Oliveira N C A C, Santos J L F, Linhares M B M
Ribeirão Preto Medical School, University of São Paulo, Brazil.
Eur J Pain. 2017 Jan;21(1):178-187. doi: 10.1002/ejp.915. Epub 2016 Jul 26.
Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients.
The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance.
The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention.
Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients.
The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were detected in subsequent acute painful procedures.
疼痛是一种压力体验,会对儿童发育产生负面影响。这项交叉研究的目的是检验视听分散注意力法对缓解儿科住院患者急性疼痛的疗效。
样本包括40名接受痛苦穿刺 procedure的住院患者(6 - 11岁)。参与者被随机分为两组,所有儿童都接受干预并作为自身对照。最初使用儿童压力量表和儿童疼痛灾难化量表进行压力和疼痛灾难化评估,目的是控制这些变量。在痛苦 procedure后,使用视觉模拟量表和面部疼痛量表修订版进行疼痛评估。第1组在穿刺 procedure前和过程中接受视听分散注意力法,另一天在无干预情况下再次进行该 procedure。第2组程序相反。视听分散注意力法使用动画短片。对2×2交叉研究进行2×2×2方差分析,统计学显著性水平为5%。
两组在压力和疼痛灾难化的基线测量上相似。两组在有和无分散注意力的时间段之间均发现显著差异,其中与无干预相比,分散注意力期间两个疼痛量表的得分均较低。两组中分散注意力干预的暴露顺序以及进行分散注意力的第一次与第二次痛苦 procedure也显著影响分散注意力干预的疗效。
视听分散注意力法有效降低了儿科住院患者的疼痛感知强度。
交叉研究设计能更好地理解分散注意力对急性疼痛管理的效果。视听分散注意力法是一种用于缓解儿科住院患者疼痛的强大且有效的非药物干预措施。在随后的急性痛苦 procedure中检测到了这种效果。