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Published on: April 5, 2019
[Multimodal distraction to relieve pain in children undergoing acute medical procedures]
Kate Miller1, Sylvia Rodger, Sam Bucolo
1Stuart Pegg Paediatric Burns Centre, The University of Queensland, Brisbane, 4029, Australia. kate.miller@uq.edu.au
Insights
A new multimodal distraction device (MMD) significantly reduced pain and anxiety in children during medical procedures compared to standard care and video games. The MMD proved effective for both burn and non-burn treatments, showing sustained benefits over time.
Area of Science:
- Pediatric pain management
- Non-pharmacological interventions
- Medical technology innovation
Context:
- Children undergoing painful medical procedures experience significant anxiety and pain.
- Traditional distraction methods and pharmacological approaches have limitations.
- Technological advancements enable novel approaches to pediatric pain control.
Purpose:
- To evaluate the effectiveness of a novel multimodal distraction device (MMD) in reducing pain and anxiety in children during medical procedures.
- To compare the MMD's efficacy against standard distraction (SD) and video games (VG).
- To assess the MMD's impact on procedural length and its sustained effect.
Summary:
- Three randomized controlled trials involving 182 children and 354 procedures were conducted.
- The MMD, an interactive device with stories and games, was used for preparation and distraction.
- Pain and anxiety were measured using validated scales by children, caregivers, and nursing staff.
Impact:
- The MMD significantly reduced anxiety and pain reported by children, parents, and staff (P < 0.01).
- The device positively influenced clinical procedure time.
- The MMD demonstrated sustained effectiveness in reducing pain and time with repeated use.
Objective:
Non-pharmacological approaches to pain management have been used by therapists for decades to reduce the anxiety and pain experienced by children during burn care procedures. With a greater understanding of pain and the principles behind what causes a child to be distracted, combined with access to state of the art technology, we have developed an easy to use, hand held multimodal distraction device (MMD). MMD is an interactive device that prepares the child for a procedure and uses developmentally appropriate distraction stories and games during the procedures to alleviate anxiety and pain. This paper summarizes the results of three randomized control trials. The trials aimed to understand the effectiveness of MMD as a distraction and preparation tool in reducing anxiety and pain in children undergoing burns and non-burns medical procedures compared to pure pharmacological approaches Standard Distraction (SD) and off the shelf video games (VG).
Methods:
Three separate prospective randomized control trials involving 182 children having 354 dressing changes were conducted in the burns and orthopedic departments at Royal Children's Hospital, Brisbane, Australia, to address the above aims. Pain and anxiety scores were completed for the child, caregiver and nursing staff according to the Modified Faces, Legs, Activity, Cry and Consolability Scale, Faces Pain Scale-Revised, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale. Procedural length was recorded.
Results:
MMD as a preparation and distraction tool were shown to have a significant impact on child, parent and nursing staff reported anxiety and pain during procedures compared to standard care and video games (P < 0.01). The MMD had a positive effect on clinical time and was shown to sustain its impact on pain and time with further dressing changes.
Conclusions:
MMD is more effective in reducing the pain and anxiety experienced by children in acute medical procedures as compared with SD and VG. MMD is continuing to be trialed and is continuing to show positive clinical outcomes.
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