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Care, innovation, education and research

news item News Friday, December 21, 2018 Friday, December 21, 2018 1:43 PM - Friday, December 21, 2018 1:43 PM

Managing patients’ anxiety in the cast room

Child life specialists are pediatric health care professionals who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness and disability. At Shriners Hospitals for Children — Springfield, certified child life specialists have advanced training in child development and developmentally appropriate interventions, and work in partnership with doctors, nurses, social workers and parents to meet the unique emotional, developmental and cultural needs of each child and family.

Studies indicate that the presence of a child life specialist during a health care procedure is therapeutic in allaying anxiety and improving the experience for the child, as well as the parent, whose satisfaction is often directly associated with observations and perceptions of the child's comfort level.

One study appearing in the Journal of Pediatric Orthopaedics examined the role of a child life specialist during orthopaedic cast procedures through a prospective-randomized trial. Procedures included splint removals, initial cast placements, fracture manipulation, isolated pin removal and cast removal, and involved a total of 86 children, aged 2 to 10 years. Forty-two of the children had a child life specialist present in the cast room and 44 children did not have a child life specialist present. Pulse oximeters were utilized to record the children's heart rates at four time intervals, and a behavior scale was created in an attempt to objectively evaluate the child's emotional state. The scale identified negative behaviors such as crying, protesting and physical non-compliance as well as positive behaviors including smiling/laughing, playing and calm/compliance. The study demonstrated that the therapeutic presence of a child life specialist while a child was undergoing an orthopaedic procedure positively affected the observed behavior score. Also, a greater increase in heart rate was observed when there was no child life specialist in the room.  

“Shriners Hospitals for Children is proud to be able to provide this service whenever necessary to support children in uncomfortable situations in the cast room, as well as throughout the hospital,” says Samantha West, MSW, CCLS, a child life specialist at the Springfield Shriners Hospital.