PINS: VIRTUAL REALITY (VR) COMPARED TO PASSIVE DISTRACTION FOR PAIN AND ANXIETY MANAGEMENT DURING ORTHOPAEDIC PROCEDURES IN CHILDREN. A MULTICENTRE PRAGMATIC RANDOMIZED CLINICAL TRIAL
Notice bibliographique
Résumé
Orthopaedic procedures such as percutaneous pins or sutures removal represent a potential source of pain and anxiety for the paediatric patients, as well as a source of anxiety for parents and caregivers. Pain and anxiety contribute to children and families negative trauma experience with possible long-term sequelae. The aim of this trial was to examine the effect of VR distraction compared to passive distraction for pain and anxiety relief during percutaneous pins removal and/or removal of sutures in paediatric orthopaedic clinics. It was a multicenter pragmatic randomized controlled trial (RCT) using a parallel design with two groups: 1) immersive VR and 2) control - non-immersive video game on tablet in an equal ratio of participants per group. Pain and anxiety were assessed immediately before (T0) and after (T1) the procedure, as well as one week after (T2) (memory of pain) using the Numerical Rating Scale (NRS) and the Child Fear Scale (CFS) respectively. Satisfaction scale (0-10) was used for parents and children and a satisfaction survey was delivered to caregivers after the procedure. Analyses were carried out according to the intention-to-treat principle, with a significance level (α) of 0.025, considering Bonferroni's correction. Subgroups analyses were planned for age and sex. One hundred eighty-eight participants aged from six to 17 years with a mean age of 10.8 ± 3.3 years were recruited from three tertiary centers. No statistically significant differences between the two groups were observed for pain and anxiety scores at T0, T1 and T2. However, a significant difference was observed on anxiety at T1 in favor of teenage boys over 12 years in the VR group (p=0.025). Statistically higher level of satisfaction with the use of VR was reported by parents (p=0.015) and caregivers (p=0.009) with 100% of caregivers recommending immersive VR for future non-invasive paediatric orthopaedic procedures. Procedural time was comparable for the two interventions (p=0.10). This large multicenter RCT showed no statistically significant differences in reduction of pain and anxiety in children using immersive VR compared to non-immersive video game during percutaneous pins removal and/or removal of sutures in orthopaedic clinics. However, VR was efficacious in reducing anxiety in teenage boys. Parents and caregivers were highly satisfied with the use of VR during the procedure. Even if VR is probably not the only answer for reducing pain and anxiety levels, it is part of the tools available at relatively low costs for children undergoing painful and stressful procedures in paediatric orthopaedic clinics.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».