Neil Izenberg

Use of a preanesthetic video for facilitation of parental education and anxiolysis before pediatric ambulatory surgery.

UNLABELLED In this study, we evaluated the effects of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a randomized, controlled design. During their routine preoperative visit, 85 parents of children scheduled to undergo ambulatory surgical procedures under general anesthesia were randomized to view either the experimental videotape about pediatric anesthesia or a control videotape with no medical content. Before and immediately after viewing the assigned videotape, parents completed measures of situational anxiety (State-Trait Anxiety Inventory-State), preoperative anxiety and need for information (Amsterdam Preoperative Anxiety and Information Scale), and anesthesia knowledge (Standard Anesthesia Learning Test). Repeated-measures analyses of variance showed that parents who viewed the experimental videotape showed a significant increase in anesthesia knowledge (P < 0.022) and a significant reduction in their state of anxiety (P < 0.031), anesthesia-specific anxiety, and need for information (P < 0.0001) compared with the control group. These results demonstrated that viewing a preoperative educational videotape about pediatric anesthesia can provide immediate educational and anxiolytic benefits for parents of children undergoing ambulatory surgery. The duration of these benefits remains to be determined. IMPLICATIONS In this study, we demonstrated the benefits of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a randomized, controlled design. We found that videotape viewing facilitated preoperative preparation and lessened preoperative anxiety.

Do Parents Understand Growth Charts? A National, Internet-Based Survey

OBJECTIVE: The objective of this study was to assess parental knowledge and understanding of growth charts. METHODS: An online survey was conducted with 1000 parents selected to be demographically representative of the US population. Questions explored awareness of, knowledge of, and attitudes toward growth monitoring, as well as the ability to interpret growth chart data. RESULTS: Seventy-nine percent of parents surveyed claimed to have seen a growth chart before, with the majority thinking that they understood it well. Sixty-four percent of parents thought it was important to be shown growth charts to see how their child was growing, and 40% expressed the need to see their childs growth chart as confirmation of their health care providers verbal interpretation. However, when provided with multiple-choice questions and answers, only 64% could identify a childs weight when shown a plotted point on a growth chart. Ninety-six percent had heard of the term “percentile,” but only 68% identified the percentile of the plotted point, and only 56% could identify the definition of percentile. Up to 77% interpreted incorrectly charts containing height/weight measurements in tandem. CONCLUSIONS: Although growth charts are used frequently as visual aids to educate parents about their childrens growth, many parents cannot comprehend the data. This finding is significant because many parents prefer to be shown growth charts by their health care provider, and many parents report recording their childrens measurements on growth charts at home.

The Web, Communication Trends, and Children's Health Part 1: Development and Technology of the Internet and Web

The Internet and The World Wide Web are changing the way pediatricians find medical information and provide care. This article, the first in a four-part series on The Web, Communication Trends, and Childrens Health, published in consecutive issues of this journal, describes how the Web was created and how its multimedia capabilities are affecting information exchange.

The Web, Communication Trends, and Children's Health Part 4: How Children Use the Web

Children are embracing the Internet and the World Wide Web. How are they using it and what do they find? This article, the fourth in a five-part series, explores the “whys” and the “wherefores” of childrens Web use. Included are online recourses geared specifically for children, including health, educational, and entertainment sites.

The Web, Communication Trends, and Children's Health Part 3: The Web and Health Consumers

The World Wide Web has the potential to change significantly how medical care is both delivered and consumed. This, the third of a five-part series on The Web, Communication Trends, and Childrens Health, considers how families can use the Internet to find consumer health information and to access care. This article also discusses some of the potential and limitations of Web-based health resources. Part 1 of this series described the development and technology of the Internet and the Web. Part 2 suggested how pediatricians can use the Web to gather medical information and how the increasing capabilities of the Web may affect clinical practice.

Perceptions of Tobacco Use in Early Adolescents

In an effort to strengthen tobacco use prevention programs, this study explores early (9- to 13-year-old) adolescent motivations for and perceptions of use. Data were collected, via electronic keypads, from students visiting 12 health education centers in the U.S. (N=1433). Multivariate logistic regression showed that perceptions of frequent peer tobacco use and popularity of adolescent smoking, in addition to absence of family discussion of tobacco use, were associated with greater likelihood for smoking and of reporting past smoking. Even though most participants thought adolescents who smoke are very unpopular, more than 60% said the primary reason for adolescent smoking was that smokers believe it will make them popular. Participants thought the best way to prevent use was to give kids “other fun things to do instead.” Recommendations are given for customizing curricula or programs.Editors’ Strategic Implications: These promising findings, based on cross-sectional data, make an argument for earlier tobacco use prevention efforts. Prevention researchers, more broadly, should look at the innovative and promising method of using centralized remote computer keypads for data collection.

Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents Stakeholder Engagement in the Design of Web-Based Decision Aids

Purpose This article describes the stakeholder-driven design, development, and testing of web-based, multimedia decision aids for youth with type 1 diabetes who are considering the insulin pump or continuous glucose monitoring and their parents. This is the initial phase of work designed to develop and evaluate the efficacy of these decision aids in promoting improved decision-making engagement with use of a selected device. Methods Qualitative interviews of 36 parents and adolescents who had previously faced these decisions and 12 health care providers defined the content, format and structure of the decision aids. Experts in children’s health media helped the research team to plan, create, and refine multimedia content and its presentation. A web development firm helped organize the content into a user-friendly interface and enabled tracking of decision aid utilization. Throughout, members of the research team, adolescents, parents, and 3 expert consultants offered perspectives about the website content, structure, and function until the design was complete. Results With the decision aid websites completed, the next phase of the project is a randomized controlled trial of usual clinical practice alone or augmented by use of the decision aid websites. Conclusions Stakeholder-driven development of multimedia, web-based decision aids requires meticulous attention to detail but can yield exceptional resources for adolescents and parents contemplating major changes to their diabetes regimens.

The Web, Communication Trends, and Children's Health Part 5: Encouraging Positive and Safe Internet Use

The previous four articles in this series on the Web, Communication Trends, and Childrens Health (Clinical Pediatrics, March-June, 1998) have shown that the Internet is a rich interactive window on the world, with health-related resources not readily available elsewhere. While the Internet brings great benefits, there are also some significant potential drawbacks. In this final article of the series, we focus on the precautions parents, teachers, and caregivers can take to help children and their families use the Internet wisely and safely.

The Angry Patient and Family: A Clinical Approach in the Acute Medical Care Setting

&dquo;Why deal at all with someone who is angry?&dquo; is a common initial response. Beyond the tendency to want to &dquo;do good&dquo; are a number of very practical reasons for dealing effectively with patient-related anger. The clinician has limited time and energy, whether working in a busy private practice or in a demanding emergency-care setting. Conservation of energy is essential, particularly during a shift which may last up to 36 hours, with suboptimal conditions and inadequate backup.’ By dealing successfully with a patient’s, family’s, or colleague’s anger, the clinician can defuse a tense situation and avoid

The Web, Communication Trends, and Children's Health Part 2: The Web and the Practice of Pediatrics

This article, Part 2 of a five-part series on The Web, Commmunications Trends, and Childrens Health, describes how the Webs “virtual library” lets pediatricians tap into an ever-growing body of resources, including the latest medical information and online Continuing Medical Education. In addition, the Web creates new ways to practice pediatrics and share patient information.