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Exposure therapy is a widely used treatment for patients with post-traumatic stress dis -order. It involves reduction of fear through progressive exposure to frightening stimuli in a therapeutic environment. Here we propose a new method designed to improve the effectiveness of exposure therapy. We hypothesized that device-guided breathing during exposure therapy can increase the capability of the patient to undergo effective exposure. The successful application of the method is described for a single patient. Using a device to slow and regularize breathing, the patient was calmed and experienced a greater sense of control and a profound effect of the exposure. The use of the breathing-guiding device is believed to reduce arousal level and excitability of sympathetic “fight-flight” behaviors. The present study suggests that device-guided breathing integrated with exposure therapy may provide a practically feasible and potentially promising non-pharmacological treatment after trauma.

This study aims to determine the factors influencing caregivers' uncertainty about children undergoing cardiac surgery in a tertiary hospital in Bangkok, Thailand.

A correlational predictive study was conducted among 75 caregivers of children from infancy to fifteen years old who were undergoing first time cardiac surgery in a tertiary hospital in Bangkok, Thailand. Four questionnaires were inquired to evaluate caregivers' uncertainty about the illness, and influential factors included (1) perception of the severity of the illness, (2) credible authority of health-care providers and (3) information and emotional support. The descriptive statistics, Pearson correlation coefficient and multiple regression analysis were used to analyze the data and influential factors.

The significant influential factors affecting caregivers' uncertainty were (1) perception of the severity of the illness (β = 0.413, p < 0.001), (2) credible authority of health-care providers (β = −0.287, p = 0.004) and (3) information and emotional support (β = −0.223, p = 0.026), and their explanation power was about 33.9 % (R² = 0.339, F = 13.630, p < 0.001).

A limitation of this study was that the researcher selected the sample group by convenient sampling and only caregivers of children who underwent cardiac surgery in Siriraj hospital were selected. Therefore, the sample group might have lacked variety and was not a good representative of the population. Future studies should be conducted by varying the setting and using randomized sampling.

This study provides clear recommendations to assess the perception of the severity of the illness by caregivers, build credibility and trust by providing quality care and should develop information and emotional support interventions for reducing the levels of caregivers' uncertainty of children undergoing cardiac surgery.

Health-care providers should develop the appropriate intervention for reducing caregivers' uncertainty by assessing the perception of the severity of the illness, providing information and emotional support and building trust for the caregivers of the children who are undergoing cardiac surgery.