Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture A Randomized Clinical Trial

被引:27
作者
Wong, Cho Lee [1 ]
Choi, Kai Chow [1 ]
机构
[1] Chinese Univ Hong Kong, Nethersole Sch Nursing, Fac Med, Hong Kong, Peoples R China
关键词
MEDICAL PROCEDURES; CHINESE VERSION; YOUNG-CHILDREN; DISTRACTION; DISTRESS; SCALE; MANAGEMENT; EFFICACY;
D O I
10.1001/jamanetworkopen.2023.0001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
IMPORTANCE Venipuncture is one of the most painful and distressing procedures experienced by pediatric patients. Emerging evidence suggests that providing procedural information and distraction using immersive virtual reality (IVR) may reduce pain and anxiety among children undergoing needle-related procedures. OBJECTIVES To examine the effects of IVR on reducing the pain, anxiety, and stress experienced by pediatric patients undergoing venipuncture. DESIGN, SETTING, AND PARTICIPANTS This 2-group randomized clinical trial recruited pediatric patients aged 4 to 12 years undergoing venipuncture from a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March to May 2022. INTERVENTIONS Participants were randomly allocated to an intervention (an age-appropriate IVR intervention offering distraction and procedural information) or a control (standard care only) group. MAIN OUTCOMES AND MEASURES The primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure (rated on a 40 point scale, with higher scores indicating greater satisfaction). Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure. RESULTS A total of 149 pediatric patients were recruited, with 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group (mean [SD] age, 7.21 [2.49] years), the 75 participants in the IVR group (mean [SD] age, 7.21 [2.43] years) reported significantly less pain (beta = -0.78; 95% CI, -1.21 to -0.35; P <.001) and anxiety (beta = -0.41; 95% CI, -0.76 to -0.05; P =.03) immediately after the intervention. Health care professional satisfaction in the IVR group (mean [SD] score, 34.5 [4.5]) was significantly higher than that in the control group (mean [SD] score, 32.9 [4.0]; P =.03). Moreover, the length of venipuncture procedure in the IVR group (mean [SD] duration, 4.43 [3.47] minutes) was significantly shorter than that in the control group (mean [SD] duration, 6.56 [7.39] minutes; P =.03). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, integrating procedural information and distraction in an IVR intervention for pediatric patients undergoing venipuncture significantly improved pain and anxiety in the IVR group compared with the control group. The results shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures.
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页数:13
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[1]   The Use of the Buzzy, Jet Lidokaine, Bubble-blowing and Aromatherapy for Reducing Pediatric Pain, Stress and Fear Associated with Phlebotomy [J].
Alemdar, Dilek Kucuk ;
Aktas, Yesim Yaman .
JOURNAL OF PEDIATRIC NURSING-NURSING CARE OF CHILDREN & FAMILIES, 2019, 45 :E64-E72
[2]  
[Anonymous], 1952, ORIGINS INTELLIGENCE, DOI DOI 10.1037/11494-000
[3]   Psychological interventions for needle-related procedural pain and distress in children and adolescents [J].
Birnie, Kathryn A. ;
Noel, Melanie ;
Chambers, Christine T. ;
Uman, Lindsay S. ;
Parker, Jennifer A. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2018, (10)
[4]   Systematic Review and Meta-Analysis of Distraction and Hypnosis for Needle-Related Pain and Distress in Children and Adolescents [J].
Birnie, Kathryn A. ;
Noel, Melanie ;
Parker, Jennifer A. ;
Chambers, Christine T. ;
Uman, Lindsay S. ;
Kisely, Steve R. ;
McGrath, Patrick J. .
JOURNAL OF PEDIATRIC PSYCHOLOGY, 2014, 39 (08) :783-808
[5]   Reference values for quantitative sensory testing in children and adolescents: Developmental and gender differences of somatosensory perception [J].
Blankenburg, M. ;
Boekens, H. ;
Hechler, T. ;
Maier, C. ;
Krumova, E. ;
Scherens, A. ;
Magerl, W. ;
Aksu, F. ;
Zernikow, B. .
PAIN, 2010, 149 (01) :76-88
[6]   The Perioperative Validity of the Visual Analog Anxiety Scale in Children: A Discriminant and Useful Instrument in Routine Clinical Practice to Optimize Postoperative Pain Management [J].
Bringuier, Sophie ;
Dadure, Christophe ;
Raux, Olivier ;
Dubois, Amandine ;
Picot, Marie-Christine ;
Capdevila, Xavier .
ANESTHESIA AND ANALGESIA, 2009, 109 (03) :737-744
[7]   Play and heal: Randomized controlled trial of Ditto™ intervention efficacy on improving re-epithelialization in pediatric burns [J].
Brown, Nadia J. ;
Kimble, Roy M. ;
Rodger, Sylvia ;
Ware, Robert S. ;
Cuttle, Leila .
BURNS, 2014, 40 (02) :204-213
[8]   Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials [J].
Chan, Evelyn ;
Hovenden, Michael ;
Ramage, Emma ;
Ling, Norman ;
Pham, Jeanette H. ;
Rahim, Ayesha ;
Lam, Connie ;
Liu, Linly ;
Foster, Samantha ;
Sambell, Ryan ;
Jeyachanthiran, Kasthoori ;
Crock, Catherine ;
Stock, Amanda ;
Hopper, Sandy M. ;
Cohen, Simon ;
Davidson, Andrew ;
Plummer, Karin ;
Mills, Erin ;
Craig, Simon S. ;
Deng, Gary ;
Leong, Paul .
JOURNAL OF PEDIATRICS, 2019, 209 :160-+
[9]   Virtual Reality in Health System: Beyond Entertainment. A Mini-Review on the Efficacy of VR During Cancer Treatment [J].
Chirico, Andrea ;
Lucidi, Fabio ;
De Laurentiis, Michele ;
Milanese, Carla ;
Napoli, Alessandro ;
Giordano, Antonio .
JOURNAL OF CELLULAR PHYSIOLOGY, 2016, 231 (02) :275-287
[10]   Nurse coaching and cartoon distraction: An effective and practical intervention to reduce child, parent, and nurse distress during immunizations [J].
Cohen, LL ;
Blount, RL ;
Panopoulos, G .
JOURNAL OF PEDIATRIC PSYCHOLOGY, 1997, 22 (03) :355-370