Department of Emergency, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China.
Ital J Pediatr. 2023 Aug 31;49(1):109. doi: 10.1186/s13052-023-01518-4.
Procedural pain is very important in clinical children care. We aimed to evaluate the effects of active versus passive distraction for reducing procedural pain and anxiety in children.
Two researchers searched the Web of Science, PubMed, EMBASE, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure, Weipu databases for the randomized controlled trials(RCTs) on the active versus passive distraction affecting procedural pain and anxiety in children until May 18, 2023. The literature screening and data extraction were carried out by two researchers independently. Review Manager 5.3 software was used for data analysis.
13 RCTs were finally included. 553 children received active distraction intervention and 551 children received passive distraction intervention. There were no significant differences in the children self-reported procedural pain betweent active and passive distraction. The parent-reported procedural pain, medical staff-reported procedural pain, children-reported procedural anxiety, parent-reported procedural anxiety, medical staff-reported procedural anxiety in the active distraction were significant less than that of active distraction. Egger regression analysis showed that there was no publication bias in the results.
Existing evidence suggests that active distraction may be more effective in reducing operational pain and anxiety in children than passive distraction. More studies on the effects of active distraction versus passive distraction in children with larger sample size are needed in the future.
程序性疼痛在临床儿童护理中非常重要。我们旨在评估主动与被动分散注意力对减轻儿童程序性疼痛和焦虑的影响。
两名研究人员在 2023 年 5 月 18 日之前，在 Web of Science、PubMed、EMBASE、Cochrane、SinoMed、万方、中国知识基础设施、维普数据库中搜索了关于主动与被动分散注意力对儿童程序性疼痛和焦虑影响的随机对照试验（RCT）。两名研究人员独立进行文献筛选和数据提取。使用 Review Manager 5.3 软件进行数据分析。
最终纳入 13 项 RCT。553 名儿童接受主动分散注意力干预，551 名儿童接受被动分散注意力干预。主动和被动分散注意力之间，儿童自我报告的程序性疼痛无显著差异。主动分散注意力组的父母报告的程序性疼痛、医务人员报告的程序性疼痛、儿童报告的程序性焦虑、父母报告的程序性焦虑、医务人员报告的程序性焦虑显著低于主动分散注意力组。Egger 回归分析显示，结果无发表偏倚。
现有证据表明，主动分散注意力可能比被动分散注意力更能有效减轻儿童的手术疼痛和焦虑。未来需要更多关于主动与被动分散注意力对儿童影响的研究，样本量更大。
