A software‐based observational coding approach for evaluating paediatric dental pain, anxiety, and fear

Abstract

AbstractBackgroundDental practitioners desire non‐pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high‐quality evidence, however, is required to evaluate methods' efficacy.AimThis study aimed to develop and validate an observation‐based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non‐pharmacological behavior management techniques for anxiety, fear, and pain.DesignObjective (video‐based) and subjective (self‐reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal‐assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7–14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter‐rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software.ResultsA novel, software‐based coding approach was developed, with moderately high inter‐rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment‐interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements.ConclusionPAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.