Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain.
Virgen del Rocio University Hospital, 41013, Seville, Spain; Centro Universitario de Enfermería Cruz Roja, adscrito a la Universidad de Sevilla, 41009 Seville, Spain.
J Pediatr Nurs. 2023 Nov-Dec;73:22-33. doi: 10.1016/j.pedn.2023.08.014. Epub 2023 Aug 19.
Non-pharmacological distraction methods are novel alternatives that can help to alleviate pain and anxiety generated by venipuncture in the pediatric population. The aim is to determine the effectiveness of virtual reality, compared to cold and vibration devices (Buzzy® device), as a distraction method used during venipuncture in the management of pain and anxiety in children.
Clinical trials, cohort and quasi-experimental studies, published between 2017 and 2022, in Spanish or English and pediatric age, found in Medline, the Cochrane Library, Scopus, Web Of Science, CINAHL and Embase databases.
Twenty-one studies were included and ten met the criteria for meta-analysis.
Fifty-seven percent of the studies evaluate virtual reality, 33.3% the Buzzy® device and 9.5% both comparatively. The effectiveness of virtual reality in reducing pain (66.6%, n = 14) and anxiety (47.6%, n = 10) compared to standard care (control group), 95% CI = 1.53 [0.91-2.16], p < 0.001, I2 = 78% and 95% CI = 1.53 [1.16-1.90]), p < 0.001, I2 = 77% respectively is demonstrated. Similarly, the effectiveness of Buzzy® in reducing pain (42.9%, n = 9) and anxiety (23.8%, n = 5), 95% CI = 1.62 [0.90-2.34], p < 0.001, I2 = 94% and 95% CI = 1.40 [0.06-2.20, p < 0.001, I2 = 91% respectively is demonstrated. Comparatively, there is no significant difference between both methods 95% CI = 0.29 [-0.19-0.78], p = 0.24, I2 = 81%.
The methods studied are effective in relieving pain and anxiety during venipuncture. Further research is needed on the level of satisfaction, adverse effects and cost-benefit.
This study provides evidence of novel tools in daily practice to provide more humane, holistic and quality care.
非药物性分散方法是一种新颖的替代方法,可以帮助减轻儿科人群静脉穿刺引起的疼痛和焦虑。目的是确定虚拟现实与冷和振动设备(Buzzy®设备)相比,作为一种在儿童静脉穿刺时用于缓解疼痛和焦虑的分散方法的有效性。
2017 年至 2022 年间发表的西班牙语或英语的临床试验、队列和准实验研究,以及在 Medline、Cochrane 图书馆、Scopus、Web Of Science、CINAHL 和 Embase 数据库中发现的儿科年龄的研究。
纳入了 21 项研究,其中 10 项符合荟萃分析的标准。
57%的研究评估了虚拟现实,33.3%评估了 Buzzy®设备,9.5%同时评估了两者。与标准护理(对照组)相比,虚拟现实在减轻疼痛(66.6%,n=14)和焦虑(47.6%,n=10)方面的有效性,95%CI=1.53[0.91-2.16],p<0.001,I2=78%和 95%CI=1.53[1.16-1.90]),p<0.001,I2=77%。同样,Buzzy®在减轻疼痛(42.9%,n=9)和焦虑(23.8%,n=5)方面的有效性,95%CI=1.62[0.90-2.34],p<0.001,I2=94%和 95%CI=1.40[0.06-2.20],p<0.001,I2=91%分别得到了证明。相比之下,两种方法之间没有显著差异 95%CI=0.29[-0.19-0.78],p=0.24,I2=81%。
所研究的方法在静脉穿刺时缓解疼痛和焦虑是有效的。需要进一步研究满意度、不良反应和成本效益。
本研究为日常实践中提供更人性化、更全面和更优质护理的新工具提供了证据。