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虚拟现实分散注意力干预措施对降低儿科患者牙科焦虑的有效性:一项系统评价和荟萃分析。

Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: A systematic review and meta-analysis.

作者信息

Yan Xinyi, Yan Yongyang, Cao Mengyao, Xie Wenxuan, O'Connor Siobhán, Lee Jung Jae, Ho Mu-Hsing

机构信息

School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 3 Sassoon Road, Hong Kong, China.

Division of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester, United Kingdom.

出版信息

J Dent. 2023 May;132:104455. doi: 10.1016/j.jdent.2023.104455. Epub 2023 Feb 24.

Abstract

OBJECTIVES

To analyse the effectiveness of virtual reality (VR) distraction intervention for the management of dental anxiety in paediatric patients.

DATA

Randomised controlled trials (RCTs) of VR distraction interventions for reducing anxiety in paediatric patients, published in English were included.

SOURCES

Seven databases, including PubMed, Web of Science, Scopus, MEDLINE via ProQuest, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials, covering the period between January 2000 and September 2022 were searched.

STUDY SELECTION

A total of 12 RCTs involving 818 participants were included. Quality appraisal was undertaken using the Cochrane risk-of-bias tool for randomised trials by two authors independently. Random-effects model was used to summarise the effects of the interventions and pool data.

CONCLUSIONS

Results showed that VR distraction interventions were effective in reducing the dental anxiety of paediatric patients. In meta-analysis, the VR distraction interventions had a significant effect on reducing paediatric patients' anxiety (SMD = -1.74, 95%CI = -2.46, -1.02, p < 0.001, I² = 95%), pain (SMD = -1.57, 95%CI = -2.22, -0.91, p < 0.001, I² = 91%) and heart rate (MD = -10.54, 95%CI = -20.26, -0.81, p = 0.03, I² = 99%) during dental treatment. However, the evidence of VR in managing dental anxiety would become weak because of the publication bias.

CLINICAL SIGNIFICANCE

VR distraction interventions could be an effective approach to alleviate the dental anxiety of paediatric patients. Additional well-designed and high-quality RCTs with larger sample sizes are needed to determine the optimal way to deliver VR interventions in paediatric dental clinics.

摘要

目的

分析虚拟现实(VR)分散注意力干预措施在管理小儿牙科焦虑方面的有效性。

数据

纳入以英文发表的关于VR分散注意力干预措施减轻小儿患者焦虑的随机对照试验(RCT)。

来源

检索了7个数据库,包括PubMed、科学网、Scopus、通过ProQuest检索的MEDLINE、EMBASE、护理学与健康领域数据库(CINAHL)以及Cochrane对照试验中心注册库,涵盖2000年1月至2022年9月期间。

研究选择

共纳入12项涉及818名参与者的RCT。由两位作者独立使用Cochrane随机试验偏倚风险工具进行质量评估。采用随机效应模型总结干预措施的效果并汇总数据。

结论

结果表明,VR分散注意力干预措施在减轻小儿患者牙科焦虑方面有效。在荟萃分析中,VR分散注意力干预措施对减轻小儿患者牙科治疗期间的焦虑(标准化均数差[SMD]= -1.74,95%可信区间[CI]= -2.46,-1.02,p<0.001,I²=95%)、疼痛(SMD= -1.57,95%CI= -2.22,-0.91,p<0.001,I²=91%)和心率(平均差[MD]= -10.54,95%CI= -20.26,-0.81,p = 0.03,I²=99%)有显著效果。然而,由于发表偏倚,VR用于管理牙科焦虑的证据可能会变弱。

临床意义

VR分散注意力干预措施可能是减轻小儿患者牙科焦虑的有效方法。需要更多设计良好、样本量更大的高质量RCT来确定在小儿牙科诊所提供VR干预措施的最佳方式。

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