A Virtual Reality Biofeedback Computer Game for Pediatric Pain Relief

描述（由申请人提供）：儿童经历了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立即的影响，而且会产生延迟的影响。当他们的孩子处于医疗困境时，父母会感到附带的焦虑。一些行为干预有效地减少了儿童及其父母的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治疗过程中指导儿童的高昂费用的限制。技术可用于制定干预措施，对儿童进行培训和指导，而不是给父母或医务人员增加负担。此外，科技有可能给孩子们带来高度吸引人的分心。该应用程序的主要目的是将生物反馈和交互式电脑游戏结合起来进行干预，在训练和指导儿童深呼吸放松的同时分散他们的注意力。干预措施将通过冷压任务进行改进，然后在接受骨折操作和修复的儿童的临床试验中进行全面评估。通过主观评分、生理指标和行为观察量表对儿童的焦虑和疼痛以及家长的焦虑进行评估。研究结果应为儿童痛苦的其他干预措施的制定提供信息，该软件包可能适用于一系列儿童医疗和非医疗压力源。

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.