Aim:To design a nursing intervention program to prevent anxiety in the perioperative in adolescents aged 14 to 18, using the Medical Research Council (MRC) framework.
Methods/Design:
The design of the nursing intervention program is based on the enriched development phase of the MRC framework ( Craig et al., 2008; Richards & Hallberg, 2015; Bleijenberg et al., 2018). A multi-phase study is planned to develop the design of the intervention to prevent anxiety in perioperative, in adolescents. Different methodological approaches, namely qualitative and quantitative, are organized to use according to each one element within the development phase of the complex intervention:
Problem identification and definition– The authors will conduct a quantitative and a qualitative descriptive study to explore and describe the levels and the experience of anxiety in the perioperative process in adolescents’ aged 14 to 18. In the quantitative descriptive study we will use the StateTrait Anxiety Inventory for children (STAIC) and Visual Analogue Scale – Anxiety (VAS-A) to evaluate the levels of anxiety. In the qualitative study, the authors will conduct interviews with adolescents and his parents, separately, transcribe and after the text analysis, describe the characteristics of the experience.
Systematically identifying the evidence– Two systematic reviews are being developed. First, a scoping review withthe aim to examine and map the range of non-pharmacological interventions used in a perioperative period to prevent anxiety in adolescents.
The second, in a systematic review of effectiveness, the authors will identify the studies and synthetize the current evidence. The aim of this review is to evaluate the effectiveness of non-pharmacological interventions used to prevent anxiety during in the perioperative period in adolescents.
Identifying or developing theory– The Neuman Systems Model a Nursing Model from Betty Neuman was selected to underpin the intervention. The primary aim of this nursing model is the stability of the client system (Neuman & Fawcett, 2011). This is attained through nursing interventions to reduce the stressors. This model strains the importance of identifying the client’s and nurse’s perceptions and collaboration between them in all stages of the process. Neuman’s model identifies three levels of intervention: primary, secondary and tertiary.
Determine the needs– A qualitative descriptive study using the interview technique will be conducted to determine the difficulties and the needs of the adolescents. The authors will also describe the determinants that influence the adherence to an intervention to prevent anxiety in the perioperative period. The findings will be discussed regarding the literature review.
Examine current practice and context– To explore the context in which the nursing intervention program will be implemented, the authors are conducting interviews with adolescents and their parents and focus groups with pediatric nurses. We will also analyze the documents where evidence is reported, guidelines, policy documents and registries in order to understand the context in were the nursing intervention program will be executed.
Results: According to the MRC guidelines for the development of complex interventions is useful to enhance the probability of success. The selection of this framework gives to the authors a better chance of producing an intervention that can be well adopted, appropriate to its context and it is effective. Due to the high levels of adolescents’ anxiety in the perioperative period, it is important to design and systematically develop an intervention to reduce it.
Conclusion:All of the investment in the development phase of complex interventions is time-consuming however, it is a chance to improve the intervention before conduct a full trial (Bleijenberg et al., 2018). The development of non-pharmacological interventions to prevent anxiety in the perioperative period using the MRC framework give to the authors a better chance of producing a nursing intervention program that it is well-adopted answering to the population needs and fitted to it context.
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