Mohanasundari Sekkulandai K, Raghu Valalahalli A, Joseph Joyce, Mohan Remiya, Sharma Suresh
College of Nursing, All India Institute of Medical Sciences, Jodhpur, IND.
Cureus. 2021 Aug 12;13(8):e17134. doi: 10.7759/cureus.17134. eCollection 2021 Aug.
Introduction Pain experienced by children during painful procedures may cause stress, fear, and anxiety. Currently, a number of interventions are used to reduce pain perception during medical procedures and distraction therapy is one of the most commonly used interventions. Method A randomized control trial was conducted among 105 children aged between three years and 12 years undergoing painful procedures such as intravenous cannulation, blood sampling, and injections to evaluate the effect of flippits and virtual reality therapy (VRT) on pain and anxiety Through a computerized random approach, 35 samples were allotted to each group. Experimental group -1 received VRT, experimental group -2 received flippit (distraction card) therapy during painful procedures, and the control group received the conventional intervention. Standard tools were used to assess the pain and anxiety. Result Total 128 children were admitted to the ward and 23 were not included in the study for various reasons. Total 105 children undergone randomization to three groups, 35 in each group. All were analyzed for primary and secondary outcomes. After adjusting for confounding factors using multiple logistic regression, it was found that pain scores of VRT and flippit groups were less than the control group (aOR, 95% CI 0.635, 0.504-0.799, P = 0.000 and aOR, 95% CI 0.705, 0.572-0.868, P = 0.001, respectively) and no difference was observed between VRT and Flippit group (aOR, 95% CI; 0.901, 0.723 - 1.123, P 0.353). Flippit group perceived less intensity of pain compared to control group (aOR, 95% CI 0.542, 0.322-0.912, P = 0.021) and children received VRT perceived less intensity of pain than both control and flippit groups of children (aOR, 95% CI 0.258, 0.132-0.503, P = 0.000 and aOR, 95% CI 0.476, 0.252-0.900, respectively). Children received VRT and flippit therapy perceived less anxiety compared to control group (aOR, 95% CI 0.589, 0.348-0.999, P = 0.050 and aOR, 95% CI 0.385, 0.217-0.682, P = 0.001, respectively). But, there was no difference between VRT and flippit groups (aOR, 95% CI 1.532, 0.940-2.498, P = 0.087). Conclusion Flippit therapy and virtual reality therapy were better than conventional therapy in reducing the perception of anxiety and pain in children, aged three to 12 years, undergone painful procedures. Virtual reality therapy had an edge over flippit therapy in reducing the worst hurt.
儿童在痛苦的医疗程序中所经历的疼痛可能会导致压力、恐惧和焦虑。目前，有多种干预措施用于减轻医疗程序中的疼痛感知，分心疗法是最常用的干预措施之一。
对105名年龄在3岁至12岁之间、正在接受诸如静脉插管、采血和注射等痛苦医疗程序的儿童进行了一项随机对照试验，以评估翻转卡片和虚拟现实疗法（VRT）对疼痛和焦虑的影响。通过计算机随机方法，每组分配35个样本。实验组-1接受VRT，实验组-2在痛苦的医疗程序中接受翻转卡片（分心卡片）疗法，对照组接受常规干预。使用标准工具评估疼痛和焦虑。
共有128名儿童入住病房，23名因各种原因未纳入研究。总共105名儿童被随机分为三组，每组35名。所有儿童均对主要和次要结局进行了分析。在使用多元逻辑回归调整混杂因素后，发现VRT组和翻转卡片组的疼痛评分低于对照组（调整后比值比，95%置信区间分别为0.635，0.504 - 0.799，P = 0.000和0.705，0.572 - 0.868，P = 0.001），且VRT组和翻转卡片组之间未观察到差异（调整后比值比，95%置信区间；0.901，0.723 - 1.123，P = 0.353）。与对照组相比，翻转卡片组感觉到的疼痛强度较小（调整后比值比，95%置信区间为0.542，0.322 - 0.912，P = 0.021），接受VRT的儿童感觉到的疼痛强度低于对照组和翻转卡片组的儿童（调整后比值比，95%置信区间分别为0.258，0.132 - 0.503，P = 0.000和0.476，0.252 - 0.900）。与对照组相比，接受VRT和翻转卡片疗法的儿童感觉到的焦虑较少（调整后比值比，95%置信区间分别为0.589，0.348 - 0.999，P = 0.050和0.385，0.217 - 0.682，P = 0.001）。但是，VRT组和翻转卡片组之间没有差异（调整后比值比，95%置信区间为1.532，0.940 - 2.498，P = 0.087）。
对于3至12岁正在接受痛苦医疗程序的儿童，翻转卡片疗法和虚拟现实疗法在减轻焦虑和疼痛感知方面优于传统疗法。在减轻最严重的疼痛方面，虚拟现实疗法比翻转卡片疗法更具优势。
