Abstract：
BACKGROUND: Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics and VR immersion level on the effectiveness of VR for managing pediatric pain and anxiety during venipuncture.
OBJECTIVE: The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures.
METHODS: This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children\'s Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention.
RESULTS: Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain.
CONCLUSIONS: VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR\'s success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population.
BACKGROUND: ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901.
OBJECTIVE: The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures.
METHODS: This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children\'s Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention.
RESULTS: Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain.
CONCLUSIONS: VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR\'s success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population.
BACKGROUND: ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901.
摘要：
背景：虚拟现实（VR）是一种经过充分研究的数字干预措施，已用于管理接受各种医疗程序的儿科患者的急性疼痛和焦虑。这项研究的重点是调查独特的患者特征和VR沉浸水平对VR在静脉穿刺期间管理儿科疼痛和焦虑的有效性的作用。
目的：本研究的目的是确定VR干预期间特定患者特征和沉浸水平如何影响接受静脉穿刺手术的儿科患者的焦虑和疼痛水平。
方法：本研究是对2种组合的二次数据分析，先前发表的随机对照试验在洛杉矶儿童医院于2017年4月12日至2019年7月24日对252名10-21岁的儿科患者进行了观察.在3种临床环境中进行了一项随机临床试验，检查了周围静脉导管的放置（放射学和输液中心）和抽血（静脉切开术）。使用条件过程分析进行适度和调解分析，以评估VR干预期间沉浸水平的影响。
结果：在预测术后焦虑时，沉浸水平和焦虑敏感性之间存在显著的缓和（P=0.01）。在护理标准范围内表现出最高焦虑敏感度的患者，相对于高沉浸水平的个体，术后焦虑升高为1.9（95％CI0.9-2.8；P<.001）。没有发现其他重要因素可以介导或减轻沉浸对术后焦虑或疼痛的影响。
结论：VR对于焦虑敏感性较高的患者最有效，他们报告感觉高度沉浸。年龄,程序的位置，和患者的性别未发现显著影响VR成功管理术后疼痛或焦虑水平，这表明沉浸式VR可能是广泛的儿科人群的有益干预措施。
背景：ClinicalTrials.govNCT04268901;https://clinicaltrials.gov/study/NCT04268901。
目的：本研究的目的是确定VR干预期间特定患者特征和沉浸水平如何影响接受静脉穿刺手术的儿科患者的焦虑和疼痛水平。
方法：本研究是对2种组合的二次数据分析，先前发表的随机对照试验在洛杉矶儿童医院于2017年4月12日至2019年7月24日对252名10-21岁的儿科患者进行了观察.在3种临床环境中进行了一项随机临床试验，检查了周围静脉导管的放置（放射学和输液中心）和抽血（静脉切开术）。使用条件过程分析进行适度和调解分析，以评估VR干预期间沉浸水平的影响。
结果：在预测术后焦虑时，沉浸水平和焦虑敏感性之间存在显著的缓和（P=0.01）。在护理标准范围内表现出最高焦虑敏感度的患者，相对于高沉浸水平的个体，术后焦虑升高为1.9（95％CI0.9-2.8；P<.001）。没有发现其他重要因素可以介导或减轻沉浸对术后焦虑或疼痛的影响。
结论：VR对于焦虑敏感性较高的患者最有效，他们报告感觉高度沉浸。年龄,程序的位置，和患者的性别未发现显著影响VR成功管理术后疼痛或焦虑水平，这表明沉浸式VR可能是广泛的儿科人群的有益干预措施。
背景：ClinicalTrials.govNCT04268901;https://clinicaltrials.gov/study/NCT04268901。
