The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
JAMA Netw Open. 2023 Feb 1;6(2):e230001. doi: 10.1001/jamanetworkopen.2023.0001.
Venipuncture is one of the most painful and distressing procedures experienced by pediatric patients. Emerging evidence suggests that providing procedural information and distraction using immersive virtual reality (IVR) may reduce pain and anxiety among children undergoing needle-related procedures.
To examine the effects of IVR on reducing the pain, anxiety, and stress experienced by pediatric patients undergoing venipuncture.
DESIGN, SETTING, AND PARTICIPANTS: This 2-group randomized clinical trial recruited pediatric patients aged 4 to 12 years undergoing venipuncture from a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March to May 2022.
Participants were randomly allocated to an intervention (an age-appropriate IVR intervention offering distraction and procedural information) or a control (standard care only) group.
The primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure (rated on a 40 point scale, with higher scores indicating greater satisfaction). Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure.
A total of 149 pediatric patients were recruited, with 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group (mean [SD] age, 7.21 [2.49] years), the 75 participants in the IVR group (mean [SD] age, 7.21 [2.43] years) reported significantly less pain (β = -0.78; 95% CI, -1.21 to -0.35; P < .001) and anxiety (β = -0.41; 95% CI, -0.76 to -0.05; P = .03) immediately after the intervention. Health care professional satisfaction in the IVR group (mean [SD] score, 34.5 [4.5]) was significantly higher than that in the control group (mean [SD] score, 32.9 [4.0]; P = .03). Moreover, the length of venipuncture procedure in the IVR group (mean [SD] duration, 4.43 [3.47] minutes) was significantly shorter than that in the control group (mean [SD] duration, 6.56 [7.39] minutes; P = .03).
In this randomized clinical trial, integrating procedural information and distraction in an IVR intervention for pediatric patients undergoing venipuncture significantly improved pain and anxiety in the IVR group compared with the control group. The results shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures.
Chinese Clinical Trial Registry identifier: ChiCTR1800018817.
静脉穿刺是儿科患者经历的最痛苦和最痛苦的程序之一。新出现的证据表明，提供程序信息和使用沉浸式虚拟现实 (IVR) 分散注意力可能会降低接受与针相关程序的儿童的疼痛和焦虑。
研究 IVR 对减轻接受静脉穿刺的儿科患者的疼痛、焦虑和压力的影响。
设计、地点和参与者：这项 2 组随机临床试验招募了 2019 年 1 月至 2020 年 1 月期间从香港一家公立医院接受静脉穿刺的 4 至 12 岁儿科患者。数据于 2022 年 3 月至 5 月进行分析。
参与者被随机分配到干预组（提供分散注意力和程序信息的适龄 IVR 干预）或对照组（仅标准护理）。
主要结果是儿童报告的疼痛。次要结果包括儿童报告的焦虑、心率、唾液皮质醇、手术时间以及医疗保健专业人员对手术的满意度（评分 40 分，分数越高表示满意度越高）。结果在手术前 10 分钟、手术期间、手术结束后立即和 30 分钟进行评估。
共招募了 149 名儿科患者，其中 86 名女性患者（57.7%）和 66 名患者（44.3%）被诊断为发热。与对照组的 74 名参与者（平均年龄[标准差]，7.21 [2.49] 岁）相比，接受 IVR 组的 75 名参与者（平均年龄[标准差]，7.21 [2.43] 岁）报告的疼痛（β= -0.78；95%CI，-1.21 至 -0.35；P<0.001）和焦虑（β= -0.41；95%CI，-0.76 至 -0.05；P=0.03）明显减轻。IVR 组的医疗保健专业人员满意度（平均[标准差]评分，34.5 [4.5]）明显高于对照组（平均[标准差]评分，32.9 [4.0]；P=0.03）。此外，IVR 组的静脉穿刺程序长度（平均[标准差]持续时间，4.43 [3.47] 分钟）明显短于对照组（平均[标准差]持续时间，6.56 [7.39] 分钟；P=0.03）。
在这项随机临床试验中，将程序信息和分散注意力整合到接受静脉穿刺的儿科患者的 IVR 干预中，与对照组相比，IVR 组的疼痛和焦虑明显减轻。结果为 IVR 作为其他痛苦和压力大的医疗程序的干预措施的全球研究趋势和临床发展提供了依据。
中国临床试验注册中心标识符：ChiCTR1800018817。
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