Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 3-583 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Women and Children's Health Research Institute (WCHRI), Edmonton, AB, Canada.
CJEM. 2021 Jan;23(1):85-93. doi: 10.1007/s43678-020-00023-5. Epub 2020 Dec 10.
Our objectives were to evaluate the effectiveness of humanoid robot-based distraction on reducing distress and pain in children undergoing intravenous insertion.
A two-arm, open-label randomized controlled trial was conducted April 2017-May 2018, in a pediatric emergency department (ED). A sample of 86 children aged 6-11 years who required intravenous insertion were recruited. Exclusion criteria included hearing/visual impairments, neurocognitive delay, sensory impairment to pain, previous enrollment, and ED clinical staff discretion. Outcome measures included the Observed Scale of Behavioral Distress-Revised (OSBD-R) (distress) and the Faces Pain Scale-Revised (FPS-R) (pain).
Of the 86 children recruited (median age 9 years, IQR 7,10); 55% (47/86) were male, 9% (7/82) were premature, 82% (67/82) had a previous ED visit, 31% (25/82) had a previous hospitalization and 78% (64/82) had previous intravenous insertion. Ninety-six percent (78/81) received topical anesthetic prior to intravenous insertion. Total OSBD-R distress score was 1.49 ± 2.36 (standard care) versus 0.78 ± 1.32 (robot) (p < 0.05). FPS-R pain score was 4 (IQR 2,6) (standard care) versus 2 (IQR 0,4) (robot) (p = 0.13). Parental anxiety immediately after the procedure was 36.7 (11.1) (standard care) versus 31.3 (8.5) (robot) (p = 0.04). Parents were more satisfied with pain management in the robotic distraction group (95% vs 72% very satisfied) (p = 0.002).
Humanoid robot-based distraction therapy is associated with a modest positive impact on child distress for pediatric intravenous insertion, but not pain. It can be considered a potential tool in the ED toolkit for procedural pain-associated distress reduction.
Clinicaltrials.gov Identifier: NCT02997631.
评估基于仿人机器人的分散注意力对减轻儿童静脉插入时的痛苦和痛苦的效果。
这是一项双臂、开放标签的随机对照试验，于 2017 年 4 月至 2018 年 5 月在儿科急诊室（ED）进行。招募了 86 名年龄在 6-11 岁、需要静脉插入的儿童。排除标准包括听力/视力障碍、神经认知障碍、疼痛感觉障碍、先前入组和 ED 临床工作人员的酌情决定。观察结果包括修订后的行为困扰观察量表（OSBD-R）（困扰）和修订后的面部疼痛量表（FPS-R）（疼痛）。
在招募的 86 名儿童中（中位数年龄为 9 岁，IQR 为 7,10）；55%（47/86）为男性，9%（7/82）为早产儿，82%（67/82）有急诊就诊史，31%（25/82）有住院史，78%（64/82）有过静脉插入。96%（78/81）在静脉插入前接受了局部麻醉。OSBD-R 总困扰评分分别为 1.49±2.36（标准护理）和 0.78±1.32（机器人）（p<0.05）。FPS-R 疼痛评分分别为 4（IQR 2,6）（标准护理）和 2（IQR 0,4）（机器人）（p=0.13）。程序后父母立即出现的焦虑程度分别为 36.7（11.1）（标准护理）和 31.3（8.5）（机器人）（p=0.04）。父母对机器人分散注意力组的疼痛管理更满意（95% vs 72%非常满意）（p=0.002）。
基于仿人机器人的分散注意力疗法对儿科静脉插入引起的儿童困扰有适度的积极影响，但对疼痛没有影响。它可以被认为是 ED 工具包中用于减轻与程序相关的疼痛相关困扰的潜在工具。
Clinicaltrials.gov 标识符：NCT02997631。
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