pain relief, yet they can cause potentially fatal respiratory depression. Aim: The aim of this study was to examine the risk factors for the development of severe opioid-induced respiratory depression (OIRD) in hospitalized adults to ensure adequate monitoring of high-risk patients. Methods: A retrospective case–control study was conducted using data from the medical records of a university-affiliated hospital in Canada. Cases were eligible if they were adults (≥18 years old) and received opioid analgesia within 24 h of naloxone administration for respiratory depression. Controls had the same eligibility criteria, except for respiratory depression and naloxone administration. The case–control ratio was 1:1, and they were matched based on sex, type of unit, opioid molecule and the presence/absence of medication errors. Results: A total of 133 cases and 133 controls were included. Following cumulative risk factor analysis, renal failure (odds ratio [OR] = 2.176, 95% confidence interval [CI], 1.021–4.640, P = 0.044), the first 24 h of opioid administration (OR = 1.899, 95% CI, 1.090–3.309, P = 0.024), concomitant central nervous system (CNS) depressants (OR = 1.785, 95% CI, 1.023–3.113, P = 0.041), and increasing age (OR = 1.019, 95% CI, 1.002–1.035, P = 0.028) were positively associated with severe OIRD. Conclusions: Some adult hospitalized patients were at higher risk of experiencing severe OIRD, such as those with renal failure, those in their first 24 h of opioid administration, those receiving CNS depressants in addition to opioids, and those with an advanced age. These results will assist with the screening of patients at higher risk for severe OIRD, which is key to implementing appropriate monitoring and enhancing the safety of opioid use in hospital settings.
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Affiliation(s)
- Madalina Boitor
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ariane Ballard
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
| | - Jessica Emed
- CIUSSS West-Central-Montreal, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada.,Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Céline Gélinas
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.,Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
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21
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Ballard A, Khadra C, Adler S, Parent E, Trottier ED, Bailey B, Poonai N, May SL. 100 External Cold and Vibration for Pain Management of Children Undergoing Needle-Related Procedures in the Emergency Department: A Randomized Controlled Non-Inferiority Trial. Paediatr Child Health 2019. [DOI: 10.1093/pch/pxz066.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ariane Ballard
- Faculty of Nursing, Université de Montréal, Montreal, Canada
| | - Christelle Khadra
- Faculty of Nursing, Université de Montréal, Montreal, Canada
- CHU Sainte-Justine Research Centre, Montreal, Canada
| | | | - Emilie Parent
- Faculty of Medicine, Université de Sherbrooke, Chicoutimi, Canada
| | | | - Benoit Bailey
- Department of Pediatrics, CHU Sainte-Justine, Montreal, Canada
| | - Naveen Poonai
- Department of Emergency Medicine, London Health Sciences Centre, Canada
- Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Children’s Health Research Institute, London Health Sciences Centre, London, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, Montreal, Canada
- CHU Sainte-Justine Research Centre, Montreal, Canada
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Tsimicalis A, Rennick J, Le May S, Stinson J, Sarkis B, Séguin K, Siedlikowski M, Choquette A, Louli J. “Tell it as it is”: How Sisom prompts children and parents to discuss their cancer experience. Cancer Rep (Hoboken) 2019. [DOI: 10.1002/cnr2.1173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Janet Rennick
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Montreal Children's HospitalMcGill University Health Centre Montreal Quebec Canada
| | - Sylvie Le May
- UHC Sainte‐Justine Montreal Quebec Canada
- University of Montreal Montreal Quebec Canada
| | - Jennifer Stinson
- The Hospital for Sick Children Toronto Ontario Canada
- Lawrence S Bloomberg Faculty of NursingUniversity of Toronto Toronto Ontario Canada
| | - Bianca Sarkis
- Faculty of MedicineMcGill University Montreal Quebec Canada
| | - Karine Séguin
- Faculty of ScienceMcGill University Montreal Quebec Canada
| | - Maia Siedlikowski
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
- Shriners Hospitals for Children®‐Canada Montreal Quebec Canada
| | - Anne Choquette
- Montreal Children's HospitalMcGill University Health Centre Montreal Quebec Canada
| | - Julie Louli
- Ingram School of Nursing, Faculty of MedicineMcGill University Montreal Quebec Canada
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De Clifford-Faugère G, Aita M, Le May S. Nurses' practices regarding procedural pain management of preterm infants. Appl Nurs Res 2019; 45:52-54. [PMID: 30683251 DOI: 10.1016/j.apnr.2018.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/26/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND It is well known that preterm neonates can feel pain which can be expressed through specific behaviors and signs. Repeated and untreated pain has consequences for the preterm neonates such as hypersensitivity to pain, as well as important repercussions on their motor and intellectual development. The use of non-pharmacological interventions for pain management by nurses is imperative to prevent these consequences in the NICU. The aim of this study is to survey neonatal nurses' interventions for pain management of preterm neonates. METHODS Twenty (20) nurses were recruited for this pilot observational survey study. Standard pain management interventions used by nurses during heel prick were evaluated by means of a questionnaire. In addition, 11 out of the 20 nurses were observed during heel prick to evaluate what and how interventions were done. RESULTS All infants (n = 11) received at least one pain management intervention during heel prick. Heterogeneity in pain management practices used by nurses is considerable. For 95% (19/20) of nurses, sucrose is a standard intervention reported in the survey but observations showed that it not always applied (64%). Positioning is more used (64%) by nurses than reported in the survey (45%). Swaddling also was also reported as a standard intervention by 45% of nurses, but it does not appear to be adequately performed (36%). CONCLUSION According to the results, it would be essential to review nurses' knowledge and skills regarding standard pain management interventions, during painful procedures, as the quality of these practices is questionable. Homogeneity of the standard of care is particularly important in research to allow an appropriate comparison between study groups and prevention study bias.
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Affiliation(s)
- Gwenaëlle De Clifford-Faugère
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, QC, H3C 3J7, Canada; CHU Sainte-Justine Research Center, Montreal, QC, H3T 1C5, Canada.
| | - Marilyn Aita
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, QC, H3C 3J7, Canada; CHU Sainte-Justine Research Center, Montreal, QC, H3T 1C5, Canada.
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, QC, H3C 3J7, Canada; CHU Sainte-Justine Research Center, Montreal, QC, H3T 1C5, Canada.
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Ballard A, Khadra C, Adler S, D Trottier E, Bailey B, Poonai N, Théroux J, Le May S. External cold and vibration for pain management of children undergoing needle-related procedures in the emergency department: a randomised controlled non-inferiority trial protocol. BMJ Open 2019; 9:e023214. [PMID: 30782698 PMCID: PMC6340451 DOI: 10.1136/bmjopen-2018-023214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Needle-related procedures are considered as the most important source of pain and distress in children in hospital settings. Considering the physiological and psychological consequences that could result from these procedures, management of pain and distress through pharmacological and non-pharmacological methods is essential. Therefore, it is important to have interventions that are rapid, easy-to-use and likely to be translated into clinical practice for routine use. The aim of this study will be to determine whether a device combining cold and vibration (Buzzy) is non-inferior to a topical anaesthetic (liposomal lidocaine 4% cream) for pain management of children undergoing needle-related procedures in the emergency department. METHODS AND ANALYSIS This study will be a randomised controlled non-inferiority trial comparing the Buzzy device to liposomal lidocaine 4% cream for needle-related pain management. A total of 346 participants will be randomly assigned in a 1:1 ratio to one of the two study groups. The primary outcome will be the mean difference in pain intensity between groups during needle-related procedures. A non-inferiority margin of 0.70 on the Color Analogue Scale will be considered. A Non-inferiority margin of 0.70 on the Color Analogue Scale will be considered. The secondary outcomes will be the level of distress during the procedure, the success of the procedure at first attempt, the occurrence of adverse events, the satisfaction of both interventions and the memory of pain 24 hours after the procedure. The primary outcome will be assessed for non-inferiority and the secondary outcomes for superiority. ETHICS AND DISSEMINATION This study protocol was reviewed and approved by the institutional review board of the study setting. Findings of this trial will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER NCT02616419.
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Affiliation(s)
- Ariane Ballard
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
| | - Christelle Khadra
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
| | - Samara Adler
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Evelyne D Trottier
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Benoit Bailey
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Naveen Poonai
- Department of Emergency Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Children's Health Research Institute, London Health Sciences Centre, London, Ontario, Canada
| | - Jean Théroux
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
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Tremblay V, Khadra C, Ballard A, Charette S, Fortin C, Paquette J, Villeneuve E, Le May S. Développement et validation de l’Échelle d'Observation Comportementale du Confort d'Enfants Brûlés (OCCEB-BECCO). ACTA ACUST UNITED AC 2018. [DOI: 10.31770/2561-7516.1017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Trottier ED, Ali S, Thull-Freedman J, Meckler G, Stang A, Porter R, Blanchet M, Dubrovsky AS, Kam A, Jain R, Principi T, Joubert G, Le May S, Chan M, Neto G, Lagacé M, Gravel J. Treating and reducing anxiety and pain in the paediatric emergency department-TIME FOR ACTION-the TRAPPED quality improvement collaborative. Paediatr Child Health 2018; 23:e85-e94. [PMID: 30046273 PMCID: PMC6054215 DOI: 10.1093/pch/pxx186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND/OBJECTIVES In 2013, the TRAPPED-1 survey reported inconsistent availability of pain and distress management strategies across all 15 Canadian paediatric emergency department (PEDs). The objective of the TRAPPED-2 study was to utilize a procedural pain quality improvement collaborative (QIC) and evaluate the number of newly introduced pain and distress-reducing strategies in Canadian PEDs over a 2-year period. METHODS A QIC was created to increase implementation of new strategies, through collaborative information sharing among PEDs. In 2015, 11 of the 15 Canadian PEDs participated in the TRAPPED QIC. At the end of the year, the TRAPPED-2 survey was electronically sent to a representative member at each of the 15 PEDs. The successful introduction of the chosen strategies by the QIC was assessed as well as the addition of new strategies per site. The number of new strategies introduced in the participating and nonparticipating QIC sites were described. RESULTS All 15 PEDs (100%) completed the TRAPPED-2 survey. Overall, 10/11 of QIC-participating sites implemented the strategy they had initially identified. All 15 Canadian PEDs implemented some new strategies during the study period; participants in the QIC reported a mean of 5.2 (1-11) new strategies compared to 2.5 (1-4) in the nonactively participating sites. CONCLUSION While all PEDs introduced new strategies during the study, QIC-participating sites successfully introduced the majority of their previously identified new strategies in a short time period. Sharing deadlines and information between centres may have contributed to this success.
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Affiliation(s)
| | - Samina Ali
- Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta
| | | | - Garth Meckler
- BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia
| | - Antonia Stang
- Alberta Children’s Hospital, University of Calgary, Calgary, Alberta
| | - Robert Porter
- Janeway Children’s Hospital, Memorial University, St-Johns, Newfoundl
| | | | | | - April Kam
- McMaster Children’s Hospital, McMaster University, Hamilton, Ontario
| | | | - Tania Principi
- Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | | | - Sylvie Le May
- CHU Sainte-Justine, Université de Montréal, Montréal, Québec
| | - Melissa Chan
- Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta
| | - Gina Neto
- CHEO, University of Ottawa, Ottawa, Ontario
| | - Maryse Lagacé
- CHU Sainte-Justine, Université de Montréal, Montréal, Québec
| | - Jocelyn Gravel
- CHU Sainte-Justine, Université de Montréal, Montréal, Québec
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Tsimicalis A, Rennick J, Stinson J, May SL, Louli J, Choquette A, Treherne S, Berube S, Yoon S, Ruland C. Usability Testing of an Interactive Communication Tool to Help Children Express Their Cancer Symptoms. J Pediatr Oncol Nurs 2018; 35:320-331. [PMID: 29848164 DOI: 10.1177/1043454218777728] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Sisom is an interactive computer software program that allows children to rate the severity of their cancer symptoms. The study objectives were to describe the usability of Sisom in terms of ease of use, usefulness, and aesthetics and to offer suggestions for improvement. METHOD A multisite, descriptive study was conducted to describe the usability of Sisom. A purposive sample of children, ages 6 to 12 years, being treated for cancer was recruited. English- and French-speaking children completed the eight tasks in Sisom recorded using Morae software and provided input via an audiotaped interview. Data were downloaded, transcribed verbatim, and analyzed descriptively. RESULTS Thirty-four children with varying cancers participated. The majority of children liked Sisom and found Sisom easy to use, found it to be helpful in expressing their symptoms, and were satisfied with the aesthetics. Some children provided suggestions for improvement to optimize Sisom use in Canada. CONCLUSIONS Children's positive responses and desire to use Sisom again suggest that future research should be directed toward implementing and evaluating its effectiveness in a variety of settings.
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Affiliation(s)
- Argerie Tsimicalis
- 1 McGill University, Montreal, Quebec, Canada.,2 Shriners Hospitals for Children®-Canada, Montreal, Quebec, Canada
| | - Janet Rennick
- 1 McGill University, Montreal, Quebec, Canada.,3 Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jennifer Stinson
- 4 The Hospital for Sick Children, Toronto, Ontario, Canada.,5 University of Toronto, Toronto, Ontario, Canada
| | - Sylvie Le May
- 6 UHC Sainte-Justine, Montreal, Quebec, Canada.,7 University of Montreal, Montreal, Quebec, Canada
| | - Julie Louli
- 1 McGill University, Montreal, Quebec, Canada
| | - Anne Choquette
- 3 Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Sarah Berube
- 6 UHC Sainte-Justine, Montreal, Quebec, Canada.,7 University of Montreal, Montreal, Quebec, Canada
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Ballard A, Khadra C, Adler S, Doyon-Trottier E, Le May S. Efficacy of the Buzzy® device for pain management of children during needle-related procedures: a systematic review protocol. Syst Rev 2018; 7:78. [PMID: 29788987 PMCID: PMC5964660 DOI: 10.1186/s13643-018-0738-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/01/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Needle-related procedures are the most important source of pain in children in hospital setting. Unmanaged pain could result in short- and long-term physiological, psychological, and emotional consequences. Although the efficacy of numerous interventions has been evaluated, procedural pain management is often suboptimal in children undergoing needle-related procedures. The main objective of this systematic review is to examine the evidence for the efficacy of the Buzzy® device for needle-related procedural pain in children. METHODS An electronic search will be conducted in the following databases: CENTRAL, PubMed, MEDLINE, EMBASE, PsycInfo, and CINAHL. There will be no restriction regarding the language, date of publication, and publication status. Eligible studies will be randomized controlled trials using the Buzzy® device for pain management in children undergoing needle-related procedures. Selection of studies, data extraction and management, assessment of risk of bias and quality of evidence will be performed by two independent reviewers. A third researcher will be consulted in case of discrepancies. Depending on the availability and quality of the data as well as clinical and statistical heterogeneity, a meta-analysis will be performed. Otherwise, findings will be qualitatively reported. DISCUSSION This will be the first systematic review to examine the efficacy of the Buzzy® device on pain management of children during needle-related procedures. Results of this review will guide clinical practice and recommendations for further research to improve procedural pediatric pain management. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017076531.
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Affiliation(s)
- Ariane Ballard
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Christelle Khadra
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Samara Adler
- Faculty of Medicine, University of Montreal, 2900, boulevard Édouard-Monpetit, Montreal, QC H3T 1J4 Canada
| | - Evelyne Doyon-Trottier
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, 2375, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1A8 Canada
- CHU Sainte-Justine Research Centre, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1C4 Canada
- Faculty of Nursing, University of Montreal, P.O. Box 6128, Succursale Centre-Ville, Montreal, QC H3C 3J7 Canada
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Martorella G, Boitor M, Berube M, Fredericks S, Le May S, Gélinas C. Tailored Web-Based Interventions for Pain: Systematic Review and Meta-Analysis. J Med Internet Res 2017; 19:e385. [PMID: 29127076 PMCID: PMC5701966 DOI: 10.2196/jmir.8826] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated. OBJECTIVE The primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions. METHODS We conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (<1 month), medium term (1-6 months), and long term (6-12 months). RESULTS After full-text review, we excluded 31 articles, resulting in 17 eligible studies. Only 1 study concerned acute pain and was removed from the meta-analysis, resulting in 16 studies available for quantitative assessment. Compared with standard care or a waiting list, tailored Web-based intervention showed benefits immediately after, with small effect sizes (<0.40) for pain intensity (10 randomized controlled trials [RCTs], n=1310, P=.003) and pain-related disability (6 RCTs, n=953, P<.001). No other improvements were observed at follow-up in the medium and long terms. Compared with the active control group, no improvements were found for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing (2 RCTs, n=333, P<.001) immediately after the intervention. CONCLUSIONS Tailored Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain catastrophizing compared with active control interventions. Considering the diversity of approaches used in tailored Web-based interventions for chronic pain management, their efficacy is yet to be explored. Moreover, their contribution to acute pain management is embryonic. TRIAL REGISTRATION International prospective register of systematic reviews (PROSPERO): CRD42015027669; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42015027669 (Archived by WebCite at http://www. webcitation.org/6uneWAuyR).
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Affiliation(s)
- Geraldine Martorella
- College of Nursing, Florida State University, Tallahassee, FL, United States
- Tallahassee Memorial Hospital Center for Research and Evidence-Based Practice, Tallahassee, FL, United States
- Quebec Nursing Intervention Research Network (RRISIQ), Montreal, QC, Canada
| | - Madalina Boitor
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Melanie Berube
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Department of Trauma, Centre Integré Universitaire du Nord de l'Île de Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
- Department of Nursing, Centre Integré Universitaire du Nord de l'Île de Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Suzanne Fredericks
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sylvie Le May
- Quebec Nursing Intervention Research Network (RRISIQ), Montreal, QC, Canada
- Faculté des sciences infirmières, Université de Montréal, Montreal, QC, Canada
- Centre de recherche, Centre hospitalier universitaire Ste Justine, Montreal, QC, Canada
| | - Céline Gélinas
- Quebec Nursing Intervention Research Network (RRISIQ), Montreal, QC, Canada
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Center for Nursing Research, Jewish General Hospital, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC, Canada
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Le May S, Ali S, Plint AC, Mâsse B, Neto G, Auclair MC, Drendel AL, Ballard A, Khadra C, Villeneuve E, Parent S, McGrath PJ, Leclair G, Gouin S. Oral Analgesics Utilization for Children With Musculoskeletal Injury (OUCH Trial): An RCT. Pediatrics 2017; 140:peds.2017-0186. [PMID: 29021235 DOI: 10.1542/peds.2017-0186] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Musculoskeletal injuries (MSK-Is) are a common and painful condition among children that remains poorly treated in the emergency department (ED). We aimed to test the efficacy of a combination of an anti-inflammatory drug with an opioid for pain management of MSK-I in children presenting to the ED. METHODS In this randomized, double-blinded, placebo-controlled trial, we enrolled children between 6 and 17 years presenting to the ED with an MSK-I and a pain score >29 mm on the visual analog scale (VAS). Participants were randomly assigned to oral morphine (0.2 mg/kg) + ibuprofen (10 mg/kg) (morphine + ibuprofen) or morphine (0.2 mg/kg) + placebo of ibuprofen or ibuprofen (10 mg/kg) + placebo of morphine. Primary outcome was children with VAS pain score <30 mm at 60 minutes postmedication administration. RESULTS A total of 501 participants were enrolled and 456 were included in primary analyses (morphine + ibuprofen = 177; morphine = 188; ibuprofen = 91). Only 29.9% (morphine + ibuprofen), 29.3% (morphine), and 33.0% (ibuprofen) of participants achieved the primary outcome (P = .81). Mean VAS pain reduction at 60 minutes were -18.7 (95% confidence interval [CI]: -21.9 to -16.6) (morphine + ibuprofen), -17.0 (95% CI: -20.0 to -13.9) (morphine), -18.6 (95% CI: -22.9 to -14.2) (ibuprofen) (P = .69). Children in the morphine + ibuprofen group (P < .001) and in the morphine group (P < .001) experienced more side effects than those in the ibuprofen group. No serious adverse event was reported. CONCLUSIONS Combination of morphine with ibuprofen did not provide adequate pain relief for children with MSK-I in the ED. None of the study medication provided an optimal pain management because most of children did not reach a mild pain score (NCT02064894).
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Affiliation(s)
- Sylvie Le May
- Faculties of Nursing and .,CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Samina Ali
- Women and Children's Health Research Institute, Edmonton, Alberta, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Amy C Plint
- Departments of Pediatrics and.,Emergency Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Benoit Mâsse
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Gina Neto
- Emergency Department, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Amy L Drendel
- Departments of Pediatrics and.,Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ariane Ballard
- Faculties of Nursing and.,CHU Sainte-Justine Research Center, Montreal, Quebec, Canada.,Women and Children's Health Research Institute, Edmonton, Alberta, Canada
| | - Christelle Khadra
- Faculties of Nursing and.,CHU Sainte-Justine Research Center, Montreal, Quebec, Canada.,Women and Children's Health Research Institute, Edmonton, Alberta, Canada
| | | | | | - Patrick J McGrath
- IWK Health Centre, Nova Scotia Health Authority and Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Serge Gouin
- Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada; and
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Théroux J, Stomski N, Hodgetts CJ, Leboeuf-Yde C, Walker BF, Le May S, Labelle H. Tracking low back pain in adolescent idiopathic scoliosis: a prospective cohort study protocol. Chiropr Man Therap 2017; 25:22. [PMID: 28878881 PMCID: PMC5584321 DOI: 10.1186/s12998-017-0155-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/25/2017] [Indexed: 11/23/2022] Open
Abstract
Background Numerous methodological limitations have constrained the findings of previous studies that have examined the prevalence of low back pain in adolescents with idiopathic scoliosis. This article presents a study protocol that has been designed to address the shortcomings of prior research in this area. In addition, it will establish the level of disease burden associated with acute, recurrent, and chronic low back pain in adolescents with idiopathic scoliosis. Methods This study will involve a prospective cohort of adolescents with idiopathic scoliosis presenting to an outpatient department in a paediatric hospital. Potential participants will be eligible for inclusion if they are aged 10–17 years, experience adolescent idiopathic scoliosis, own a mobile phone, and are able to communicate in either French or English adequately. The primary outcome measure is the presence of low back pain. The secondary outcome will be measures with the Brief Pain Questionnaire and the PedsQL questionnaire. Participants will be followed over a 12-month period reporting weekly, via SMS-tracking. Discussion Previous studies frequently established the prevalence of low back pain through asking participants to recall whether they experienced low back pain over certain periods. These periods often extended beyond many months, and hence were subject to recall bias. Our study addresses such bias through gathering data on a weekly basis using SMS-tracking providing detailed information about the progression of low back pain, which allows researchers to establish the prevalence of acute, recurrent, and chronic low back pain with a better certainty. Furthermore, the previous studies failed to use a standardised definition of low back pain. As such, it is not possible to determine whether the reported low back pain was experienced at the following standardised defined location: “pain in the space between the lower posterior margin of the rib cage and the horizontal gluteal fold”. Conclusion This research protocol will be the first study to determine the proportion of adolescents with idiopathic scoliosis who experience acute, recurrent, and chronic low back pain, and establish the level of the burden associated with these subgroups of low back pain.
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Affiliation(s)
- Jean Théroux
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,School of Health Professions, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Norman Stomski
- School of Health Professions, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Christopher J Hodgetts
- School of Health Professions, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Charlotte Leboeuf-Yde
- School of Health Professions, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Bruce F Walker
- School of Health Professions, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Sylvie Le May
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Hubert Labelle
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Medicine, University of Montreal, Montreal, Canada
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Théroux J, Stomski N, Innes S, Ballard A, Khadra C, Labelle H, Le May S. Revisiting the psychometric properties of the Scoliosis Research Society-22 (SRS-22) French version. Scoliosis Spinal Disord 2017; 12:21. [PMID: 28725867 PMCID: PMC5513359 DOI: 10.1186/s13013-017-0129-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 06/16/2017] [Indexed: 11/30/2022]
Abstract
Background Adolescent idiopathic scoliosis (AIS) is among the most common spinal deformities affecting adolescents. The Scoliosis Research Society-22 questionnaire is commonly used to assess health-related quality of life in AIS patients, including pain. The objective of this study is to verify the psychometric properties of the Scoliosis Research Society-22 French version (SRS-22fv) questionnaire. Methods A prospective methodological design was used to verify the psychometric properties of the French version of the SRS-22fv. Participants were initially recruited from the orthopaedic scoliosis department at Sainte-Justine Hospital (Montreal, Canada) and completed the SRS-22fv and the SF-12 questionnaire. The SRS-22fv’s structure was evaluated through principal component analysis (PCA). Linear regression was used to assess convergent validity between the SRS-22fv and the SF-12. Results Data was available from 352 participants with AIS. Most participants were female (87%, n = 307), and the average age was 14.3 (SD = 1.8) years. The mean thoracic and lumbar Cobb angles were 27.9° (SD = 3.3) and 23.6° (SD = 9.4), respectively. Overall, 71.4% (n = 252) of the participants presented with spinal pain. About one-third (29%) reported thoracic pain, and almost half (44%) experienced lumbar pain. The PCA identified four redundant items, which resulted in a modified 18-item questionnaire. In comparison to the original questionnaire, the modified version showed higher levels of internal consistency for four of the five factors, explained a greater proportion of the total variance (63.3%), and generated higher inter-item total correlations. Conclusion We propose a shorter version of the SRS-22fv, thus the Canadian SRS-18fv, which showed an improved internal consistency and scale structure compared to the original SRS-22fv. We believe that this modified version would be better suited to assess the quality of life of adolescents with idiopathic scoliosis.
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Affiliation(s)
- Jean Théroux
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,School of Health Profession, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Norman Stomski
- School of Health Profession, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Stanley Innes
- School of Health Profession, Murdoch University, 90, South Street, Murdoch, WA 6150 Australia
| | - Ariane Ballard
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Christelle Khadra
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Hubert Labelle
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Sylvie Le May
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
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Théroux J, Stomski N, Losco CD, Khadra C, Labelle H, Le May S. Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review. J Manipulative Physiol Ther 2017; 40:452-458. [PMID: 28822477 DOI: 10.1016/j.jmpt.2017.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/09/2017] [Accepted: 03/14/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to perform a systematic review of clinical trials of spinal manipulative therapy for adolescent idiopathic scoliosis. METHODS Search strategies were developed for PubMed, CINHAL, and CENTRAL databases. Studies were included through June 2016 if they were prospective trials that evaluated spinal manipulative therapy (eg, chiropractic, osteopathic, physical therapy) for adolescent idiopathic scoliosis. Data were extracted and assessed by 2 independent reviewers. Cochrane risk of bias tools were used to assess the quality of the included studies. Data were reported qualitatively because heterogeneity prevented statistical pooling. RESULTS Four studies satisfied the inclusion criteria and were critically appraised. The findings of the included studies indicated that spinal manipulative therapy might be effective for preventing curve progression or reducing Cobb angle. However, the lack of controls and small sample sizes precluded robust estimation of the interventions' effect sizes. CONCLUSION There is currently insufficient evidence to establish whether spinal manipulative therapy may be beneficial for adolescent idiopathic scoliosis. The results of the included studies suggest that spinal manipulative therapy may be a promising treatment, but these studies were all at substantial risk of bias. Further high-quality studies are warranted to conclusively determine if spinal manipulative therapy may be effective in the management of adolescent idiopathic scoliosis.
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Affiliation(s)
- Jean Théroux
- Chiropractic Discipline, School of Health Profession, Murdoch University, Murdoch, Western Australia, Australia.
| | - Norman Stomski
- School of Health Profession, Murdoch University, Murdoch, Western Australia, Australia
| | | | - Christelle Khadra
- Faculty of Nursing, University of Montréal, Montréal, Québec, Canada
| | - Hubert Labelle
- Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Sylvie Le May
- Faculty of Nursing, University of Montréal, Montréal, Québec, Canada
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34
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Théroux J, Stomski N, Hodgetts CJ, Ballard A, Khadra C, Le May S, Labelle H. Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropr Man Therap 2017; 25:10. [PMID: 28439404 PMCID: PMC5399433 DOI: 10.1186/s12998-017-0143-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 04/19/2017] [Indexed: 12/20/2022] Open
Abstract
Background Adolescent idiopathic scoliosis is the most common spinal deformity occurring in adolescents and its established prevalence varies from 2 to 3%. Adolescent idiopathic scoliosis has been identified as a potential risk factor for the development of low back pain in adolescents. The purpose of this study was to systematically review studies of the prevalence of low back pain in adolescents with idiopathic scoliosis in order to establish the quality of the evidence and determine whether the prevalence estimates could be statistically pooled. Methods Systematic electronic searches were undertaken in PubMed, CINAHL, and CENTRAL without any restrictions. Studies were eligible for inclusion if they reported the prevalence of low back pain in adolescents with idiopathic scoliosis. Studies were excluded if they detailed the prevalence of pain in post-surgical subjects or were published in languages other than English or French. Data were reported qualitatively, since there was insufficient evidence for statistical pooling. Results The electronic search strategies yielded 1811 unique studies. Only two studies fulfilled the eligibility criteria. The prevalence of low back pain in adolescents with idiopathic scoliosis ranged from 34.7 to 42.0%. However, these prevalence estimates should be viewed cautiously as the included studies were at high risk of bias. Conclusion The results of this systematic review indicate that adolescents with idiopathic scoliosis frequently experience low back pain. However, there was insufficient evidence to confidently estimate low back pain prevalence in adolescents with idiopathic scoliosis and further studies are needed in this area. Electronic supplementary material The online version of this article (doi:10.1186/s12998-017-0143-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean Théroux
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,School of Health Profession, Murdoch University, 90, South Street, Murdoch, 6150 WA Australia
| | - Norman Stomski
- School of Health Profession, Murdoch University, 90, South Street, Murdoch, 6150 WA Australia
| | - Christopher J Hodgetts
- School of Health Profession, Murdoch University, 90, South Street, Murdoch, 6150 WA Australia
| | - Ariane Ballard
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Christelle Khadra
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Sylvie Le May
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Nursing, University of Montreal, Montreal, QC Canada
| | - Hubert Labelle
- Research Center, Sainte-Justine University Hospital Center, Montreal, QC Canada.,Faculty of Medicine, University of Montreal, Montreal, Canada
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Khadra C, Le May S, Ballard A, Théroux J, Charette S, Villeneuve E, Parent S, Tsimicalis A, MacLaren Chorney J. Validation of the scale on Satisfaction of Adolescents with Postoperative pain management - idiopathic Scoliosis (SAP-S). J Pain Res 2017; 10:137-143. [PMID: 28138264 PMCID: PMC5238766 DOI: 10.2147/jpr.s124365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Spinal fusion is a common orthopedic surgery in children and adolescents and is associated with high pain levels postoperatively. If the pain is not well managed, negative outcomes may ensue. To our knowledge, there is no measure in English that assesses patient’s satisfaction with postoperative pain management following idiopathic scoliosis surgery. The aim of the present study was to assess the psychometric properties of the satisfaction subscale of the English version of the Satisfaction of Adolescents with Postoperative pain management – idiopathic Scoliosis (SAP-S) scale. Methods Eighty-two participants aged 10–18 years, who had undergone spinal fusion surgery, fully completed the SAP-S scale at 10–14 days postdischarge. Construct validity was assessed through a principal component analysis using varimax rotation. Results Principal component analysis indicated a three-factor structure of the 13-item satisfaction subscale of the SAP-S scale. Factors referred to satisfaction regarding current medication received (Factor 1), actions taken by nurses and doctors to manage pain (Factor 2) and information received after surgery (Factor 3). Cronbach’s alpha was 0.91, showing very good internal consistency. Data on satisfaction and clinical outcomes were also reported. Conclusion The SAP-S is a valid and reliable measure of satisfaction with postoperative pain management that can be used in both research and clinical settings to improve pain management practices. Although it was developed and validated with adolescents who had undergone spinal fusion surgery, it can be used, with further validation, to assess adolescents’ satisfaction with pain management in other postoperative contexts.
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Affiliation(s)
- Christelle Khadra
- Faculty of Nursing, Université de Montréal; CHU Sainte-Justine Research Centre; Montreal Chest Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal; CHU Sainte-Justine Research Centre
| | - Ariane Ballard
- Faculty of Nursing, Université de Montréal; CHU Sainte-Justine Research Centre
| | - Jean Théroux
- Faculty of Nursing, Université de Montréal; School of Health Professions, Murdoch University, Perth, WA, Australia
| | | | - Edith Villeneuve
- Department of Anesthesia, CHU Sainte-Justine; Department of Anesthesia
| | - Stefan Parent
- CHU Sainte-Justine Research Centre; Department of Surgery, Faculty of Medicine, Université de Montréal; Orthopaedic Service, Department of Surgery, CHU Sainte-Justine
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University; Shriners Hospitals for Children, Montreal, QC
| | - Jill MacLaren Chorney
- Pediatric Complex Pain Team, IWK Health Centre; Department of Anesthesia, Pain Management, and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Ballard A, Le May S, Khadra C, Théroux J, Charette S, Villeneuve E, Chorney J, Fortin C, Parent S. Développement et validation de la version canadienne-française de l’échelle de Satisfaction des Adolescents de la gestion de la Douleur postopératoire – Scoliose idiopathique (SAD-S). Can J Pain 2017; 1:50-60. [PMID: 35005341 PMCID: PMC8730624 DOI: 10.1080/24740527.2017.1324947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Spinal fusion for scoliosis generates moderate to severe pain intensity. There are currently no instruments available to measure adolescents’ satisfaction regarding post-spinal fusion pain management. Aims: To develop and validate a scale on satisfaction of adolescents regarding pain management following spinal fusion for scoliosis. Methods: A methodological design was used to develop and validate the French-Canadian scale “Satisfaction des Adolescents de la gestion de la Douleur postopératoire – Scoliose idiopathique (SAD-S)”. A modified Delphi method, with seven healthcare professionals and 10 adolescents, was used to establish content validity of the SAD-S. A pre-test of the scale was conducted with 10 adolescents post-spinal fusion. The final version of the scale was validated through a pilot study with 98 adolescents following their surgery. Results: The SAD-S scale includes a total of 13 items. Principal component analysis yielded a two-factor structure (2 subscales): 1) Pain management education and 2) Education regarding medication. These two factors explained 47,8% of the total variance for satisfaction. A Cronbach’s alpha of 0,84 was obtained for internal consistency. Conclusion: Validation of the SAD-S scale showed that it has good psychometric properties with this population. Further validation is required with a larger sample to pursue its validation.
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Affiliation(s)
- Ariane Ballard
- Université de Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Sylvie Le May
- Université de Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Christelle Khadra
- Université de Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
- Centre Universitaire de Santé McGill, Montréal, Québec, Canada
| | | | - Sylvie Charette
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Edith Villeneuve
- Université de Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Jill Chorney
- Faculté de Médecine, Université Dalhousie, Halifax, Nouvelle-Écosse, Canada
- IWK Health Centre, Halifax, Nouvelle-Écosse, Canada
| | | | - Stefan Parent
- Université de Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
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Tsimicalis A, Le May S, Stinson J, Rennick J, Vachon MF, Louli J, Bérubé S, Treherne S, Yoon S, Nordby Bøe T, Ruland C. Linguistic Validation of an Interactive Communication Tool to Help French-Speaking Children Express Their Cancer Symptoms. J Pediatr Oncol Nurs 2016; 34:98-105. [PMID: 27226380 DOI: 10.1177/1043454216646532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Sisom is an interactive tool designed to help children communicate their cancer symptoms. Important design issues relevant to other cancer populations remain unexplored. This single-site, descriptive, qualitative study was conducted to linguistically validate Sisom with a group of French-speaking children with cancer, their parents, and health care professionals. The linguistic validation process included 6 steps: (1) forward translation, (2) backward translation, (3) patient testing, (4) production of a Sisom French version, (5) patient testing this version, and (6) production of the final Sisom French prototype. Five health care professionals and 10 children and their parents participated in the study. Health care professionals oversaw the translation process providing clinically meaningful suggestions. Two rounds of patient testing, which included parental participation, resulted in the following themes: (1) comprehension, (2) suggestions for improving the translations, (3) usability, (4) parental engagement, and (5) overall impression. Overall, Sisom was well received by participants who were forthcoming with input and suggestions for improving the French translations. Our proposed methodology may be replicated for the linguistic validation of other e-health tools.
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Affiliation(s)
- Argerie Tsimicalis
- 1 McGill University, Montreal, Quebec, Canada.,2 Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Sylvie Le May
- 3 University of Montreal, Montreal, Quebec, Canada.,4 CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Jennifer Stinson
- 5 The Hospital for Sick Children, Toronto, Ontario, Canada.,6 University of Toronto, Toronto, Ontario, Canada
| | - Janet Rennick
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
| | | | - Julie Louli
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Sarah Bérubé
- 3 University of Montreal, Montreal, Quebec, Canada.,4 CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Stephanie Treherne
- 1 McGill University, Montreal, Quebec, Canada.,7 Montreal Children's Hospital, Montreal, Quebec, Canada
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Ballard A, Khadra C, Le May S, Gendron S. Différentes traditions philosophiques pour le développement des connaissances en sciences infirmières. Rech Soins Infirm 2016. [DOI: 10.3917/rsi.124.0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Ballard A, Khadra C, Le May S, Gendron S. [Different philosophical traditions for knowledge development in nursing sciences]. Rech Soins Infirm 2016:8-18. [PMID: 27311259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION doctoral studies in nursing engage a critical reflections about philosophical traditions inherent to knowledge development. BACKGROUND critical realism, hermeneutics, postmodernism and poststructuralism refer to philosophical traditions that are generally less explored in nursing, although they are attracting greater attention. OBJECTIVE this paper offers an introductory presentation to these traditions as the authors also reflect upon their contribution to nursing knowledge development in. METHOD for each tradition, ontological and epistemological properties are presented to provide an overview of their main features. Contributions to nursing knowledge development are then discussed. RESULTS ontology refers to stratified, fixed and changing, or multiple realities, depending on the philosophical tradition. Likewise, epistemology emphasizes the explanatory power of knowledge, intersubjectivity, or inherent power dynamics. DISCUSSION the diversity of philosophical traditions represents an asset that can significantly contribute to the advancement of the nursing discipline. CONCLUSION clarification of the philosophical dimensions that underlie knowledge development is essential for doctoral nursing students in the process of developing their research projects and future programmes of research.
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Tsimicalis A, Denis-Larocque G, Michalovic A, Lepage C, Williams K, Yao TR, Palomo T, Dahan-Oliel N, Le May S, Rauch F. The psychosocial experience of individuals living with osteogenesis imperfecta: a mixed-methods systematic review. Qual Life Res 2016; 25:1877-96. [PMID: 26894269 DOI: 10.1007/s11136-016-1247-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Osteogenesis imperfecta (OI) is a genetic disorder (prevalence: 1:10,000), leading to bone fragility, frequent fractures, and varying degrees of physical limitations. Despite a substantial amount of research on the genetics, pathophysiology, and treatments related to OI, there remains a paucity of knowledge concerning the lived psychosocial experience of the OI population. This mixed-methods systematic review aimed to review, appraise, and synthesize the literature on the psychosocial experience of children and adults with OI with the goal of identifying implications for research, practice, and policy-making. METHODS Using a systematic methodology, quantitative, qualitative, and mixed-methods studies were accessed through database searching, screened, assessed for eligibility, and appraised. Data from the selected studies fulfilling the eligibility and quality criteria were extracted and synthesized using thematic analysis with an inductive approach. RESULTS A total of four qualitative and 20 quantitative studies, with various study designs and methodologies ranging in quality, were included in the review (n = 800; comprising 610 children and 175 adults with OI types I, III, IV, and V, ten parents and five healthcare professionals). Six themes were identified: intellectual feats, isolation and feeling different, fear of fractures, coping with challenges, adapting by learning new skills, and social relationships. CONCLUSION These findings highlighted key aspects of the experiences of children and adults with OI and will be essential for improving the quality and direction of research, tailoring clinical interventions addressing the psychosocial needs and quality of life of individuals with OI, and raising awareness among caregivers, healthcare professionals, administrators, and policy-makers associated with the OI population.
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Affiliation(s)
- Argerie Tsimicalis
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada.
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada.
| | - Gabrielle Denis-Larocque
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Alisha Michalovic
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Carolann Lepage
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Karl Williams
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Tian-Ran Yao
- Ingram School of Nursing, Faculty of Medicine, McGill University, Wilson Hall, 3506 University St., Montreal, QC, H3A 2A7, Canada
| | - Telma Palomo
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
- Bone and Mineral Unit, Division of Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Noemi Dahan-Oliel
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sylvie Le May
- CHU Ste-Justine, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Frank Rauch
- Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Aubin CÉ, Cobetto N, Clin J, Desbiens-Blais F, Labelle H, Le May S, Parent S. Improved brace design combining CAD/CAM and finite element simulation for the conservative treatment of adolescent idiopathic scoliosis (AIS): preliminary results of a randomized control trial. Scoliosis 2015. [PMCID: PMC4340252 DOI: 10.1186/1748-7161-10-s1-o59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
BACKGROUND While mortality due to pediatric cancer has decreased, suffering has increased due to complex and lengthy treatments. Cancer in adolescence has repercussions on personal and physical development. Although suffering can impede recovery, there is no validated scale in French or English to measure suffering in adolescents with cancer. OBJECTIVE To develop an objective scale to measure suffering in adolescents with cancer. METHODS A methodological design for instrument development was used. Following a MEDLINE search, semistructured interviews were conducted with adolescents 12 to 19 years of age who had undergone four to six weeks of cancer treatment, and with a multidisciplinary cohort of health care professionals. Adolescents with advanced terminal cancer or cognitive impairment were excluded. Enrollment proceeded from the hematology-oncology department⁄clinic in Montreal, Quebec, from December 2011 to March 2012. Content validity was assessed by five health care professionals and four adolescents with cancer. RESULTS Interviews with 19 adolescents and 16 health care professionals identified six realms of suffering: physical, psychological, spiritual, social, cognitive and global. Through iterative feedback, the Adolescent Cancer Suffering Scale (ACSS) was developed, comprising 41 questions on a four-point Likert scale and one open-ended question. Content validity was 0.98, and inter-rater agreement among professionals was 88% for relevance and 86% for clarity. Adolescents considered the scale to be representative of their suffering. CONCLUSIONS The ACSS is the first questionnaire to measure suffering in adolescents with cancer. In future research, the questionnaire should be validated extensively and interventions developed. Once validated, the ACSS will contribute to promote a holistic approach to health with appropriate intervention or referral.
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Affiliation(s)
- Christelle Khadra
- Faculty of Nursing, University of Montreal, Montreal, Quebec
- Centre hospitalier universitaire Sainte-Justine Research Center, Montreal, Quebec
| | - Sylvie Le May
- Faculty of Nursing, University of Montreal, Montreal, Quebec
- Centre hospitalier universitaire Sainte-Justine Research Center, Montreal, Quebec
| | - Isabelle Tremblay
- Department of Psychology, Centre hospitalier universitaire Sainte-Justine, Montreal, Quebec
| | - France Dupuis
- Faculty of Nursing, University of Montreal, Montreal, Quebec
- Centre hospitalier universitaire Sainte-Justine Research Center, Montreal, Quebec
| | - Chantal Cara
- Faculty of Nursing, University of Montreal, Montreal, Quebec
| | - Geneviève Mercier
- Department of Hematology/Oncology, Centre hospitalier universitaire Sainte-Justine, Montreal, Quebec
| | - Marie France Vachon
- Department of Hematology/Oncology, Centre hospitalier universitaire Sainte-Justine, Montreal, Quebec
| | - Jacinthe Lachance Fiola
- Faculty of Nursing, University of Montreal, Montreal, Quebec
- Centre hospitalier universitaire Sainte-Justine Research Center, Montreal, Quebec
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Trottier ED, Ali S, Le May S, Gravel J. Treating and Reducing Anxiety and Pain in the Paediatric Emergency Department: The TRAPPED survey. Paediatr Child Health 2015; 20:239-44. [PMID: 26175559 PMCID: PMC4472050 DOI: 10.1093/pch/20.5.239] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Management of children's pain and anxiety in the emergency department is likely suboptimal. OBJECTIVE To determine the availability of currently used strategies in Canadian paediatric emergency departments. METHODS A cross-sectional survey involving all centres of the Pediatric Emergency Research Canada group was performed. The primary outcome was the availability of specific procedures for pain and anxiety management for children in the emergency department. One person per centre was identified to complete the survey. Data were collected from October 2013 to January 2014 using an electronic survey tool. RESULTS All 15 Pediatric Emergency Research Canada centres agreed to participate. The verbal numerical scale was widely used (80%) to assess pain. One-half of respondents (53%) had access to a child life specialist. The following techniques were available for minor procedures: television as a distraction tool (87% of respondents), topical anesthetic before intravenous needle insertion (73%) and positioning of the child on parent's lap (60%); most remaining centres reported that these could be easily implemented. Intravenous morphine was available at every centre. Intranasal fentanyl was available (60%) or considered to be easy to implement (33%). Few centres reported availability of clinical guidelines regarding pain for doctors (27%) and nurses (40%); all respondents considered them to be easy to implement. CONCLUSIONS There was wide variation in paediatric pain and anxiety management strategies among tertiary care Canadian emergency departments. Several pain-reduction procedures (distraction, positioning on parent's lap, topical anesthetic, intranasal administration) were identified that could be easily implemented to address the gap.
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Affiliation(s)
- Evelyne D Trottier
- Division of Pediatric Emergency Medicine, Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec
| | - Samina Ali
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
- Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta
| | - Sylvie Le May
- Centre hospitalier universitaire Sainte-Justine Research Centre
- Faculty of Nursing, University of Montreal, Montreal, Quebec
| | - Jocelyn Gravel
- Division of Pediatric Emergency Medicine, Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec
- Centre hospitalier universitaire Sainte-Justine Research Centre
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Charette S, Fiola JL, Charest MC, Villeneuve E, Théroux J, Joncas J, Parent S, Le May S. Guided Imagery for Adolescent Post-spinal Fusion Pain Management: A Pilot Study. Pain Manag Nurs 2015; 16:211-20. [DOI: 10.1016/j.pmn.2014.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 06/17/2014] [Accepted: 06/18/2014] [Indexed: 10/24/2022]
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Cobetto N, Aubin CE, Clin J, Le May S, Desbiens-Blais F, Labelle H, Parent S. Braces Optimized With Computer-Assisted Design and Simulations Are Lighter, More Comfortable, and More Efficient Than Plaster-Cast Braces for the Treatment of Adolescent Idiopathic Scoliosis. Spine Deform 2014; 2:276-284. [PMID: 27927348 DOI: 10.1016/j.jspd.2014.03.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/03/2014] [Accepted: 03/18/2014] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Feasibility study to compare the effectiveness of 2 brace design and fabrication methods for treatment of adolescent idiopathic scoliosis: a standard plaster-cast method and a computational method combining computer-aided design and fabrication and finite element simulation. OBJECTIVES To improve brace design using a new brace design method. SUMMARY OF BACKGROUND DATA Initial in-brace correction and patient's compliance to treatment are important factors for brace efficiency. Negative cosmetic appearance and functional discomfort resulting from pressure points, humidity, and restriction of movement can cause poor compliance with the prescribed wearing schedule. METHODS A total of 15 consecutive patients with brace prescription were recruited. Two braces were designed and fabricated for each patient: a standard thoracolumbo-sacral orthosis brace fabricated using plaster-cast method and an improved brace for comfort (NewBrace) fabricated using a computational method combining computer-aided design and fabrication software (Rodin4D) and a simulation platform. Three-dimensional reconstructions of the torso and the trunk skeleton were used to create a personalized finite element model, which was used for brace design and predict correction. Simulated pressures on the torso and distance between the brace and patient's skin were used to remove ineffective brace material situated at more than 6 mm from the patient's skin. Biplanar radiographs of the patient wearing each brace were taken to compare their effectiveness. Patients filled out a questionnaire to compare their comfort. RESULTS NewBraces were 61% thinner and had 32% less material than standard braces with equivalent correction. NewBraces were more comfortable (11 of 15 patients) or equivalent to (4 of 15 cases) standard braces. Simulated correction was simulated within 5° compared with in-brace results. CONCLUSIONS This study demonstrates the feasibility of designing lighter and more comfortable braces with correction equivalent to standard braces. This design platform has the potential to further improve brace correction efficiency and its compliance.
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Affiliation(s)
- Nikita Cobetto
- Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079, Downtown Station, Montreal, Quebec H3C 3A7, Canada; Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
| | - Carl-Eric Aubin
- Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079, Downtown Station, Montreal, Quebec H3C 3A7, Canada; Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada.
| | - Julien Clin
- Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079, Downtown Station, Montreal, Quebec H3C 3A7, Canada; Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
| | - Sylvie Le May
- Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
| | - Frederique Desbiens-Blais
- Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079, Downtown Station, Montreal, Quebec H3C 3A7, Canada; Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
| | - Hubert Labelle
- Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
| | - Stefan Parent
- Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada
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Genois A, Haig M, Des Roches A, Sirard A, Le May S, McCuaig CC. Case report of atopic dermatitis with refractory pruritus markedly improved with the novel use of clonidine and trimeprazine. Pediatr Dermatol 2014; 31:76-9. [PMID: 22747704 DOI: 10.1111/j.1525-1470.2012.01756.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a 6-year-old boy with severe atopic dermatitis and refractory pruritus. The novel use of clonidine, an adrenergic agonist, along with trimeprazine, led to dramatic improvement. This represents the first case report of clonidine's effect in relieving pruritus in atopic dermatitis.
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Affiliation(s)
- Annie Genois
- Faculty of MedicineDepartments of AnesthesiaServices of Allergy and ImmunologyPediatricsDermatology, CHU Sainte JustineDepartment of Nursing, University of Montreal, Montreal, Quebec, Canada
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Aita M, Lampron A, Héon M, Dupuis F, Le May S. [Professional development groups]. Perspect Infirm 2013; 10:31-34. [PMID: 24046894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Marilyn Aita
- Faculté des sciences infirmières de l'Université de Montréal
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Stevens BJ, Harrison D, Rashotte J, Yamada J, Abbott LK, Coburn G, Stinson J, Le May S. Pain assessment and intensity in hospitalized children in Canada. J Pain 2013; 13:857-65. [PMID: 22958873 DOI: 10.1016/j.jpain.2012.05.010] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 05/10/2012] [Accepted: 05/24/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Numerous acute pediatric pain assessment measures exist; however, pain assessment is not consistently performed in hospitalized children. The objective of this study was to determine the nature and frequency of acute pain assessment in Canadian pediatric hospitals and factors influencing it. Pain assessment practices and pain intensity scores documented during a 24-hour period were collected from 3,822 children aged 0 to 18 years hospitalized on 32 inpatient units in 8 Canadian pediatric hospitals. Pain assessment was documented at least once within the 24 hours for 2,615/3,822 (68.4%) children; 1,097 (28.7%) with a pain measure alone, 1,006 (26.3%) using pain narratives alone, and 512 (13.4%) with both a measure and narrative. Twenty-eight percent of assessments were conducted with validated measures. The mean standardized pain intensity score was 2.6/10 (SD 2.8); however, 33% of the children had either moderate (4-6/10) or severe (7-10/10) pain intensity recorded. Children who were older, ventilated, or hospitalized in surgical units were more likely to have a pain assessment score documented. Considerable variability in the nature and frequency of documented pain assessment in Canadian pediatric hospitals was found. These inconsistent practices and significant pain intensity in one-third of children warrant further research and practice change. PERSPECTIVE This article presents current pediatric pain assessment practices and data on pain intensity in children in Canadian pediatric hospitals. These results highlight the variability in pain assessment practices and the prevalence of significant pain in hospitalized children, highlighting the need to effectively manage pain in this population.
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Affiliation(s)
- Bonnie J Stevens
- The Hospital for Sick Children and The University of Toronto, Toronto, Ontario, Canada.
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Le May S, Gouin S, Fortin C, Messier A, Robert MA, Julien M. Efficacy of an Ibuprofen/Codeine Combination for Pain Management in Children Presenting to the Emergency Department with a Limb Injury: A Pilot Study. J Emerg Med 2013; 44:536-42. [DOI: 10.1016/j.jemermed.2012.06.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 02/10/2012] [Accepted: 06/28/2012] [Indexed: 11/17/2022]
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Paquette J, Le May S, Lachance Fiola J, Villeneuve E, Lapointe A, Bourgault P. A randomized clinical trial of a nurse telephone follow-up on paediatric tonsillectomy pain management and complications. J Adv Nurs 2013; 69:2054-65. [PMID: 23311981 DOI: 10.1111/jan.12072] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2012] [Indexed: 11/28/2022]
Abstract
AIMS To determine the effect of a nurse telephone follow-up on paediatric post-tonsillectomy pain intensity, complications, and use of other healthcare services. BACKGROUND After tonsillectomy, children experience moderate-to-severe pain for days. Parents tend to give insufficient analgesia, with resulting increases in pain and postoperative complications. In adults, nurse telephone follow-up for ambulatory surgeries reduces postoperative pain. DESIGN The study design was a randomized clinical trial. METHODS In this trial, children aged 4-12 years undergoing elective tonsillectomy in June-October 2010 were assigned to a nurse telephone follow-up with parents on postoperative days 1, 3, 5 and 10, or standard care with no follow-up but data collection. Outcomes included pain intensity, analgesics administered, complications, and healthcare use. RESULTS Of 45 participants, the intervention group (n = 24) received more analgesics on postoperative days 1 and 3, increased their fluid intake at days 1 and 3, but had more constipation at day 3 than the control group (n = 21). There was no significant difference regarding pain intensity or use of healthcare resources. CONCLUSION Nurse telephone follow-up was beneficial for some pain management and prevention of complications, although better analgesic treatments are needed. The intervention was simple, safe, and appreciated by parents.
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