Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, University Center for Excellence in Developmental Disabilities, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States of America.
Psychology Department, University of La Verne, La Verne, CA, United States of America.
J Pediatr Nurs. 2022 Sep-Oct;66:151-159. doi: 10.1016/j.pedn.2022.06.008. Epub 2022 Jun 28.
As a brief, noninvasive, cost-effective, and technology-driven therapy, biofeedback is a promising and welcomed clinical intervention for children and adolescents with pediatric chronic pain conditions. The aim of this pilot study was to explore the application of a brief Heart Rate Variability (HRV) biofeedback intervention supplemented by at-home breathing practice as a tool for reducing symptomatology associated with chronic pain in a pediatric urban hospital setting.
Twenty-one participants aged 10-17 years (M = 14.05, SD = 1.91; 76% female) and their caregivers completed the study. Participants were randomized to either 1) receive immediate biofeedback treatment including at-home breathing practice or 2) to be placed on a 4-week waitlist and then enrolled in the biofeedback treatment. Study outcomes included self-reported pain intensity, health-related quality of life (HRQOL), and anxiety sensitivity. HRV data were obtained from biofeedback sessions.
Following biofeedback treatment, participants achieved significant reductions in self-reported pain intensity, higher levels of self-reported school functioning, and increased HRV, as measured by Blood Volume Pulse (BVP) amplitude. Participants in the waitlist group experienced an increase in pain intensity during the waitlist period.
Further research is needed to understand the mechanisms underlying HRV biofeedback and its treatment of pediatric chronic pain.
Nurses are ideal practitioners for biofeedback given their training in physiology and background in healthcare and should be encouraged to explore training in this area. Suggested biofeedback-related apps and mobile devices to share with patients at bedside are provided.
生物反馈作为一种简短、无创、经济实惠且技术驱动的治疗方法，是一种有前途且受欢迎的儿科慢性疼痛患者的临床干预手段。本研究旨在探索补充家庭呼吸练习的简短心率变异性（HRV）生物反馈干预作为一种工具，在城市儿科医院环境中减少与慢性疼痛相关症状的应用。
21 名年龄在 10-17 岁的参与者（M=14.05，SD=1.91；76%为女性）及其照顾者完成了这项研究。参与者被随机分为 1）立即接受生物反馈治疗，包括家庭呼吸练习，或 2）进入 4 周的等待名单，然后参加生物反馈治疗。研究结果包括自我报告的疼痛强度、健康相关生活质量（HRQOL）和焦虑敏感性。HRV 数据来自生物反馈会议。
在接受生物反馈治疗后，参与者的自我报告疼痛强度显著降低，自我报告的学校功能水平提高，心率变异性增加，血容量脉搏（BVP）振幅增加。等待名单组的参与者在等待名单期间经历了疼痛强度的增加。
需要进一步研究来了解心率变异性生物反馈的机制及其对儿科慢性疼痛的治疗作用。
护士因其生理学培训和医疗保健背景，是生物反馈的理想实践者，应鼓励他们探索这一领域的培训。提供了一些建议的与生物反馈相关的应用程序和移动设备，以便在床边与患者分享。
