Virtual Reality and Acute Pain Management for Children

描述(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)测试虚拟现实的互动性是否对其在急性实验室疼痛体验(冷加压)期间作为分心物的有效性起到关键作用；2)测试通过虚拟现实技术提供的互动分心是否比不使用虚拟现实技术提供的互动分心在减少冷加压痛方面更有效；3)在比文献中使用的更小的儿童样本中测试虚拟现实分心的有效性(即，除了年龄较大的小学和中学儿童外，还有6-8岁的儿童)；4)通过对血液肿瘤患者进行VR分心试验，测试实验室获得的结果是否适用于临床人群的血液病患者；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。建议进行三项研究。研究1测试了在实验室冷加压任务中交互和被动虚拟现实分心的效果。66名儿童将完成基线冷加压试验，然后被分配到两个实验分心条件之一或第二个冷加压试验的对照条件下。研究2测试了90名正在接受实验室冷加压任务的儿童在使用和不使用VR技术的情况下互动分心。将采用与研究1类似的3(试验组)×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在疼痛耐受性、疼痛阈值和感知疼痛强度方面都有改善。然而，在研究1中，交互式VR分心被认为优于被动VR分心。在研究2中，有VR的互动分心被认为比没有VR的互动分心更好。研究3测试了基于虚拟现实的交互式分心技术在临床环境中的适用性。在一项交替治疗的设计中，接受重复血液检查程序的儿童的试点样本将在使用和不使用VR技术的情况下接受互动分心。与基线相比，在两种分心条件下，自我报告的医疗过程中的疼痛和明显的行为困扰预计都会较低，当使用VR技术时，好处最明显。

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.