Peña Jorge, Koebner Ian, Weisman William
Department of Communication, University of California, Davis, 367 Kerr Hall,, Davis, CA, 95616, United States, 1 9167540977.
Cultural Agents Initiative, Harvard University, Cambridge, MA, United States.
JMIR Serious Games. 2024 Nov 27;12:e52294. doi: 10.2196/52294.
Arts engagement using virtual reality and serious games represent promising nonpharmacological self-management treatment approaches to chronic pain. This study is the first randomized controlled trial to explore the impact of a web-based serious game that simulated a visit to an art museum on pain and social disconnection among individuals living with chronic pain and loneliness.
This study aimed to test the joint and separate effects of exposure to digital art and attachment figure priming on pain and social disconnection among individuals living with chronic pain and loneliness.
This randomized controlled trial used a 2 (digital artwork present and absent) × 2 (secure attachment and avoidant attachment prime) repeated measures factorial web-based experimental design with a hanging control condition. Mediation and moderation analyses examined how feelings about the social world triggered by the artwork and frequency of museum visits impacted the effects of the interventions on pain and social disconnection.
The results are based on 308 participants. Mean age of the participants was 42.78 (SD 13.11; range 18-76) years, and 60.2% (n=186) were women. Posttest pain was lower than pretest pain for the artwork present (P=.001) and absent (P=.001) conditions. Similarly, posttest pain was lower than pretest pain for the secure (P=.001) and avoidant (P=.001) attachment priming conditions. Relative to the control group, artwork present (P=.001) and absent (P=.01) conditions had decreased posttest pain. The secure (P=.001) and avoidant (P=.001) attachment priming conditions also had lower posttest pain scores relative to the control group. Moreover, social disconnection decreased from pre- to posttest for both the artwork present (P=.04) and the secure attachment priming (P=.002) conditions. Relative to the control group, posttest social disconnection was lower for the artwork present (P=.02) and secure attachment priming condition (P=.03). The artwork-secure attachment (P=.001) and artwork-avoidant attachment (P=.006) conditions had lower posttest pain scores compared with the control group. Social disconnection decreased from pre- to posttest for the artwork-secure attachment (P=.01) and no artwork-secure attachment (P=.05) conditions. Posttest social disconnection was lower for the artwork-secure attachment condition compared with the control group (P=.04). Positive feelings about the social world triggered by artwork exposure and frequency of museum visits in the last year played a mediating and moderating role in these effects. Positive feelings about the social world were associated with decreased pain (B=-.53) and social disconnection (B=-.25), and these effects operated on individuals exposed to digital artwork at low, medium, and high frequency of physical museum visits.
Relative to a control group, visiting a web-based art museum reliably decreased pain and social disconnection among individuals living with chronic pain and loneliness. Engaging with digital artwork that triggers positive feelings about the social world may mitigate the burden of chronic pain.
利用虚拟现实和严肃游戏进行艺术参与代表了慢性疼痛有前景的非药物自我管理治疗方法。本研究是第一项随机对照试验，旨在探究一款模拟参观艺术博物馆的网络严肃游戏对慢性疼痛且孤独个体的疼痛和社交脱节的影响。
本研究旨在测试接触数字艺术和依恋对象启动对慢性疼痛且孤独个体的疼痛和社交脱节的联合及单独影响。
本随机对照试验采用2（有数字艺术品和无数字艺术品）×2（安全依恋启动和回避依恋启动）重复测量析因网络实验设计，并设有一个悬而未决的对照条件。中介分析和调节分析考察了艺术品引发的对社会世界的感受以及博物馆参观频率如何影响干预措施对疼痛和社交脱节的效果。
结果基于308名参与者。参与者的平均年龄为42.78岁（标准差13.11；范围18 - 76岁），60.2%（n = 186）为女性。对于有艺术品（P = 0.001）和无艺术品（P = 0.001）的条件，后测疼痛均低于前测疼痛。同样，对于安全（P = 0.001）和回避（P = 0.001）依恋启动条件，后测疼痛也低于前测疼痛。相对于对照组，有艺术品（P = 0.001）和无艺术品（P = 0.01）的条件下后测疼痛降低。安全（P = 0.001）和回避（P = 0.001）依恋启动条件相对于对照组后测疼痛评分也较低。此外，对于有艺术品（P = 0.04）和安全依恋启动（P = 0.002）的条件，从测试前到测试后社交脱节均有所减少。相对于对照组，有艺术品（P = 0.02）和安全依恋启动条件（P = 0.03）下测试后的社交脱节较低。与对照组相比，艺术品 - 安全依恋（P = 0.001）和艺术品 - 回避依恋（P = 0.006）条件下后测疼痛评分较低。对于艺术品 - 安全依恋（P = 0.01）和无艺术品 - 安全依恋（P = 0.05）条件，从测试前到测试后社交脱节减少。与对照组相比，艺术品 - 安全依恋条件下测试后的社交脱节较低（P = 0.04）。艺术品暴露引发的对社会世界的积极感受以及过去一年的博物馆参观频率在这些影响中起中介和调节作用。对社会世界的积极感受与疼痛减轻（B = -0.53）和社交脱节减少（B = -0.25）相关，并且这些影响在低、中、高实体博物馆参观频率下接触数字艺术品的个体中均起作用。
相对于对照组，访问网络艺术博物馆可靠地降低了慢性疼痛且孤独个体的疼痛和社交脱节。接触能引发对社会世界积极感受的数字艺术品可能减轻慢性疼痛的负担。
