Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial.
Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial.
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DOI：
10.1186/s40814-022-01150-9
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发表时间：
2022-08-18
影响因子：
1.7
通讯作者：
Xiang, Henry
中科院分区：
文献类型：
--
作者：
Armstrong, Megan;Lun, Jonathan;Groner, Jonathan, I;Thakkar, Rajan K.;Fabia, Renata;Noffsinger, Dana;Ni, Ai;Keesari, Rohali;Xiang, Henry
虚拟现实(VR)游戏被认为是医院标准疼痛缓解的安全有效的替代方案。这项研究探讨了由我们的研究团队开发的一款VR游戏的潜在有效性和可行性，该游戏可以在家中反复更换烧伤敷料。在2019年9月至2021年6月期间，在美国烧伤协会验证的一家大型儿科烧伤中心的门诊烧伤诊所招募的患者中进行了一项随机临床试验。我们纳入了5-17岁说英语的烧伤患者，在第一次门诊换药后，每天至少要换一周的敷料。其中一组人在换衣服时玩互动VR游戏，而另一组人在家中使用标准的分心技术，时间长达一周。孩子和照顾者都被要求在0-10的数值评分(NRS)上评估感知到的疼痛。对于VR组，患者还被要求对VR游戏的各个方面进行评分，NRS为0-10，照顾者被问及评估易用性的问题。本研究共招募了35名儿童，其中24名儿童完成了完整的学习测量。大多数患者为男性(n=19，54.3%)、白色(n=29，82.9%)和二度烧伤(n=32，91.4%)。在第四次换药时，VR组的儿童和照顾者报告的疼痛程度低于对照组。与对照组相比，VR组的参与者在儿童报告的总体疼痛(33.3%)和照顾者报告的最严重疼痛(31.6%)方面显示出临床上有意义的减少(≥30%)。在一周的时间里，孩子们对VR的满意度保持在较高的水平，报告称，随着时间的推移，孩子们对VR的真实感和参与度都在增加。超过一半的儿童(54.5%)喜欢玩这个游戏，没有报告任何挑战和副作用。受试者发现VR在更换家居服装时是一种有用的分心工具，并且没有报告任何挑战/副作用。在家中更换烧伤敷料时，VR应该被认为是一种非药物治疗疼痛的伴侣。ClinicalTrials.gov标识：NCT04548635。注册于2020年9月14日-追溯注册的在线版本包含补充材料，可在10.1186/s40814-022-01150-9找到。
Virtual reality (VR) gaming is considered a safe and effective alternative to standard pain alleviation in the hospital. This study addressed the potential effectiveness and feasibility of a VR game that was developed by our research team for repeated at-home burn dressing changes. A randomized clinical trial was conducted among patients recruited from the outpatient burn clinic of a large American Burn Association–verified pediatric burn center between September 2019 and June 2021. We included English-speaking burn patients aged 5–17 years old requiring daily dressing changes for at least 1 week after first outpatient dressing change. One group played an interactive VR game during dressing changes, while the other utilized standard distraction techniques available in the home for up to a week. Both child and caretaker were asked to assess perceived pain on a numerical rating scale (NRS) of 0–10. For the VR group, patients were also asked to rate various aspects of the VR game on a NRS of 0–10 and caregivers were asked questions assessing ease of use. A total of 35 children were recruited for this study with 24 fully completing study measures. The majority of participants were male (n=19, 54.3%), White (n=29, 82.9%), and with second degree burns (n=32, 91.4%). Children and caregivers in the VR group reported less pain than the control group at the 4th dressing change. Participants in the VR group showed a clinically meaningful (≥30%) reduction in child-reported overall pain (33.3%) and caregiver-reported worst pain (31.6%) in comparison with subjects in the control group. Children’s satisfaction with the VR remained at a high level across dressing changes over the 1-week period, with reported realism and engagement increasing over time. Over half of the children (54.5%) enjoyed playing the game and did not report any challenges nor any side effects. Subjects found the VR to be a useful distraction during home dressing changes and reported no challenges/side effects. VR should be considered as a nonpharmacologic companion for pain management during at-home burn dressing changes. ClinicalTrials.gov Identifier: NCT04548635. Registered September 14, 2020—retrospectively registered The online version contains supplementary material available at 10.1186/s40814-022-01150-9.