DEVELOPING AND TESTING THE FEASIBILITY AND PRELIMINARY EFFECTS OF AN INTELLIGENT CUSTOMER-DRIVEN SOLUTION FOR PAEDIATRIC SURGERY CARE ON THE IMPROVEMENT OF OUTCOMES OF PARENTS AND THEIR CHILDREN UNDERGOING CIRCUMCISION (ICORY-CIRCUMCISION): A PILOT RANDOMISED CONTROLLED TRIAL

Abstract

Background: Circumcision, a common elective paediatric surgery in Singapore and worldwide, is a stressful and anxiety-inducing experience for parents and children. Although current perioperative interventions proved effective such as reducing pre-operative anxiety, there are limited holistic solutions using mobile apps. Therefore, we have developed an intelligent customer-driven solution for paediatric surgery care on the improvement of outcomes of parents and their children undergoing circumcision (ICory-Circumcision). Aim: This study aims to develop and test the feasibility and preliminary effects of ICoryCircumcision on primarily parent’s self-efficacy in children’s perioperative care (PSeCPC). Secondary outcomes include knowledge, anxiety, need-for-information, satisfaction, children’s anxiety, postoperative pain, reduction of no-show/ delayed show up for surgery and health services usage. Methods: This study comprised two phases. Phase I focused ICory-Circumcision’s development. Phase II tested the feasibility and preliminary effects of ICory-Circumcision through an internal pilot randomised controlled trial followed by a qualitative process evaluation. Six dyads of parents and their children (7-12 years old) were randomised into intervention or control group. A self-developed Parents’s Self-efficacy in Children’s Perioperative Care Questionnaire (PSeCPCQ) was used to measure the primary outcome parental self-efficacy. Semi-structured interviews were conducted for ICory-Circumcision users (parents, children and healthcare professionals). IBM SPSS 26.0 was used to analyse quantitative data while content analysis was used to analyse interview data. Results: Parents who used ICory-Circumcision showed increasing trends of PSeCPC and knowledge; reducing trends of anxiety, need-for-information and children’s anxiety. Inconclusive trends for children’s postoperative pain, satisfaction, healthcare service use and number of delayed/no show. Recruitment rate target was met but completion rate target was not. Conclusion: ICory-Circumcision seemed to lean towards being useful. However, results have to be interpreted with discretion due to the lack of statistical testing. Feasibility of the study and intervention is possible with suggested recommendations for main trial.