Tips for children's better cooperation during the examination of the head and neck: A Delphi method.
OBJECTIVE
To obtain and rate tips for the head and neck examination in children.


METHODS
A two-round Delphi method study was conducted to survey 13 practising paediatric otolaryngologists (PO) in North America and Europe to obtain tips on how to approach a 2- to 6-year-old child for head and neck examination. The tips were rated by the PO according to their frequency of utilization and usefulness on a scale of 1 (high) to 6 (low). One-sample Wilcoxon signed rank tests were used to evaluate each tip according to frequency of use and success rate. "Top Tips" were identified when both their Wilcoxon p-values were still significant, after a Bonferroni correction. An exact chi-square test for equality of proportions was used to determine the age groups for which satisfactory tips are to be favoured.


RESULTS
The panellists rated forty-three tips. Seven tips obtained a p-value ≤0.001 for the frequency of use and usefulness in all age groups with an emphasis on the initial moments: eye contact, mood assessment, approach behaviour and strategy. Six more tips proved to be satisfactory for specific age groups without reaching the top tip significance level.


CONCLUSIONS
Seven tips to approach a 2- to 6-year-old child reached a top consensus between the experts. Initial eye contact with the child and mood assessment are essential for a satisfactory outcome. The use of a gentle approach with explanation of each step of the physical exam and avoidance of pain are also important.
Department of Otolaryngology - Head & Neck Surgery, Centre Hospitalier Universitaire de Québec, Quebec City, Canada. Electronic address: jeleclerc@ccapcable.com.
Jacques E
JE
Leclerc
Clinical Research Platform, CHU de Québec Research Center, Quebec City, Canada.
Anne-Sophie
AS
Julien
Laval University, Quebec City, Canada.
Louis David
LD
Leclerc
Centre Hospitalier Universitaire de Québec, Quebec City, Canada.
Théa
T
Bergeron-Dupras
D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D032921:Consensus; D003299:Cooperative Behavior; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000523:psychology*; D011369:Professional-Patient Relations; D012919:Social Behavior; D011795:Surveys and Questionnaires
Child cooperation; ENT examination; Head & neck examination