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Several studies have shown the efficacy of psychological interventions in reducing preoperative anxiety in children undergoing surgery. This study aims to investigate the effectiveness of a specific non-pharmacological technique, the relaxation-guided imagery, in reducing both preoperative anxiety and postoperative pain in a sample of 60 children (...
Citations
... In our study, we conducted a thorough literature review on MT in pediatric and oncology settings, identifying two scales to assess specific parameters of interest: the "AQR-Assessment of the Quality of Relationships" [21] and the "m-YPAS, Yale Preoperative Anxiety Scale" [22]. These scales cover aspects like arousal, eye contact, choicemaking, and interactions with parents and physicians, addressing concerns observed during clinical sessions. ...
Background: Musicotherapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients’ physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound–musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. Results: Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child’s ability to take the initiative in sessions, their sense of agency, and the parent’s role in guiding them. Significant differences were recorded at each time point between all variables considered. Conclusions: The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer.
... Pengalihan perhatian, misalnya dengan metode guided imagery untuk relaksasi yang efektif mengurangi kecemasan pada pasien. [6] Sedasi juga digunakan sebagai praktik standar untuk mengatasi tantangan hasil pencitraan yang kurang optimal pada pemindaian MRI pediatrik dan meningkatkan efektivitas diagnostik. [7] Salah satu cara lain yang dapat digunakan dalam metode pengalihan perhatian adalah dengan Virtual Reality (VR). ...
... These include delirium, agitation, and pain; delayed awakening from anesthesia in patients undergoing ultrashort procedures; and delayed discharge from the hospital (3,6,7). Given the adverse effects of pharmacologic treatments, nonpharmacologic interventions are becoming more popular, and nonpharmacologic interventions include clown doctors, virtual reality, cognitive behavioral therapy, music therapy, hypnosis, guided imagery relaxation therapy, massage, games (8)(9)(10)(11)(12)(13).Although there have been several published studies on preoperative anxiety, confirming that a variety of interventions have a positive impact on reducing preoperative anxiety, the number of studies is small, and the heterogeneity of sample sizes, research methodologies and study designs means that further research is needed, while there is still a lack of quantitative bibliometric analysis in the field of preoperative anxiety. Therefore, this paper uses bibliometric research methods to organize and summarize the research in this field over the past fifteen years to quantitatively show the development path, research hotspots, and research trends in this research field and to provide a more comprehensive compendium and analysis of the development of this field through knowledge mapping. ...
Objective
This study aimed to analyze the current state of research on preoperative anxiety in children through CiteSpace, VOSviewer, and the identification of hot spots and frontiers.
Method
Relevant data were retrieved from the Web of Science Core Collection using the search terms children and preoperative anxiety. Data were analyzed using VOSviewer (version 1.6.18), CiteSpace (5.7. R5) software, and Scimago Graphica.
Results
A total of 622 articles were published between 2007 and 2022, with an increasing trend over time. Kain, Zeev N. (13; 2.09%) and Dalhousie University (15; 2.41%) were the most influential authors and most prolific institutions, respectively. The United States (121; 19.45%) was the country with the most publications. Pediatric anesthesia (55; 8.84%) had the most publications. High-frequency keywords were categorized into three themes, including nonpharmacologic interventions for preoperative anxiety in children, preoperative medications, and risk factors for anxiety; of these, “predictor” (38; 2016) and “sedative premedication” (20; 2016) were the most studied keywords over the past 6 years. “Distraction” (67; 2019) and “dexmedetomidine” (65; 2019) have been the main areas of interest in recent years.
Conclusion
Research on preoperative anxiety in children has been the focus of increasing attention over the past fifteen years, with the majority of publications from high-income countries. This review provides a useful perspective for understanding research trends, hot topics, and research gaps in this expanding field.
... При этом обучение методам 14 совладания со стрессом дополнительно снижает вероятность дезадаптивного поведения в период госпитализации и непосредственно после выписки [61]. В исследовании, включившем 60 детей 6-12 лет, в группе, где использовалась методика релаксации с управляемыми образами, были отмечены значимо более низкий уровень предоперационной тревоги и меньшая интенсивность боли в послеоперационный период [51]. При этом, однако, в работе А. Горницки с соавт. ...
p>The article presents a review of studies on the psychological reactions of children to a situation of surgical treatment. Surgical treatment is considered as a situation with a high potential for stress, which is due to the variety and high intensity of stress effects which are experienced by the child as new and uncontrolled. Negative psychological responses are observed in children both at the preoperative and postoperative stages. At the preoperative stage, preoperative anxiety is highly prevalent. The risk of its development depends on a complex of factors related to the child themself, his/her environment, as well as the disease, hospital environment, the treatment and the circumstances of hospitalization. Preoperative anxiety is a risk factor for more severe pain symptoms, emotional and behavioral changes in the postoperative period. The article discusses the modern methods for the prevention and correction of preoperative anxiety and postoperative emotional and behavioral changes in children: the presence of parents during the induction of anesthesia, providing information using modern technologies and principles of social learning, distraction and other cognitive and behavioral methods for the correction of the mental state, multimodal methods for harmonizing the emotional state and behavior of children (art therapy, play therapy, clown therapy). The authors come to the conclusion that further research is needed in order to develop algorithms for the psychological support of children in a situation of surgical treatment, taking into account their age, clinical characteristics, the psychological features of the child and his/her parents.</p
... With 60 kids between the ages of 6 and 12 undergoing minor surgery, Laura Vagnoli (Vagnoli et al., 2019) employed guided imaging to explore the effectiveness of the intervention in terms of preoperative anxiety and postoperative pain in kids. Children's preoperative anxiety and postoperative discomfort were significantly reduced by relaxation-guided imaging, according to the study's findings, and it was also recommended that future research should establish more specific protocols for guided imaging approaches. ...
Background
Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non‐pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non‐pharmacologic pain reduction methods.
Objective s
To give clinical wound pain management a new direction, locating and assessing non‐pharmacological interventions regarding pain brought on by wound dressing changes are necessary.
Method
The researchers conducted a comprehensive literature review on non‐pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0.
Results
In total, 951 people were involved in 11 investigations covering seven non‐pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect.
Conclusion
The key to managing wounds is pain management. According to our review, there is some indication that non‐pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non‐pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.
... Relaxation-guided imagery for children is generally comprised of a combination of behavioral interventions (body relaxation) and cognitive interventions (guided imagery), which is non-invasive, self-regulative, and appropriate for children and adolescents. It consists of three "active" phases that generate new internal experiences, unlike the passive act of relaxing [19]: Body relaxation, helps the child to focus on the body and to progressively release muscle tension from the feet to the head, by taking deep breaths; Imagery is a spontaneous or deliberate mental reconstruction of sights, sounds, smells, tastes, and feelings as if they were actually occurring. During this phase, the child is asked to visualize a favorite place, whether real or not, using the same words for each participant; and returning to reality, the child remains in the chosen place for a while, knowing that it could be visited any time he/she wants; then, contact with the surrounding environment is gradually resumed until the child opens his/her eyes. ...
Background
Mental imagery has long been used in psychological therapies, but only recently did research begin to provide a scientific background for it.Imagery interventions are inexpensive anda substantial body of research supports their effectiveness on behavior change, promotion of adaptive health outcomes, anxiety reduction, and adherence to medical interventions, in both adults and children. However, literature on relaxation and guided imagery interventions benefits for children in elementary school context is very scarce. This Randomized Controlled Trial (RCT) aims to contribute to that knowledge by implementing and testing the benefits of an intervention program MindRegulation (MR) comprising relaxation, instructions for body posture, and guided imagery with socioemotional learning (SEL), conveying adaptive beliefs about oneself, the relationships with others and the environment.
Method
The MR intervention will be developed in the classroom for 15 minutes before learning activities, three times per week, for five months, and its effects will be measured on a range of emotional, physiological, and cognitive outcomes. Fifteeen classes will be randomly assigned to three conditions: (a) relaxation and guided imagery-MR; (b) relaxation only; and (c) waitlist control. The RCT includes four data collection times: pretest, intermediate, posttest, and a six-month follow-up (trial registration NCT06101225, 05th October, 2023). The sample comprises 240 students, elementary school third and fourth graders, 8–11 years old. The variables measured in all times, except the intermediate, are: well-being, affect, anxiety, emotional regulation, socioemotional competencies, attention and processing speed, and perceived benefits of the intervention. Physiological indicators of emotional arousal, emotional regulation, stress and well-being are also taken, specifically, heart rate variability, electrodermal activity, actigraphy and salivary cortisol. The validity of the measures will be tested for the population and objectives of the study.
Discussion
Significant improvements on the children's well-being, socioemotional regulation, cognitive function, physiological activity and academic performance are expected - after 5-months’ intervention at posttest and11 months’ follow-up -at MR condition, compared to the relaxation and control conditions. Changes in physiological activity are expected during MR and relaxation sessions. Emotional regulation, well-being and anxiety are expected to mediate the effects ofthe interventions over socioemotional competence, cognitive function and academic performance. Well-being and anxiety levels at pretest are expected to moderate the interventions’ effects.
Trial Registration: MindRegulation
https://ichgcp.net/clinical-trials-registry/NCT06101225
Date version: MindRegulation Study Protocol 4th November 2023
... Training in self-regulation skills is a special gift for children with many chronic conditions such as physical disabilities, diabetes, sickle-cell disease, thalassemia, RAP, Crohn Disease, cancer, rheumatoid arthritis, asthma, congenital blindness or deafness (Kohen & Olness, 2022;Rutten et al., 2014;Tome-Pires & Miro, 2012). Non-pharmacologic pain management is helpful to children undergoing many types of procedures, including immunizations, vena punctures, burn treatment, and wound care (Chester et al., 2018;Kohen & Olness, 2022;Vagnoli, 2019). ...
... Five articles utilized cognitive interventions (i.e., relaxation-guided imagery, clown exposure, hypnosis, therapeutic play, concrete objective information, and coping information). Relaxation-guided imagery, which is a focused relaxation that helps create harmony between the mind and body in study conducted by Vagnoli where in a randomized study with 60 participants (age range 6 -12 years [18]. The m-YPAS and FLACC Scale were used to measure pre-operative anxiety and post-operative pain, respectively. ...
... In addition to influencing post-operative pain and anxiety, the studies that utilized cognitive interventions also altered the patient's attitudes regarding their upcoming procedure and their overall hospital experience. It was found that pediatric patients who had previously endured a negative surgical experience benefitted from relaxation-guided imagery as a tool to calm their anxiety [18,22]. Along with the relaxation-guided imagery, exposure to a clown and the use of therapeutic play prior to surgery was favored by parents and healthcare providers, as it reduced the anxiety experienced by these patients [21,23]. ...
The pediatric population is more prone to experiencing anxiety and fear before undergoing an inpatient surgical procedure than adults. Non-pharmaceutical interventions, such as music therapy and virtual reality programs, have shown significant promise in reducing the post-operative pain associated with pre-operative anxiety of patients and their caregivers. While there is evidence to support the use of non-pharmaceutical treatment in the mitigation of pre-operative anxiety, there are limited published reports of non-pharmacological interventions for pre-operative anxiety in children undergoing inpatient surgical procedures. The goal of this scoping review was to identify and classify specific non-pharmacological interventions utilized inpatient among children to improve pre-operative anxiety and post-operative complications inflicting pain. Comprehensive searches were conducted using Ovid Medline, Embase Emtree, CINAHL Complete, and COCHRANE Central databases. The articles had to be peer-reviewed, written in English, published between 2000-2022, and contain measurements of pre-operative anxiety and post-operative pain to be included in the scoping review. Articles that reported findings on patients younger than 18 undergoing elective and/or routine surgeries, excluding emergent surgical cases, were selected. After a systemized screening process, 9 articles were selected for the final review. The findings indicated that non-pharmacological interventions such as virtual reality, hypnosis, and clowns reduced pre-operative anxiety and post-operative pain in pediatric patients. This scoping review identified a wide range of non-pharmacological interventions to mitigate the post-operative effects of pre-operative anxiety among children, including but not limited to music, visual reality, and other holistic methods. More longitudinal studies are warranted to understand the specific interventions that may be the most efficacious.
... Furthermore, Vagnoli et al. studied the effect of relaxation-guided imagery compared to standard care on preoperative anxiety and postoperative pain in children aged 6 to 12 and found that preoperative anxiety was significantly less in children who received relaxation-guided imagery [mean difference in m-YPAS score; 95% CI; − 44.2 (− 52.4 to − 36), p < 0.001] [35]. ...
... The Guided Imagery technique for relaxation is designed for children undergoing dental treatment. This approach is the Relaxation-guided imagery method based on Vagnoli, L., Bettini, A., Amore, E. et al. 13 By taking deep breaths, the child can focus on their body and gradually release muscle tension from the feet to the head. A mental recreation of sights, sounds, smells, tastes, and feelings as though they were truly happening while instructing to imagine a favourite place, real or imagined, using the same terms for each participant; and after the child remains in the chosen location for a while, contact with the surrounding world is gradually reestablished until the child opens his or her eyes. ...
Anxiety has been defined as a “vague, unpleasant feeling accompanied by a premonition that something undesirable is about to happen”. Dental anxiety is driven by a strong negative or unpleasant emotion towards a dental office or dental procedures. Children with a high level of dental anxiety are more resistant to treatment, and due to this avoidance in dental care can lead to needing more dental treatments. The quality of a treatment being carried out, as well as what materials that are to be used, is directly influenced by a child’s level of cooperation and ability to follow instructions. Behaviour management techniques play a major role during all paediatric treatment procedures, and it is the clinician who is responsible to properly and safely guide the child’s behaviour. Guided Imagery is a visual and sensory-based complementary and alternative medicine (CAM) technique. In hypnotherapy which is a type of mind-body intervention; increased suggestibility is used in the treatment of a medical or psychological disease or condition. Therefore, there is a need of a newer modality based on guided imagery and hypnotherapy to be used in as a whole or in tandem with other conventional behaviour management techniques. The aim of this study is to evaluate and compare anxiety levels after using Guided Imagery for relaxation and modified Guided Imagery-Hypnotherapy techniques in 6-14 year-old children undergoing local anesthesia administration.
