Effects of a Virtual Reality Game on Children's Anxiety During Dental Procedures (VR-TOOTH): Protocol for a Pilot Randomized Controlled Trial.

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.

The role of fathers during breastfeeding.

OBJECTIVE: identify fathers' perceptions of their role in a breastfeeding context. SETTING: three different geographic areas (urban, semi-urban, and rural) of Quebec, a francophone province in Canada. PARTICIPANTS: 43 fathers whose children had been exclusively breastfed for a minimum of six months. METHODS: a qualitative study using semi-structured interviews was undertaken. Thematic analysis of the interviews was carried out with NVivo 11. FINDINGS: variations were identified in the role of father during breastfeeding, namely, 1) acting as partners in decision-making; 2) being responsible for the family functioning, and 3) providing emotional support to the mother. These different variants each entail challenges and tasks. KEY CONCLUSIONS: participating fathers perceived their role as much more complex than the limited role of breastfeeding facilitator that is usually attributed to them. Fathers saw themselves as stakeholders in decision-making relating to how their child was fed and they reacted to the imbalance created by breastfeeding. Their involvement occurred at several levels: that of their child, their spouse, and their family. IMPLICATIONS FOR PRACTICE: these results suggest that more attention should be given to fathers' roles in a breastfeeding context and more investigation is required into the extent to which health professionals, such as midwives and nurses, support fathers in managing these various roles and the challenges they entail.

Fathers' integration in Quebec's perinatal and early childhood public policies.

Mothers' physical and mental health, as well as their socio-economic status, are currently acknowledged as determining factors in the health and development of young children in Quebec. It is thus not surprising to find that the majority of government perinatal and early childhood initiatives are directed toward mothers. Yet, fathers today are increasingly involved in the care and education of their children, and scientific studies have shown that their involvement is just as crucial as that of mothers. It is recognized that a father's involvement optimizes the physical, cognitive, affective and social development of his children. The purpose of this text is to examine how fathers are taken into account in two public perinatal and early childhood policies. It has been found that fathers are virtually absent from Quebec government's objectives and orientations, and when they do appear, no concrete means are offered to reach them. Considering that health care workers have difficulty offering truly inclusive services to fathers, recommendations with regard to inclusion of fathers in public policies are necessary in order to optimize the health of children and their families.

[Family issues after the birth of a child]. / L'expérience familiale à la naissance d'un enfant.

After the birth of a child, all members of the family are expected to adapt. This common nursing practice in Québec provides considerable support for the parents. The maternity nurse, in order to establish the father's specific needs to help him adapt to being a parent, can, thanks to a short interview, define the strengths and resources offered by each member of the family.