Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada; CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada.
CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Quebec, H3T 1C5, Canada; Department of Surgery, CHU Sainte-Justine, Montreal, QC, Canada.
Pain Manag Nurs. 2021 Apr;22(2):191-197. doi: 10.1016/j.pmn.2020.10.002. Epub 2021 Jan 22.
Many children with injuries, including burns and fractures, experience moderate to severe pain during medical procedures. Recent studies claim that nonpharmacologic pain management using virtual reality (VR) could distract children from procedural pain by engaging multiple senses.
The aims of this pilot randomized clinical trial were to assess the acceptability and feasibility of VR distraction in children with burns or fractures undergoing painful medical procedures, as well as the staff nurses, and assess the preliminary efficacy of VR distraction on pain intensity, pain-related fear, and subsequent recall of both.
A within-subject study design, in which participants served as their own control, was used. A total of 20 children from 7 to 17 years old with an injury were recruited at the surgical-trauma outpatient clinics of the Centre hospitalier universitaire Sainte-Justine (CHU Sainte-Justine). Each participant received both standard and experimental treatments through randomized order. Pain (numerical rating scale) and pain-related fear (Children's Fear Scale) measures were taken before the procedure and after each sequence, followed by a measure of children's (graphic rating scale) and nurses' acceptability of the intervention through their satisfaction level. Recall of pain intensity and pain-related fear were assessed 24 hours after the procedure. Wilcoxon signed-rank tests were used, with a significance level at 0.05.
Results showed that VR distraction was an acceptable and feasible intervention for children and nurses of these outpatient clinics. Preliminary effects showed that, compared to standard of care, children participants reported a significant decrease in pain intensity (p = .023) and pain-related fear (p = .011) during VR as well as less recalled pain-related fear (p = .012) at 24 hours after the procedure. No side effects were reported.
VR is a promising intervention with children undergoing painful procedures because it is immersive and engages multiple senses. It is a low-cost intervention well accepted by children and nursing staff at this clinical site and is easy to implement in daily practice for procedural pain management.
许多受伤的儿童，包括烧伤和骨折，在接受医疗程序时会经历中度至重度疼痛。最近的研究声称，使用虚拟现实（VR）的非药物性疼痛管理可以通过吸引多种感官来分散儿童对程序疼痛的注意力。
本试验性随机临床试验的目的是评估 VR 分散注意力在接受疼痛医疗程序的烧伤或骨折儿童中的可接受性和可行性，以及对护士的影响，并评估 VR 分散注意力对疼痛强度、疼痛相关恐惧以及随后对两者的回忆的初步疗效。
采用自身对照的研究设计，即参与者作为自己的对照。共招募了 20 名年龄在 7 至 17 岁之间的受伤儿童，他们来自 Sainte-Justine 大学医院中心（CHU Sainte-Justine）的外科创伤门诊。每个参与者都通过随机顺序接受标准和实验治疗。在程序前和每个序列后测量疼痛（数字评分量表）和疼痛相关恐惧（儿童恐惧量表），然后通过满意度衡量儿童（图形评分量表）和护士对干预措施的可接受性。在程序后 24 小时评估疼痛强度和疼痛相关恐惧的回忆。采用 Wilcoxon 符号秩检验，显著性水平为 0.05。
结果表明，VR 分散注意力是这些门诊的儿童和护士可以接受和可行的干预措施。初步结果表明，与标准护理相比，儿童参与者在 VR 期间报告疼痛强度（p=0.023）和疼痛相关恐惧（p=0.011）显著降低，并且在程序后 24 小时回忆的疼痛相关恐惧更少（p=0.012）。没有报告任何副作用。
VR 是一种有前途的干预措施，适用于接受疼痛程序的儿童，因为它具有沉浸式和吸引多种感官的特点。它是一种低成本的干预措施，在这个临床地点深受儿童和护理人员的欢迎，并且易于在日常实践中实施，以进行程序疼痛管理。
