OBJECTIVE: This study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain.
METHODS: Objective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software.
RESULTS: A novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements.
CONCLUSIONS: PAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.
目的:本研究旨在开发和验证一种基于观察的编码方法(儿科牙科疼痛,焦虑,和恐惧编码方法[PAFCA])来评估焦虑的非药理学行为管理技术,恐惧,和痛苦。
方法:客观(基于视频)和主观(自我报告)焦虑,恐惧,和疼痛数据是从评估儿科牙科动物辅助治疗(AAT)的试点临床试验中收集的,其中37名7-14岁的儿童在牙科治疗(修复或拔牙)之前被分配到AAT或对照。一种利用码本的编码方法,黄金标准校准视频,并制定了用户培训指南。训练有素的审查员为评估者之间的协议编码了黄金标准视频,蒙面,校准的检查者使用NoldusObserverXT软件分析视频。
结果:小说,开发了基于软件的编码方法,具有中等高的评分者间协议。使用PAFCA,我们发现儿童报告的疼痛程度更高,恐惧,焦虑表现出干扰治疗的行为,包括哭泣/呻吟,试图驱逐乐器,和更多的上半身运动。
结论:PAFCA有望成为评估焦虑的可靠工具,疼痛,以及对儿科牙科行为研究的恐惧。