Impact of Facility Dog and Certified Child Life Specialist Dyad on Children's Pain and Anxiety During Needlestick Procedures in a Pediatric Hematology Oncology Clinic Setting.

BACKGROUND: Pediatric Hematology Oncology patients undergo frequent needlestick procedures, often leading to negative outcomes including pain and anxiety. Animal-assisted therapy has been shown to minimize pediatric patient distress; however, its utilization by a Certified Child Life Specialist (CCLS) to reduce patient distress has not been widely studied. METHODS: Pediatric patients receiving needlesticks in the Hematology Oncology Clinic were enrolled between March 2018 and May 2021. Patients who had scheduled visits when the facility dog was present were assigned to the intervention group. Patients were assigned to the control group if the facility dog was not present. The primary objective was to use the Children's Anxiety and Pain Scale to determine whether the CCLS and facility dog dyad minimized patient pain and anxiety during procedures. RESULTS: A total of 285 patients, 5 to 17 years of age, were enrolled. One hundred forty-three patients were assigned the intervention and received procedural support from the CCLS and facility dog; 142 patients were assigned the control group and received support from the CCLS only. Patient-reported pain scores were significantly lower among patients who received the intervention ( P =0.033). CONCLUSIONS: Utilization of a CCLS and facility dog dyad during painful needlestick procedures decreases patient-reported pain compared with utilization of CCLS support alone.

Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

OBJECTIVES: Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. METHODS: This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. RESULTS: A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P < 0.05), and significant likelihood that the patient would improve relative to the 4 questions, as a result of the child life and music therapy intervention. CONCLUSIONS: Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical impact of child life psychological preparation and psychotherapy-based music therapy interventions in reducing distress in pediatric patients during common medical procedures.

Preparing children and families for surgery: Mount Sinai's multidisciplinary perspective.

Upon learning that they must undergo surgery, children experience a range of emotions including fear, anger, guilt, and sadness. It has been demonstrated that children who are prepared for surgery and who have support throughout their hospitalization recover more quickly and have fewer emotional problems, such as separation anxiety and sleep disturbances, than those who are not prepared. Pre-surgical preparation programs allow children and their families the opportunity to preview the hospital experience in a supportive environment to reduce anxiety, increase knowledge, and enhance coping. Meet Me at Mount Sinai (MMAMS) is an innovative preoperative preparation program for children and their families that seeks to provide comprehensive emotional and cognitive preparation for surgery. MMAMS is led by a multi-disciplinary team of health care providers including a pediatric surgery nurse practitioner, a registered nurse, a social worker, and a child life specialist. The program utilizes a culturally-sensitive, multimodality preparation model to prepare children and families for the surgical experience.

The impact of a computer network on pediatric pain and anxiety: a randomized controlled clinical trial.

This was the third randomized controlled clinical trial (RCCT) of Starbright World (SBW)--a private, interactive computer network for hospitalized children. The present randomized controlled clinical trial (RCCT) consisted of a series of 39 replicated single system designs (SSDs) that compared children's self-reports of pain intensity, pain aversiveness and anxiety in the SBW condition with those in a stan- dard clinical practice condition. Findings from the SSDs were aggregated using meta-analysis. Although children experienced slightly less pain intensity, pain aversiveness, and anxiety in the SBW condition, these results did not achieve statistical significance. The relationship of these findings to the two prior studies of the effectiveness of SBW is discussed.