| Real-time assessment of perioperative behaviors in children and parents: development and validation of the perioperative adult child behavioral interaction scale. | |
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MedLine Citation:
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PMID: 20357152 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Behavior in response to distressful events during outpatient pediatric surgery can contribute to postoperative maladaptive behaviors, such as temper tantrums, nightmares, bed-wetting, and attention seeking. Currently available perioperative behavioral assessment tools have limited utility in guiding interventions to ameliorate maladaptive behaviors because they cannot be used in real time, are only intended to be used during 1 phase of the experience (e.g., perioperative), or provide only a static assessment of the child (e.g., level of anxiety). A simple, reliable, real-time tool is needed to appropriately identify children and parents whose behaviors in response to distressful events at any point in the perioperative continuum could benefit from timely behavioral intervention. Our specific aims were to (1) refine the Perioperative Adult Child Behavioral Interaction Scale (PACBIS) to improve its reliability in identifying perioperative behaviors and (2) validate the refined PACBIS against several established instruments. METHODS: The PACBIS was used to assess the perioperative behaviors of 89 children aged 3 to 12 years presenting for adenotonsillectomy and their parents. Assessments using the PACBIS were made during perioperative events likely to prove distressing to children and/or parents (perioperative measurement of blood pressure, induction of anesthesia, and removal of the IV catheter before discharge). Static measurements of perioperative anxiety and behavioral compliance during anesthetic induction were made using the modified Yale Preoperative Anxiety Scale and the Induction Compliance Checklist (ICC). Each event was videotaped for later scoring using the Child-Adult Medical Procedure Interaction Scale-Short Form (CAMPIS-SF) and Observational Scale of Behavioral Distress (OSBD). Interrater reliability using linear weighted kappa (kappa(w)) and multiple validations using Spearman correlation coefficients were analyzed. RESULTS: The PACBIS demonstrated good to excellent interrater reliability, with kappa(w) ranging from 0.62 to 0.94. The Child Coping and Child Distress subscores of the PACBIS demonstrated strong concurrent correlations with the modified Yale Preoperative Anxiety Scale, ICC, CAMPIS-SF, and OSBD. The Parent Positive subscore of the PACBIS correlated strongly with the CAMPIS-SF and OSBD, whereas the Parent Negative subscore showed significant correlation with the ICC. The PACBIS has strong construct and predictive validities. CONCLUSIONS: The PACBIS is a simple, easy to use, real-time instrument to evaluate perioperative behaviors of both children and parents. It has good to excellent interrater reliability and strong concurrent validity against currently accepted scales. The PACBIS offers a means to identify maladaptive child or parental behaviors in real time, making it possible to intervene to modify such behaviors in a timely fashion. |
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Authors:
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Senthilkumar Sadhasivam; Lindsey L Cohen; Liana Hosu; Kristin L Gorman; Yu Wang; Todd G Nick; Jing Fang Jou; Nancy Samol; Alexandra Szabova; Nancy Hagerman; Elizabeth Hein; Anne Boat; Anna Varughese; Charles Dean Kurth; J Paul Willging; Joel B Gunter |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Validation Studies |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 110 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-01 Completed Date: 2010-04-23 Revised Date: 2010-05-28 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1109-15 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. senthilkumar.sadhasivam@cchmc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adaptation, Psychological Adult Algorithms Anxiety / psychology Child Child Behavior* Child, Preschool Emotions Female Humans Interpersonal Relations* Male Observer Variation Parents* Perioperative Care* Postoperative Period Predictive Value of Tests Preoperative Period Psychological Tests* Reproducibility of Results |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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