A Virtual Reality Biofeedback Computer Game for Pediatric Pain Relief

描述（由申请人提供）：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立即产生影响，还会产生延迟影响。当孩子陷入医疗困境时，父母会经历附带的焦虑。许多行为干预措施有效减少儿童及其父母与医疗程序相关的痛苦。这些干预措施的两个关键要素是放松和分散注意力。然而，目前的治疗方法受到培训家庭成员或工作人员在手术过程中指导儿童的高昂成本的限制。技术可以用来制定干预措施来训练和指导孩子，而不是给父母或医务人员增加负担。此外，技术有可能为儿童提供高度吸引人的注意力。该应用程序的主要目的是将生物反馈和交互式计算机游戏结合起来，进行干预，分散儿童的注意力，同时训练和指导他们进行深呼吸放松。该干预措施将通过冷加压任务试点进行完善，然后在接受骨折操作和修复的儿童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措施来评估儿童的焦虑和疼痛及其父母的焦虑。研究结果应为儿童痛苦的其他干预措施的制定提供信息，并且该软件包可能适用于一系列儿童医学和非医学压力源。 公共卫生相关性声明：该应用程序将开发和评估交互式生物反馈计算机游戏，该游戏将为儿童提供分散注意力和放松训练，以控制焦虑和疼痛。拟议的研究将评估对接受骨折手法和石膏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.