Digital Technology Distraction for Acute Pain in Children: A Meta-analysis

CONTEXT: Digital distraction is being integrated into pediatric pain care, but its efficacy is currently unknown. OBJECTIVE: To determine the effect of digital technology distraction on pain and distress in children experiencing acutely painful conditions or procedures. DATA SOURCES: Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Institute of Electrical and Electronics Engineers Xplore, Ei Compendex, Web of Science, and gray literature sources. STUDY SELECTION: Quantitative studies of digital technology distraction for acutely painful conditions or procedures in children. DATA EXTRACTION: Performed by 1 reviewer with verification. Outcomes were child pain and distress. RESULTS: There were 106 studies ( LIMITATIONS: Few studies directly compared different distractors or provided subgroup data to inform applicability. CONCLUSIONS: Digital distraction provides modest pain and distress reduction for children undergoing painful procedures; its superiority over nondigital distractors is not established. Context, preferences, and availability should inform the choice of distractor

A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts

<div><p>Objective</p><p>To conduct a systematic review of studies of social media platforms used by young people to discuss and view deliberate self-harm.</p><p>Study Design</p><p>11 electronic databases were searched from January 2000 to January 2012 for primary research; in June 2014 an updated search of Medline was conducted. Grey literature sources were also searched. Search results were screened by two reviewers. Data were extracted by one reviewer and verified by another. Methodological quality was assessed using the Mixed Methods Appraisal Tool.</p><p>Results</p><p>Due to heterogeneity in study objectives and outcomes, results were not pooled; a narrative analysis is presented. 26 studies were included. Most were conducted in Canada or the UK (30.8% each), used qualitative designs (42.3%), and evaluated discussion forums (73.1%). Participants were most often aged 19–21 years (69.2%), female (mean 68.6%), and 19.2% had a documented history of depression. The social media platforms evaluated were commonly supportive and provided a sense of community among users. Support included suggestions for formal treatment, advice on stopping self-harming behavior, and encouragement. Harms included normalizing and accepting self-harming behavior; discussion of motivation or triggers, concealment, suicidal ideation or plans; and live depictions of self-harm acts.</p><p>Conclusions</p><p>Although this evidence is limited by its descriptive nature, studies identify beneficial and detrimental effects for young people using social media to discuss and view deliberate self-harm. The connections users make online may be valuable to explore for therapeutic benefit. Prospective, longitudinal investigations are needed to identify short- and long-term potential harms associated with use.</p></div

Flow Diagram of Study Selection.

<p>Details of the flow of information through the phases of the systematic review.</p

Potential benefits reported in primarily positive studies regarding the use of social media platforms to discuss and view deliberate self-harm acts.

<p>Potential benefits reported in primarily positive studies regarding the use of social media platforms to discuss and view deliberate self-harm acts.</p

Potential harms reported in primarily negative studies regarding the use of social media platforms to discuss and view deliberate self-harm acts.

<p>Potential harms reported in primarily negative studies regarding the use of social media platforms to discuss and view deliberate self-harm acts.</p

Characteristics of studies reporting features of social media platforms used to discuss and view deliberate self-harm acts.

<p>Characteristics of studies reporting features of social media platforms used to discuss and view deliberate self-harm acts.</p