title: Effectiveness of audiovisual interventions on stress responses in adolescents with ENT surgery in hospital: randomized controlled trial protocol.
abstract: OBJECTIVE
  To investigate the circadian pattern of cortisol secretion and other stress indictors in association with audiovisual stimuli in adolescents having otorhinolaryngological surgery in hospital.
  
  
  BACKGROUND
  Hospitalization for surgery is a major stressful life event for adolescents causing negative consequences, including anxiety. Recent studies suggest that entertaining and educational interventions might be effective at reducing such adversities, but little is known about the pattern of these responses and effects.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Adolescents with otorhinolaryngological surgery in hospital without any contraindictions for salivary cortisol enzyme immunoassays will be recruited and randomly allocated to experimental, placebo and control. Stress indicators will be collected regularly for 5 days. Standard audiovisual interventions will be displayed for experimental and placebo groups including a simultaneous video-recording of facial and behavioural changes on the second afternoon postadmission and stress indicators will be collected pre- and three times with 20-minute interval postintervention. Follow-up will be conducted to evaluate the longer term effects at 2 weeks, 1-month and 3 months postadmission, respectively. Descriptive and comparative analyses of stress indicators will be performed to examine group differences. Competitive funding was obtained from the Independent Innovation Foundation of Shandong University for interdisciplinary research in 2012.
  
  
  CONCLUSIONS
  This study will help identify timeslots for interventions for integrating strength-building into stress response reduction in adolescents hospitalized for surgery.
authors.affiliation: School of Nursing, Shandong University, Jinan, China; ENT Unit, Shandong Provincial Hospital (West Branch), Jinan, China.
authors.forename: Cai Yun
authors.initials: CY
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.forename: Yu Li
authors.initials: YL
authors.lastname: Zang
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D001008:Anxiety Disorders / Q000451:nursing*; D001296:Audiovisual Aids / Q000706:statistics & numerical data*; D002648:Child; D002681:China; D055318:Evidence-Based Nursing / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D013315:Stress, Psychological / Q000517:prevention & control*; D055815:Young Adult
keywords: adolescent health; evidence-based practice; health promotion; otorhinolaryngology; psychosocial nursing; randomized controlled trial; stress; surgery