Hu Weihua, Yang Ke, Zhang Li, Lu Xu
Department of Urology, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410000, P.R. China.
Department of Laboratory Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410000, P.R. China.
Exp Ther Med. 2021 Jun;21(6):623. doi: 10.3892/etm.2021.10055. Epub 2021 Apr 14.
Audio-visual (AV) or music distraction may be used to reduce pain during several healthcare procedures. The present manuscript is a systematic review and meta-analysis to assess the effectiveness of media distraction in reducing pain and anxiety in extracorporeal shock wave lithotripsy (ESWL) patients. The PubMed, Embase, Scopus, BioMed Central, Ovoid and CENTRAL (Cochrane Central Register of Controlled Trials) databases were screened for studies assessing the role of media distraction (music/AV media) in reducing pain and anxiety of ESWL patients. Data were summarized using the mean difference (MD) with 95% confidence intervals (CI). A total of 11 randomized controlled trials were included. Pooled analysis indicated a statistically significant difference in pain outcomes with media distraction [mean difference (MD): -1.18; 95% CI: -2.35, -0.01; I=96.8%)]. Subgroup analysis indicated that both AV media (MD: -2.94; 95% CI: -4.70, -1.17; I=79.2%) and music (MD: -0.86; 95% CI: -1.37, -0.35; I=62.5%), led to significant reduction in pain outcomes. Pooled analysis indicated a statistically significant reduction of anxiety scores with the use of media distraction (MD: -3.91; 95% CI: -6.44, -1.38; I=77.7%). To conclude, the present review suggests that media distraction in the form of AV media or music may be beneficial in reducing the pain and anxiety of patients undergoing ESWL. Evidence is, however, weak considering the small effect size, confidence intervals being close to zero, and instability of the results on sensitivity analysis. In clinical practice, media distraction may be used during ESWL as a nursing intervention, but a clinically important reduction of pain and anxiety may not be expected.
视听（AV）或音乐分散注意力的方法可用于减轻多种医疗程序中的疼痛。本论文是一项系统综述和荟萃分析，旨在评估媒体分散注意力对减轻体外冲击波碎石术（ESWL）患者疼痛和焦虑的有效性。我们在PubMed、Embase、Scopus、BioMed Central、Ovid和CENTRAL（Cochrane对照试验中央注册库）数据库中筛选了评估媒体分散注意力（音乐/AV媒体）在减轻ESWL患者疼痛和焦虑方面作用的研究。数据采用平均差（MD）及95%置信区间（CI）进行汇总。共纳入11项随机对照试验。汇总分析表明，媒体分散注意力在疼痛结果方面存在统计学显著差异[平均差（MD）：-1.18；95%CI：-2.35，-0.01；I² = 96.8%]。亚组分析表明，AV媒体（MD：-2.94；95%CI：-4.70，-1.17；I² = 79.2%）和音乐（MD：-0.86；95%CI：-1.37，-0.35；I² = 62.5%）均能显著降低疼痛结果。汇总分析表明，使用媒体分散注意力可使焦虑评分在统计学上显著降低（MD：-3.91；95%CI：-6.44，-1.38；I² = 77.7%）。总之，本综述表明，AV媒体或音乐形式的媒体分散注意力可能有助于减轻接受ESWL治疗患者的疼痛和焦虑。然而，考虑到效应量小、置信区间接近零以及敏感性分析结果不稳定，证据力度较弱。在临床实践中，媒体分散注意力可在ESWL期间作为一种护理干预措施使用，但可能无法期望疼痛和焦虑得到具有临床意义的减轻。
