Aims: To evaluate the effectiveness of web-based mobile health interventions on paediatric patients and their parents in the day surgery context, where the primary outcome was children's pre-operative anxiety and secondary outcomes were postoperative pain and parents' anxiety and satisfaction with entire course of the day surgery.
Design: A systematic review and meta-analysis of randomized controlled trials.
Data sources: CENTRAL, CINAHL, Scopus, Ovid MEDLINE, and Web of Science were systematically searched without time limits (up to December 2018).
Review methods: Studies were appraised using the Cochrane risk of bias tool. A random effect meta-analysis of children's pre-operative anxiety was performed.
Results: Eight studies with a total of 722 patients were included in the analysis. The effectiveness of web-based mobile health interventions, including age-appropriate videos, web-based game apps, and educational preparation games made for the hospital environment, was examined in pre-operative settings. A meta-analysis (N = 560 children) based on six studies found a statistically significant reduction in pre-operative anxiety measured by the Modified Yale Pre-operative Anxiety Scale with a moderate effect size. Three studies reported parental satisfaction.
Conclusion: Web-based mobile health interventions can reduce children's pre-operative anxiety and increase parental satisfaction. Web-based mobile health interventions could be considered as non-pharmacological distraction tools for children in nursing. There is not enough evidence regarding the effectiveness of reducing children's postoperative pain and parental anxiety using similar interventions.
Impact: Web-based mobile health interventions reduce children´s pre-operative anxiety and could therefore be considered as non-pharmacological distraction tools for children in nursing.
目的: 评价在以儿童术前焦虑为主要结局指标,以术后疼痛、父母对日间手术全程的焦虑和满意度为次要结局指标的日间手术情况下基于网络的移动健康干预措施对儿科患者及其父母的有效性。 设计: 随机对照试验的系统评估与荟萃分析。 数据来源: 在无时间限制情况下,通过CENTRAL、CINAHL、Scopus、Ovid MEDLINE以及科学引文索引数据库进行了系统检索(截至2018年12月)。 评估方法: 采用Cochrane偏倚风险工具对研究进行评估。对儿童术前焦虑进行随机效应荟萃分析。 结果: 共对包括722名患者的八项研究进行了纳入分析。在术前对基于网络的移动健康干预措施的有效性进行了检验,其中包括适合年龄段的视频、基于网络的游戏应用程序和针对医院环境定制的教育准备游戏。某一基于六项研究的荟萃分析(N=560名儿童)发现,经改良耶鲁术前焦虑量表所测量的术前焦虑在统计学上呈显著降低,且具有适中效果。三项研究均报告了父母的满意度。 结论: 基于网络的移动健康干预措施可以降低儿童的术前焦虑,提升父母的满意度。基于网络的移动健康干预措施可用作儿童护理中的非药物分散注意力工具。然而,目前尚无充分证据表明使用类似干预措施可有效地缓解儿童术后疼痛和父母的焦虑。 影响: 基于网络的移动健康干预措施缓解了儿童的术前焦虑,因此可用作儿童护理中的非药物分散注意力工具。.
Keywords: anxiety; day surgery; distraction; meta-analysis; mobile health intervention; nursing; paediatric; pain; parents; systematic review.
© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.