Chiu Chia-Chi, Lin Yu-Ting, Wang Yean, Chang Tsung-Yen, Wen Yu-Chuan, Hsiao Yi-Wen, Chen Shih-Hsiang, Jaing Tang-Her
Nursing, Chang Gung Memorial Hospital, Taoyuan, TWN.
College of Medicine, Chang Gung University, Taoyuan, TWN.
Cureus. 2023 Jan 28;15(1):e34317. doi: 10.7759/cureus.34317. eCollection 2023 Jan.
Background Treatment-related pain and discomfort are two of the most common manifestations in children with acute lymphoblastic leukemia (ALL). Patients with ALL are usually treated with L-asparaginase (L-ASP) by intramuscular injection. Children receiving L-ASP chemotherapy must bear adverse reactions such as pain caused by intramuscular injections. The use of virtual reality (VR) distraction technology could be a non-pharmacological intervention to bolster patients' comfort and decrease anxiety and procedure-related pain within hospital settings. Methodology The study explored the potential benefits of VR as a psychological intervention to induce positive emotions and reduce pain levels in participants receiving L-ASP injections. Participants in the study had the opportunity to select a nature theme of their choosing during their treatment session. The study provided a noninvasive solution that promoted relaxation to reduce anxiety by shifting an individual's mood positively during treatment. The objective was met by measuring participants' mood and pain levels before and after the VR experience and participant satisfaction with the use of the technology. This mixed-methods study of children aged six to 18 received L-ASP between April 2021 and March 2022, using a Numerical Rating Scale (NRS) with sheer numbers ranging from 0 (no pain) to 10 (extreme or most pain possible). Semi-structured interviews were conducted to collect new data and explore participants' thoughts and beliefs about a particular topic. A total of 14 patients participated. Descriptive statistics and content analysis are used to describe the data analyzed. VR is an enjoyable distraction intervention for managing treatment-related pain in ALL with intramuscular chemotherapy. Results Eight of 14 patients found a reduction in perceived pain after wearing VR. During the intervention implementation, the primary caregivers felt that the patient's pain perception was more positive when using the virtual reality device, and there was less resistance and less crying. Conclusions This study describes changes and experiences associated with pain and physical discomfort in children with ALL receiving intramuscular chemotherapy. This teaching model is applied to developing medical personnel, providing information about the disease and daily care, and educating the participants' family members. This study may expand the usage of VR applications so that more patients can benefit from them.
背景 与治疗相关的疼痛和不适是急性淋巴细胞白血病（ALL）患儿最常见的两种表现。ALL患者通常通过肌肉注射L-天冬酰胺酶（L-ASP）进行治疗。接受L-ASP化疗的儿童必须承受肌肉注射引起的疼痛等不良反应。使用虚拟现实（VR）分散注意力技术可能是一种非药物干预措施，可增强患者的舒适度，并降低医院环境中与治疗过程相关的焦虑和疼痛。方法 本研究探讨了VR作为一种心理干预手段，对接受L-ASP注射的参与者诱导积极情绪并降低疼痛水平的潜在益处。研究参与者在治疗过程中有机会选择自己喜欢的自然主题。该研究提供了一种非侵入性解决方案，通过在治疗期间积极改变个体情绪来促进放松，从而减轻焦虑。通过测量参与者在VR体验前后的情绪和疼痛水平以及参与者对该技术使用的满意度来实现这一目标。这项针对2021年4月至2022年3月期间接受L-ASP治疗的6至18岁儿童的混合方法研究，使用了数字评分量表（NRS），其数字范围从0（无疼痛）到10（极痛或最痛）。进行了半结构化访谈以收集新数据，并探索参与者对特定主题的想法和信念。共有14名患者参与。使用描述性统计和内容分析来描述所分析的数据。VR是一种用于管理ALL肌肉注射化疗中与治疗相关疼痛的令人愉快的分散注意力干预措施。结果 14名患者中有8名在佩戴VR后感觉疼痛减轻。在干预实施过程中，主要护理人员认为患者在使用虚拟现实设备时对疼痛的感知更积极，反抗更少，哭泣也更少。结论 本研究描述了接受肌肉注射化疗的ALL患儿与疼痛和身体不适相关的变化及体验。这种教学模式应用于培养医务人员，提供有关疾病和日常护理的信息，并对参与者的家庭成员进行教育。本研究可能会扩大VR应用的使用范围，以便更多患者从中受益。
