Child Pain Matters: A Training Protocol for General Nursing Staff in an Infusion Center on Procedural Anxiety in Pediatric Patients with Crohn\u27s Disease and Ulcerative Colitis.

Procedural anxiety is a broad concept that encompasses fear, distress, and pain. Anxiety is the most critical factor affecting pain perception. There is a growing body of literature suggesting that early pain might have long-term consequences. There is also research evidence that has linked inadequately managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Pediatric patients with inflammatory bowel disease (IBD) refers to Crohn’s disease and Ulcerative Colitis. These chronic conditions often require multiple and repeated medical procedures that may cause pediatric patients to experience procedural anxiety. Needle related procedures are any procedures involving the use of needles for medical purposes such as immunization, venipuncture, IV insertions, intramuscular, or subcutaneous injections. The literature and relevant theories are discussed. A proposed training protocol for nursing staff in an infusion center is presented and this author created resource handouts for nurses, parents, and caregivers. A social narrative written by this author is presented. Also included are distraction card easel prototypes developed by this author to be used as a distraction technique to reduce procedural anxiety. An illustrative case study is presented to show the application of psychological interventions in reducing procedural anxiety. The future utility of the protocol, adapting to individual differences, and future directions are discussed. Keywords: Procedural anxiety, pediatric, Inflammatory Bowel Disease (IBD), social narrative, distraction, needle related procedures, comfort positions, procedural support

The effects of virutal reality on procedural pain and anxiety in pediatrics: A systematic review and meta-analysis

Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided

Unlocking VR Magic: Duration of Anxiety Relief for Pediatric Needle Procedures

There have been various studies that show the effectiveness of virtual reality (VR) being used as a non-pharmacologic and distraction method on school-aged children ranging from 6-12 years old. Despite this research, there has not been a follow-up with the use of VR and its duration of effect between each patient visit within this certain population. This study focuses on measuring the participants’ anxiety and pain levels during the needle-related procedure. The assessment tools that will be used to measure these important variables are the Children’s Fear Scale and Wong-Baker’s FACES scale. The participants of this study will be placed into two groups: VR intevention and standard care (SC) group. The SC group will be followed for the first month and after their trial, the VR group will also be going through the same process for the second. Statistical analysis will also be used to see correlation coefficients. The goal of this study is to evaluate the duration of effectiveness for VR being used in an outpatient setting. Ethical considerations are highly important for the safety and privacy of the participants in the study

Virtual Distractions From Reality

Patients in the pediatric emergency room are subject to many painful, stressful, and scary procedures which can lead to a frightened, nervous and uncooperative child. These same procedures can contribute to parental stress and lead to staff dissatisfaction as well. While the literature revealed a plethora of distraction techniques that are implemented in pediatric patients, our project explored studies that implemented virtual reality as a distraction technique across different ages and procedures. Based on the evidence that was identified, a grant was recently obtained to implement virtual reality into our pediatric emergency department at Rochester General Hospital and we are now planning the implementation phase.https://scholar.rochesterregional.org/nursingresearchday_2023/1002/thumbnail.jp

The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics

Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided

The emerging role of virtual reality as an adjunct to procedural sedation and anesthesia: a narrative review

Over the past 20 years, there has been a significant reduction in the incidence of adverse events associated with sedation outside of the operating room. Non-pharmacologic techniques are increasingly being used as peri-operative adjuncts to facilitate and promote anxiolysis, analgesia and sedation, and to reduce adverse events. This narrative review will briefly explore the emerging role of immersive reality in the peri-procedural care of surgical patients. Immersive virtual reality (VR) is intended to distract patients with the illusion of “being present” inside the computer-generated world, drawing attention away from their anxiety, pain, and discomfort. VR has been described for a variety of procedures that include colonoscopies, venipuncture, dental procedures, and burn wound care. As VR technology develops and the production costs decrease, the role and application of VR in clinical practice will expand. It is important for medical professionals to understand that VR is now available for prime-time use and to be aware of the growing body in the literature that supports VR.info:eu-repo/semantics/publishedVersio

An exploratory study on the effectiveness of virtual reality analgesia for children and adolescents with kidney diseases undergoing venipuncture

The current study evaluated the effectiveness of VR analgesia among pediatric and adolescent patients with kidney disease undergoing venipuncture. Patients at an Italian Children’s hospital (N = 82, age range 7–17 years) undergoing venipuncture were randomly assigned to a No VR group (non-medical conversation) vs. a Yes VR group (VR analgesia). After the procedure, patients gave 0–10 Verbal Numeric Pain Scale ratings. Compared with patients in the No VR Group, patients in the Yes VR group reported significantly lower “Pain intensity”(No VR mean = 2.74, SD = 2.76 vs. Yes VR mean = 1.56, SD = 1.83) and the VR group also rated “Pain unpleasantness” significantly lower than the No VR group (No VR mean = 2.41, SD = 0.94 vs. Yes VR mean = 1.17, SD = 1.80). Patients distracted with VR also reported having significantly more fun during the venipuncture procedure. No side effects emerged. In addition to reducing pain intensity, VR has the potential to make venipuncture a more fun and less unpleasant experience for children with CKD, as measured in the present study for the first time. Finally, in exploratory analyses, children aged 7–11 in the VR group reported 55% lower worst pain than control subjects in the same age range, whereas children aged 12 to 17 in the VR group only reported 35% lower worst pain than control subjects. Additional research and development using more immersive VR is recommended.info:eu-repo/semantics/publishedVersio

Virtual reality in the treatment of pain

Many medical procedures produce acute pain that in most cases is quite disturbing for the individual. Medication is the treatment of choice for acute pain. However, given the involvement of psychological aspects in the experience of pain, psychological techniques are being used as an effective adjunct to alleviate pain related to medical procedures. In the last years a new technology is demonstrating an enormous potential in this field: Virtual Reality (VR) distraction. In this article we review studies that explore the efficacy of immersive VR distraction in reducing pain related to different medical procedures. We include clinical studies and analogue studies with healthy participants. We discuss the results achieved by these studies and recommend future directions of VR pain control research