Child’s suffering: proposals to support and manage the illness

A child’s pain needs to be addressed and understood as a sensory and emotional experience, through which ‘‘invisible’’ things can be discovered. The perception of a child’s pain and its psychological, interpersonal and somatic consequences need dedicated support and management during medical treatment. Without adequate support and management, which give suffering a precise meaning, the suffering of children remains a primitive injustice. This article closely examines and looks at possible ways to approach the reception and care of suffering children. The importance of communication of the diagnosis as a decisive moment in the life of the whole family is the focus. We discussed the role of welcoming, listening and processing the thoughts concerning the disease to be able to accept, without running away from the suffering derived from the painful experienc

Post-Operative Benefits of Animal-Assisted Therapy in Pediatric Surgery: A Randomised Study

<div><p>Background</p><p>Interest in animal-assisted therapy has been fuelled by studies supporting the many health benefits. The purpose of this study was to better understand the impact of an animal-assisted therapy program on children response to stress and pain in the immediate post-surgical period.</p><p>Patients and Methods</p><p>Forty children (3–17 years) were enrolled in the randomised open-label, controlled, pilot study. Patients were randomly assigned to the animal-assisted therapy-group (n = 20, who underwent a 20 min session with an animal-assisted therapy dog, after surgery) or the standard-group (n = 20, standard postoperative care). The study variables were determined in each patient, independently of the assigned group, by a researcher unblinded to the patient’s group. The outcomes of the study were to define the neurological, cardiovascular and endocrinological impact of animal-assisted therapy in response to stress and pain. Electroencephalogram activity, heart rate, blood pressure, oxygen saturation, cerebral prefrontal oxygenation, salivary cortisol levels and the faces pain scale were considered as outcome measures.</p><p>Results</p><p>After entrance of the dog faster electroencephalogram diffuse beta-activity (> 14 Hz) was reported in all children of the animal-assisted therapy group; in the standard-group no beta-activity was recorded (100% vs 0%, p<0.001). During observation, some differences in the time profile between groups were observed for heart rate (test for interaction p = 0.018), oxygen saturation (test for interaction p = 0.06) and cerebral oxygenation (test for interaction p = 0.09). Systolic and diastolic blood pressure were influenced by animal-assisted therapy, though a higher variability in diastolic pressure was observed. Salivary cortisol levels did not show different behaviours over time between groups (p=0.70). Lower pain perception was noted in the animal-assisted group in comparison with the standard-group (p = 0.01).</p><p>Conclusion</p><p>Animal-assisted therapy facilitated rapid recovery in vigilance and activity after anaesthesia, modified pain perception and induced emotional prefrontal responses. An adaptative cardiovascular response was also present.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov" target="_blank">NCT02284100</a></p></div

Demographic and auxological features of the children at admission and vital signs pre intervention.

<p>*data are expressed as median (interquartile range)</p><p>Demographic and auxological features of the children at admission and vital signs pre intervention.</p

Flow diagram of the progress through the phases of the randomised trial of two groups (animal-assisted therapy and standard care after surgery).

<p>Flow diagram of the progress through the phases of the randomised trial of two groups (animal-assisted therapy and standard care after surgery).</p

Comparison of the model-derived profiles for heart rate (HR), diastolic blood pressure (DBP), oxygen saturation (SpO₂), cerebral prefrontal oxygenation (HbO₂) in animal-assisted therapy (AAT) and standard (STAND) groups.

<p>All models are adjusted for time of anesthesia</p

Vital signs measured in treated and standard groups.

<p>Differences and 95%CI are derived from repeated measurements models (including main effects for time and groups and their interaction) adjusted for anesthesia time.</p