Spandana Veeravalli, Maia Michaud, Judy Colton, Brenda Bourdeau, Samantha Sacks, Lindsay Hales, Elena Guadagno, Dan Poenaru
{"title":"Adapting Perioperative Care for Neurodivergent Children - A Scoping Review.","authors":"Spandana Veeravalli, Maia Michaud, Judy Colton, Brenda Bourdeau, Samantha Sacks, Lindsay Hales, Elena Guadagno, Dan Poenaru","doi":"10.1016/j.jpedsurg.2025.162224","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Routine procedures often pose heightened challenges for neurodivergent children, resulting in increased need for perioperative care compared to the general population. Healthcare professionals' reduced familiarity with infrequent neurodivergent diagnoses further underscores the necessity of evidence-based guidelines. As no guidelines currently exist, our study aims to review interventions, delineate key themes, and develop a checklist to aid healthcare professionals in navigating the perioperative process for neurodivergent patients.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we searched 8 databases from inception until May 2023 for studies assessing perioperative interventions for neurodivergent children. Articles were included if they: (1) focused on the pediatric neurodivergent population, (2) evaluated an intervention that adapted perioperative care, and (3) represented an original research study. To increase the study's inclusiveness, patient partners' perspectives were incorporated into data analysis and interpretation.</p><p><strong>Results: </strong>Out of 7992 articles screened at title and abstract level, 144 were reviewed in full-text format and 29 included in the analysis. Three key themes were identified: use of individualized care plans (27.6 % of included articles), modulation of pre-procedural sedation (17.2 %), and use of innovative mobility devices to improve safety of patient transfers (10.3 %). Care plans were created in collaboration with caregivers, assessing patients' preferences, triggers, and communication style. A multidisciplinary therapeutic approach was deemed crucial, including child life specialists - mentioned in 62.5 % of care plans studies.</p><p><strong>Conclusion: </strong>Improving perioperative care for neurodivergent children centers on the evaluation of their individual needs, followed by designing personalized care plans which include tailored pharmacological and non-pharmacological interventions.</p><p><strong>Level of evidence: </strong>III (scoping review, with lowest level of evidence included being case-control study).</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162224"},"PeriodicalIF":2.4000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pediatric surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpedsurg.2025.162224","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Routine procedures often pose heightened challenges for neurodivergent children, resulting in increased need for perioperative care compared to the general population. Healthcare professionals' reduced familiarity with infrequent neurodivergent diagnoses further underscores the necessity of evidence-based guidelines. As no guidelines currently exist, our study aims to review interventions, delineate key themes, and develop a checklist to aid healthcare professionals in navigating the perioperative process for neurodivergent patients.
Methods: Following PRISMA-ScR guidelines, we searched 8 databases from inception until May 2023 for studies assessing perioperative interventions for neurodivergent children. Articles were included if they: (1) focused on the pediatric neurodivergent population, (2) evaluated an intervention that adapted perioperative care, and (3) represented an original research study. To increase the study's inclusiveness, patient partners' perspectives were incorporated into data analysis and interpretation.
Results: Out of 7992 articles screened at title and abstract level, 144 were reviewed in full-text format and 29 included in the analysis. Three key themes were identified: use of individualized care plans (27.6 % of included articles), modulation of pre-procedural sedation (17.2 %), and use of innovative mobility devices to improve safety of patient transfers (10.3 %). Care plans were created in collaboration with caregivers, assessing patients' preferences, triggers, and communication style. A multidisciplinary therapeutic approach was deemed crucial, including child life specialists - mentioned in 62.5 % of care plans studies.
Conclusion: Improving perioperative care for neurodivergent children centers on the evaluation of their individual needs, followed by designing personalized care plans which include tailored pharmacological and non-pharmacological interventions.
Level of evidence: III (scoping review, with lowest level of evidence included being case-control study).
期刊介绍：
The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.
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