A Virtual Reality Biofeedback Computer Game for Pediatric Pain Relief

描述(申请人提供)：儿童接受许多令人焦虑和痛苦的医疗程序。越来越多的研究表明，未经治疗的儿科疼痛不仅会产生即时影响，还会产生延迟影响。当他们的孩子处于医疗困境时，父母会体验到附带的焦虑。一些行为干预措施有效地减少了儿童及其父母与医疗程序相关的痛苦。这些干预的两个关键因素是放松和分心。然而，目前的治疗受到培训家庭成员或工作人员在手术期间指导儿童的高昂成本的限制。技术可以被用来开发干预措施，以训练和指导孩子，而不是给父母或医务人员带来负担。此外，科技有可能为儿童带来高度引人入胜的分心。该应用程序的主要目标是将生物反馈和交互式电脑游戏结合在一起进行干预，在分散儿童注意力的同时，训练和指导他们进行深呼吸放松。干预措施将通过冷加压任务的试点进行改进，然后在对接受骨折操作和修复的儿童进行的临床试验中进行彻底评估。将通过主观评分、生理指标和行为观察测量来评估儿童的焦虑和疼痛以及他们的父母的焦虑。调查结果应有助于制定针对儿童痛苦的其他干预措施，该软件包可能适用于一系列儿童、医疗和非医疗应激源。 公共卫生相关声明：这个应用程序将开发和评估一个交互式生物反馈电脑游戏，它将为儿童提供分心和放松训练，以控制焦虑和疼痛。这项拟议的研究将评估对接受骨折手法和铸型治疗的儿童的干预措施，但该干预措施应适用于在医疗室内外面临一系列压力源的儿童。

DESCRIPTION (provided by applicant): Children undergo many medical procedures that are anxiety provoking and painful. Research is accumulating to suggest that there are not only immediate but also delayed repercussions to untreated pediatric pain. Parents experience collateral anxiety when their children are in medical distress. A number of behavioral interventions effectively reduce children's and their parents' medical procedure-related distress. Two key ingredients of these interventions are relaxation and distraction. However, current treatments are limited by the high cost of training family members or staff to coach children during the procedures. Technology can be used to develop interventions to train and coach the child instead of burdening parents or medical staff. Further, technology has the potential to deliver highly engaging distraction for children. Primary aims of this application are to combine biofeedback and interactive computer gaming in an intervention that distracts children while simultaneously training and coaching them in deep breathing relaxation. The intervention will be refined via piloting with the cold pressor task and then thoroughly evaluated in a clinical trial with children undergoing fracture manipulation and repair. Children's anxiety and pain and their parents' anxiety will be assessed via subjective ratings, physiological indices, and behavior observational measures. Findings should inform the development of other interventions for children's distress and the software package might be applicable to a range of childhood medical and non-medical stressors. Public Health Relevance Statement: This application will develop and evaluate an interactive biofeedback computer game, which will provide distraction and relaxation training to children for anxiety and pain management. The proposed study will evaluate the intervention for children receiving fracture manipulation and casting, but the intervention should be applicable to children facing a range of stressors in and out of the medical treatment room.