Virtual Reality and Acute Pain Management for Children

描述（由申请人提供）：拟议研究的目的是测试基于虚拟现实（VR）的交互式分心对儿童急性疼痛管理的有效性。为了实现这一总体目标，拟议的一系列研究将：1）测试VR的交互性是否是其在急性实验室疼痛体验中作为分心物的有效性的关键因素2）测试当通过VR技术提供时，交互式分心是否比在不使用VR技术的情况下提供时在减少冷加压疼痛方面更有效; 3）用比文献中使用的更年轻的儿童样本来测试VR分心的有效性（即，除了年龄较大的小学和中学年龄的儿童之外，还包括6-8岁的儿童的样本）; 4）通过对血液肿瘤患者进行VR分心的初步测试，测试在实验室中获得的发现是否推广到血液病患者的临床群体;以及5）检查儿童年龄和儿童焦虑作为治疗结果的可能调节因素的作用。提出了三项研究。研究1在实验室冷加压任务期间测试交互式与被动式VR分心。66名儿童将完成基线冷加压试验，然后将被分配到两个实验性分心条件之一或第二个冷加压试验的对照条件。研究2测试了有和没有VR技术的交互式分心，90名儿童接受了实验室冷加压任务。将使用类似于研究1的3（实验组）× 2（冷加压试验）混合设计。在这两项研究中，预计儿童在分心条件下表现出疼痛耐受力，疼痛阈值和感知疼痛强度的改善。然而，在研究1中，交互式VR分心预计上级被动VR分心。在研究2中，使用VR的交互式分心预计上级不使用VR的交互式分心。研究3测试了基于VR的交互式分心对临床环境的适用性。接受重复血液学程序的儿童的试点样本将在交替治疗设计中使用和不使用VR技术进行交互式分心。在两种分心条件下，医疗过程中自我报告的疼痛和明显的行为困扰预计会低于基线，当使用VR技术时，最大的好处显而易见。

DESCRIPTION (provided by applicant): The objective of the proposed study is to test the effectiveness of virtual reality (VR) based interactive distraction for acute pain management in children. To accomplish this general goal, the proposed series of studies will: 1) Test whether the interactive nature of VR is a critical contributor to its effectiveness as a distractor during an acute laboratory pain experience (cold pressor); 2) Test whether interactive distraction is more effective in reducing cold pressor pain when provided via VR technology than when provided without the use of VR technology; 3) Test the effectiveness of VR distraction with a younger sample of children than has been used in the literature (i.e., a sample that includes 6-8-year-old children in addition to older elementary and middle school aged children); 4) Test whether findings obtained in the laboratory generalize to a clinical population of hematology patients by conducting a pilot test of VR distraction with Hematology-Oncology patients; and 5) Examine the role of child age and child anxiety as possible moderators of treatment outcome. Three studies are proposed. Study 1 tests interactive versus passive VR distraction during a laboratory cold pressor task. Sixty-six children will complete a baseline cold pressor trial and will then be assigned to one of the two experimental distraction conditions or to a control condition for the second cold pressor trial. Study 2 tests interactive distraction with and without VR technology with 90 children undergoing a laboratory cold pressor task. A 3 (experimental group) by 2 (cold pressor trials trials) mixed design similar to Study 1 will be used. In both studies, children are expected to demonstrate improvements in pain tolerance, pain threshold, and perceived pain intensity during the distraction conditions. However, in study 1, interactive VR distraction is expected to be superior to passive VR distraction. In Study 2, interactive distraction with VR is expected to be superior to interactive distraction without VR. Study 3 tests the applicability of VR based interactive distraction to the clinical setting. A pilot sample of children undergoing repeated hematological procedures will receive interactive distraction with and without VR technology in an alternating treatments design. Self report of pain during medical procedures and overt behavioral distress are expected to be lower in both distraction conditions relative to baseline, with the greatest benefits evident when VR technology is used.