Pediatric Anesthesia: The Childs Voice

In Denmark, around 25,000 children under 18 undergo general anesthesia annually. Hospital stays and anesthesia can induce significant anxiety and stress in children due to unfamiliar environments, procedures, and communication issues. This anxiety can be linked to postoperative complications such as emergence delirium and may negatively impact both the child and their family's well-being. Engaging patients actively in their healthcare, including pediatric cases, is essential for improving outcomes. Assessing perioperative patient and family outcomes, particularly through patient-reported outcome measures (PROM) and patient-reported experience measures (PREM), can significantly enhance the quality of care provided to children. While PROMs are widely used in adults, they are less common in pediatric settings. The Pediatric Scale for Quality of Recovery (PedSQoR), developed by Australian and American researchers, is one such tool designed to measure recovery in children. This study aims to translate andvalidate the PedSQoR for Danish children aged 4-12. Furthermore, no existing instruments comprehensively assess pediatric surgery patients' experiences under general anesthesia, particularly from the child's perspective without relying on parents as proxies. Empowering children to express their healthcare experiences gives healthcare workers an insight into what matters for children and gives children a more positive outlook on healthcare, benefiting lifelong engagement. Study Aims and Objectives: The study aims to enhance the assessment of children's outcomes and experiences in perioperative settings, ultimately improving pediatric perioperative healthcare. The objectives include: 1. Translation and Adaptation: a. Translate and adapt the PedSQoR for Danish children aged 4-12. b. Validate the Danish PedSQoR version. 2. Development of a PREM Instrument: a. Develop a comprehensive PREM for children's experiences during surgery and anesthesia. b. Pilot-test and adjust the PREM questionnaire with a group of children aged 4-12. Study Methods: 1. PedSQoR Translation and Validation: A single-center prospective cohort study will adapt and test the PedSQoR for Danish children. The process involves translating the 21-item scale, validating it with a sample size of 150, and ensuring reliability through various statistical methods, including Cronbach's Alpha and test-retest reliability. Data will be collected from the Department of Anesthesiology and Intensive Care at Gødstrup Hospital. 2. PREM Instrument Development: This study will develop a PREM instrument using the Warwick Patient Experiences Framework (WaPEF), which encompasses seven dimensions of patient experience. The process will involve forming a panel of child experts, conducting focus groups, and translating insights into a pictorial questionnaire. The PREM will undergo pilot testing with 20 children to validate its effectiveness in capturing the dimensions of the WaPEF. Research Ethics: Given the vulnerability of children in research, this study will prioritize their safety and comfort, ensuring the study's benefits outweigh any potential risks. Informed consent will be obtained from both parents and children. The study will be registered with the Region Central Denmark's list of research projects and will not require approval from the Scientific Ethics Committee.

Project title: Pediatric Healthcare Empowerment: Improving Children's Perioperative Experiences with Patient-Reported Measures Acronym: PHEASE Impact: Understanding and improving children's experiences is integral to enhancing pediatric healthcare services. Annually, approximately 6 million children worldwide undergo general anesthesia, and the potential impact on their well-being and behavior is significant. The hospital environment, inadequate communication with staff and negative postoperative experiences can contribute to anxiety and sadness, particularly due to a lack of insight into children's unique needs. The common practice of relaying information to parents or caretakers often results in the child's perspective being overlooked. This study promises to empower 4-12-year-olds to express their thoughts to enhance the perioperative experience. This study will translate a newly developed tool for measuring patient-reported outcome measures in Pediatric Scale for Quality of Recovery (PedSQoR) and create a tool for children to express their experiences so that hospital staff can improve the quality of care. The impact extends beyond immediate outcomes, with the potential for lifelong benefits for children shaping their healthcare experiences. Background In Denmark, 25,000 children under the age of 18 undergo general anesthesia annually (1). Admission to hospitals and general anaesthesia affect children; a hospital stay can cause a child to experience anxiety about procedures, unknown environments, pain and fasting (2). Poor communication with staff may negatively influence the mood and behavior of the child (3). Furthermore, postoperative anxiety and melancholy may be linked to the onset of emergence delirium, the disconcerting hospital setting, and a limited understanding of the unique requirements of children (4). Post-operative symptoms can impose a burden on both children and their parents, potentially requiring them to take sick leave for varying durations. However actively engaging patients in their healthcare experience improves health outcomes, a principle applicable to pediatric cases as well (5). Consequently, assessing perioperative patient and family outcomes, postoperative well-being, and experiences may improve outcomes for children undergoing anesthesia. Ferreira et al. (2023) advocate for the combined use of patient-reported outcome measures (PROM) and patient-reported experience measures (PREM). This integrated approach incorporates both the objective and subjective aspects of the patient's experience. By 2 utilizing both measures in tandem, healthcare providers can gain a more nuanced and comprehensive insight into the overall quality of care from the patient's perspective (6). PROMs are used widely in the adult population. Patient outcomes after surgery and anaesthesia can be assessed with the 15-item Quality of Recovery Score (QoR-15) (5). For children, a group of Australian researchers have developed a 21 item Pediatr Покажи пълното описание...

Inclusion Criteria: * Pediatric patients aged 4-12, American Society of * Anesthesiologists physical status classification (ASA) I-III * undergoing surgery Exclusion Criteria: * Children with cognitive or sensory disorders * children or parents who do not speak Danish, * patients for whom there is no consent to participate.