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      The Importance of the Setting during Sedation for Intrathecal Chemotherapy in Pediatric Oncology Care: A Case Study

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          Abstract

          Increasing survival rates for childhood cancer have brought attention to the high level of burden of cancer and its treatment. Improving supportive care for children throughout their cancer trajectory is thus important and could reduce the difficulties related to treatment, including time-consuming treatments and the waiting time associated with treatment procedures. The aim of this study is to describe time intervals and the Propofol dose used during sedation for intrathecal chemotherapy in three different settings. The study is based on retrospective data from repeated treatment sessions recorded in operation planning programs and hospital records in the period 2011–2018 ( n = 164). Children, 1–12 years old ( n = 22), undergoing a varying number of treatments, were included in the study. The most crucial finding in this study is that the time from the child’s first meeting with the nurse anesthetist to the induction of sedation is significantly reduced if the procedure is performed in the children’s ward. The study highlights the importance of the setting for sedation for intrathecal chemotherapy when implementing a child-centered approach in pediatric oncology care.

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          Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery.

          Findings from published studies suggest that the postoperative recovery process is more painful, slower, and more complicated in adult patients who had high levels of preoperative anxiety. To date, no similar investigation has ever been conducted in young children. We recruited 241 children aged 5 to 12 years scheduled to undergo elective outpatient tonsillectomy and adenoidectomy. Before surgery, we assessed child and parental situational anxiety and temperament. After surgery, all subjects were admitted to a research unit in which postoperative pain and analgesic consumption were assessed every 3 hours. After 24 hours in the hospital, children were discharged and followed up at home for the next 14 days. Pain management at home was standardized. Parental assessment of pain in their child showed that anxious children experienced significantly more pain both during the hospital stay and over the first 3 days at home. During home recovery, anxious children also consumed, on average, significantly more codeine and acetaminophen compared with the children who were not anxious. Anxious children also had a higher incidence of emergence delirium compared with the children who were not anxious (9.7% vs 1.5%) and had a higher incidence of postoperative anxiety and sleep problems. Preoperative anxiety in young children undergoing surgery is associated with a more painful postoperative recovery and a higher incidence of sleep and other problems.
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            Centeredness in Healthcare: A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care

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              Perioperative anxiety in children.

              OBJECTIVES & AIM: The purpose of this investigation was to examine children's anxiety across the perioperative setting.
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                Author and article information

                Journal
                Healthcare (Basel)
                Healthcare (Basel)
                healthcare
                Healthcare
                MDPI
                2227-9032
                02 September 2020
                September 2020
                : 8
                : 3
                : 314
                Affiliations
                School of Health and Welfare, Halmstad University, 301 18 Halmstad, Sweden; petra.svedberg@ 123456hh.se (P.S.); ing-marie.carlsson@ 123456hh.se (I.-M.C.); jens.nygren@ 123456hh.se (J.M.N.)
                Author notes
                [* ]Correspondence: carina.sjoberg@ 123456hh.se
                Author information
                https://orcid.org/0000-0002-9877-7357
                https://orcid.org/0000-0002-3576-2393
                Article
                healthcare-08-00314
                10.3390/healthcare8030314
                7551382
                32887243
                01456741-77cf-4ca3-879d-11a4210b868e
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 21 July 2020
                : 31 August 2020
                Categories
                Article

                children,intrathecal chemotherapy,leukemia,pediatric anesthesia,perioperative care

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