Storytelling Medicine
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- Madlyn Daniel
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1 Storytelling Medicine Reducing Children s Anxiety in Hospitals Presented by: Ali Shahzada Luis Michelangeli
2 Funded by:
3 Children s Anxiety Negative Behaviors: Agitation Crying Spontaneous Urination Need for physical restraint
4 Children s Anxiety Physiological Responses: Negative nitrogen balance and catabolism Delay wound healing Postoperative immunosuppression
5 Children s Anxiety Effects: Increased resistance to induction Decreased compliance/cooperation to medical procedures Decreased speed of recovery Risk of having fears develop into adulthood phobias
6 Addressing Anxiety Non- Pharmacological Preparation Programs Parental Presence
7 Addressing Anxiety Non- Pharmacological Benefits Parental Presence Decreasing the need for pharmacological treatments Avoiding the anxiety caused by separation at the OR Increase child s compliance Objections Disruption of the OR routine Adverse reaction of parents Prolong anesthetic induction Additional stress on the anesthesiologist
8 Addressing Anxiety Non- Pharmacological Parental Presence
9 Addressing Anxiety Non- Pharmacological Effectiveness Ranking: Preparation Programs Coping Skills Instructions Modeling Play Therapy Operating room tours Printed material Child Life preparation programs decrease anxiety level for a short period of time after the preparation in the holding area
10 Addressing Anxiety Pharmacological Midazolam (85%) Ketamine (4%) Fentanyl (3%) Meperidine (2%) Objections: Respiratory depression Increased salivary and bronchial secretions Extended recovery period
11 Masking Pain Addressing Anxiety
12 Stretchers Addressing Anxiety
13 Environment Addressing Anxiety
14 Environment Addressing Anxiety
15 Design Process Big Idea How to make the hospital experience more enjoyable for children
16 Needs Design Process Engages all stakeholders Distracts Educates Safe Customizable Easy to implement Does not take any extra resources from the hospital
17 Storytelling Medicine Design Process
18 The System Design Process
19 Ideas Becoming Reality The Products
20 Ryan The Raccoon Core Benefits The toy provides the child with company and lasting memories The two books help the child recognize the hospital before going there Allows parents to get involved in the education process Provides continuity to the system
21 Ryan The Raccoon The Application Recreates real spaces of the hospital digitally
22 The Application Ryan The Raccoon
23 Ryan The Raccoon Core Benefits Easy interaction through touch screen Matching backgrounds with real spaces Customizable app for every hospital and type of procedure Does not require extra resources It meets health requirements from the hospital Ryan the Raccoon will show one step ahead of the process all the time
24 Proof Of Concept Study Survey Results Tested on 8 Patients September October 2011 Outpatient Day Surgeries 4 surveys performed Clinical Background Parents (pre- procedure) Parents (post- procedure) Clinical (post- procedure)
25 Clinical Background % 80.00% 60.00% 40.00% 20.00% 0.00% What % of pediatric pts (3-5yrs) are anxious during their visit to your facility 30-40% 50-60% 60-70% >75% % 80.00% 60.00% 40.00% 20.00% 0.00% Do you think your hospital/clinic would benefit from investigating a new methodology for treating children anxiety? Yes No % 80.00% 60.00% Would reducing child anxiety, help you increase your overall productivity and efficiency % 80.00% 60.00% What % of your time are you spending waiting/calming a child during a visit? 40.00% 20.00% 0.00% Yes No 40.00% 20.00% 0.00% 0-10% 10-25% 25-50% >50%
26 Parents (Pre- Procedure) Is this your child`s first procdedure? 2 Yes No 6 Was you child scared/nervous before the surgery? 3 Yes 5 No
27 Parents (Post- Procedure) 6 5 How well of a job did the hospital staff do to keep you child calm? Should the hospital invest in an additonal program that aims to decrease child anxiety? Yes No 0 Poor Moderate Great Would you be willing to spend extra during your childs hospital visit to enroll them in a progrma that promises to decrease their anxiety and tries to make the expereince more enjoyable? 5 4 How much would you be willing to pay for the service? 1 7 Yes No $100+ $75- $100 $50-75 $25-50 <$25 Should be free
28 Clinical (Post- Procedure) Did STM facilitate you providing service to your patient? Did your patient seem calmer than would otherwise be expected? Yes No 2 0 Yes No Could STM save you any time with the child? 2 6 Yes No
29 Ryan The Raccoon Next Steps Pilot - In colaboration with Dr. Schimdt and Dr. Cunningham Clinical Study - CIHR funds
30 Innovating Healthcare
31 Thank you
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