Jivraj Bejaan A, Schaeffer Emily, Bone Jeffrey N, Stunden Chelsea, Habib Eva, Jacob John, Mulpuri Kishore
Department of Family Medicine, University of British Columbia, Vancouver, Canada.
Department of Orthopaedics, University of British Columbia, Vancouver, Canada.
J Child Orthop. 2020 Dec 1;14(6):574-580. doi: 10.1302/1863-2548.14.200090.
While virtual reality (VR) has been shown to be an effective distractor in children across a range of procedures, no studies have looked at its use within paediatric orthopaedics. The purpose of this study was to look at the use of VR in reducing anxiety levels in children during cast removal. In addition, the study aimed to find ways to enhance the efficiency of future VR trials in paediatrics.
A non-blinded randomized control trial took place in children aged four to 18 years. Intraprocedural anxiety was measured using the Children's Emotional Manifestation Scale (CEMS), while pre- and post-procedural anxiety was measured using the Short State Anxiety Inventory Scale. Additional data was collected on trait anxiety, nausea levels, desire for future VR use and areas of improvement for future VR studies.
A total of 90 subjects were included in the study (control n = 45, intervention n = 45) with a mean age of 10.25 years (sd 3.35). Post-procedural anxiety and intraprocedural anxiety were 18% (p = 0.03) and 24% (p = 0.01) lower in the VR group, respectively, with the CEMS facial component showing a 31% (p < 0.001) reduction in the VR group. In all, 99% (n = 89) of subjects experienced no nausea, with one patient experiencing mild nausea that may have been present prior to VR use. Finally, 90% (n = 81) of subjects said they would like to use VR again, 1% (n = 1) said 'no' and 9% (n = 8) said 'maybe'.
VR appears to be an effective distraction technique in reducing anxiety levels in children during cast removal.
虽然虚拟现实（VR）已被证明在一系列手术中对儿童是一种有效的注意力分散方式，但尚无研究探讨其在小儿骨科中的应用。本研究的目的是观察VR在减少儿童石膏拆除过程中的焦虑水平方面的应用。此外，该研究旨在找到提高未来儿科VR试验效率的方法。
对4至18岁的儿童进行了一项非盲随机对照试验。术中焦虑使用儿童情绪表现量表（CEMS）进行测量，术前和术后焦虑使用简短状态焦虑量表进行测量。还收集了关于特质焦虑、恶心程度、未来使用VR的意愿以及未来VR研究改进方面的额外数据。
共有90名受试者纳入研究（对照组n = 45，干预组n = 45），平均年龄为10.25岁（标准差3.35）。VR组术后焦虑和术中焦虑分别降低了18%（p = 0.03）和24%（p = 0.01），CEMS面部分量表显示VR组降低了31%（p < 0.001）。总体而言，99%（n = 89）的受试者未出现恶心，1名患者出现轻度恶心，可能在使用VR之前就已存在。最后，90%（n = 81）的受试者表示他们愿意再次使用VR，1%（n = 1）表示“不愿意”，9%（n = 8）表示“可能愿意”。
VR似乎是一种有效的注意力分散技术，可降低儿童石膏拆除过程中的焦虑水平。
