Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department.
emergency department
mindfulness
pediatrics
virtual reality
Journal
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
ISSN: 1553-2712
Titre abrégé: Acad Emerg Med
Pays: United States
ID NLM: 9418450
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
28
10
2021
received:
27
07
2021
accepted:
02
11
2021
pubmed:
7
11
2021
medline:
4
5
2022
entrez:
6
11
2021
Statut:
ppublish
Résumé
Emergency department (ED) visits are known to be anxiety-ridden and stress-provoking experiences especially in the pediatric population. Distraction techniques have been used as a means to reduce anxiety and stress thereby facilitating care in the ED and making the visit less unpleasant. Our study aimed to evaluate the effectiveness of an active and immersive distraction technique, using a mindfulness-based virtual reality (VR) program (Take-Pause), to alleviate anxiety in pediatric ED patients. A prospective, randomized, single-blinded study, evaluating ED patients aged 13-17 years with a chief complaint of acute pain was conducted. Patients were randomized either to the active distraction intervention (VR group), utilizing the VR headset for 5 min, or to the passive distraction intervention (iPad group), playing on an iPad for 5 min. The primary outcome was a difference in the change in anxiety scores on the Spielberger State-Trait Anxiety Inventory between the two groups. Secondary outcomes included a difference in pain scores, respiratory rate, and heart rate between the groups. A total of 110 subjects were enrolled. At 15 min, the mean anxiety score for the VR group improved by 10 points versus 6 points in the iPad group (p < 0.001; 95% confidence interval = 0.44 to 7.6). There was no statistical significance in the reduction of pain scores (p = 0.953) and respiratory rates (p = 0.776) between the groups. Patients enrolled in both groups did not experience any adverse effects. Take-Pause, offering an active and immersive distraction technique, is more effective than a passive distraction approach to lower anxiety levels in adolescent ED patients.
Sections du résumé
BACKGROUND
Emergency department (ED) visits are known to be anxiety-ridden and stress-provoking experiences especially in the pediatric population. Distraction techniques have been used as a means to reduce anxiety and stress thereby facilitating care in the ED and making the visit less unpleasant. Our study aimed to evaluate the effectiveness of an active and immersive distraction technique, using a mindfulness-based virtual reality (VR) program (Take-Pause), to alleviate anxiety in pediatric ED patients.
METHODS
A prospective, randomized, single-blinded study, evaluating ED patients aged 13-17 years with a chief complaint of acute pain was conducted. Patients were randomized either to the active distraction intervention (VR group), utilizing the VR headset for 5 min, or to the passive distraction intervention (iPad group), playing on an iPad for 5 min. The primary outcome was a difference in the change in anxiety scores on the Spielberger State-Trait Anxiety Inventory between the two groups. Secondary outcomes included a difference in pain scores, respiratory rate, and heart rate between the groups.
RESULTS
A total of 110 subjects were enrolled. At 15 min, the mean anxiety score for the VR group improved by 10 points versus 6 points in the iPad group (p < 0.001; 95% confidence interval = 0.44 to 7.6). There was no statistical significance in the reduction of pain scores (p = 0.953) and respiratory rates (p = 0.776) between the groups. Patients enrolled in both groups did not experience any adverse effects.
CONCLUSION
Take-Pause, offering an active and immersive distraction technique, is more effective than a passive distraction approach to lower anxiety levels in adolescent ED patients.
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
270-277Informations de copyright
© 2021 by the Society for Academic Emergency Medicine.
Références
Walther-Larsen S, Petersen T, Friis SM, Aagaard G, Drivenes B, Opstrup P. Immersive virtual reality for pediatric procedural pain: a randomized clinical trial. Hosp Pediatr. 2019;9(7):501-507. doi:10.1542/hpeds.2018-0249
Canbulat N, Inal S, Sönmezer H. Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian Nurs Res (Korean Soc Nurs Sci). 2014;8(1):23-28. doi:10.1016/j.anr.2013.12.001
Tashjian VC, Mosadeghi S, Howard AR, et al. Virtual reality for management of pain in hospitalized patients: results of a controlled trial. JMIR Mental Health. 2017;4(1):e9. doi:10.2196/mental.7387
Sahiner NC, Bal MD. The effects of three different distraction methods on pain and anxiety in children. J Child Health Care. 2016;20(3):277-285. doi:10.1177/1367493515587062
Arane K, Behboudi A, Goldman RD. Virtual reality for pain and anxiety management in children. Can Fam Physician. 2017;63(12):932-934.
Pourmand A, Davis S, Marchak A, Whiteside T, Sikka N. Virtual reality as a clinical tool for pain management. Curr Pain Headache Rep. 2018;22(8):53. doi:10.1007/s11916-018-0708-2
Eijlers R, Utens EM, Staals LM, et al. Systematic review and meta-analysis of virtual reality in pediatrics: effects on pain and anxiety. Anesth Analg. 2019;129(5):1344-1353. doi:10.1213/ANE.0000000000004165
Van Dam NT, van Vugt MK, Vago DR, et al. Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspect Psychol Sci. 2018;13(1):36-61. doi:10.1177/1745691617709589
Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93(2):173-183. doi:10.1016/s0304-3959(01)00314-1
Tsze DS, Hirschfeld G, Dayan PS, Bulloch B, von Baeyer CL. Defining no pain, mild, moderate, and severe pain based on the faces pain scale-revised and color analog scale in children with acute pain. Pediatr Emerg Care. 2018;34(8):537-544. doi:10.1097/PEC.0000000000000791
Tluczek A, Henriques JB, Brown RL. Support for the reliability and validity of a six-item state anxiety scale derived from the State-Trait Anxiety Inventory. J Nurs Meas. 2009;17(1):19-28. doi:10.1891/1061-3749.17.1.19
The State-Trait Anxiety Inventory (STAI). 2011. Accessed August 28, 2020. https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/trait-state
Marteau TM, Bekker H. The development of a six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992;31(3):301-306. doi:10.1111/j.2044-8260.1992.tb00997.x
Colt HG, Powers A, Shanks TG. Effect of music on state anxiety scores in patients undergoing fiberoptic bronchoscopy. Chest. 1999;116(3):819-824. doi:10.1378/chest.116.3.819
Robinson PS, Green J. Ambient versus traditional environment in pediatric emergency department. Health Environ Res Design J. 2015;8(2):71-80. doi:10.1177/1937586714566412
Won AS, Bailey J, Bailenson J, Tataru C, Yoon IA, Golianu B. Immersive virtual reality for pediatric pain. Children (Basel). 2017;4(7):52. doi:10.3390/children4070052
Gershon J, Zimand E, Pickering M, Rothbaum BO, Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. J Am Acad Child Adolesc Psychiatry. 2004;43(10):1243-1249. doi:10.1097/01.chi.0000135621.23145.05
Ryu JH, Park JW, Nahm FS, et al. The effect of gamification through a virtual reality on preoperative anxiety in pediatric patients undergoing general anesthesia: a prospective, randomized, and controlled trial. J Clin Med. 2018;7(9):284. doi:10.3390/jcm7090284