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Published on: April 14, 2016
Digital Technology Distraction for Acute Pain in Children: A Meta-analysis
Michelle Gates1,2, Lisa Hartling3,2, Jocelyn Shulhan-Kilroy1,2
1Department of Pediatrics and.
Insights
Digital distraction moderately reduces pain and distress in children during procedures. However, its effectiveness compared to non-digital methods is not yet established, requiring consideration of individual patient factors.
Area of Science:
- Pediatric Pain Management
- Digital Health Interventions
- Evidence-Based Practice
Background:
- Digital distraction is increasingly used in pediatric pain care.
- The efficacy of digital distraction for pain management in children remains largely unknown.
- There is a need to evaluate the impact of these technologies on pediatric patient outcomes.
Purpose of the Study:
- To systematically review the evidence on the effectiveness of digital technology distraction for reducing pain and distress in children.
- To synthesize findings from quantitative studies examining digital interventions during painful procedures.
- To assess the clinical significance of digital distraction in pediatric pain management.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Medline, Embase, PsycINFO, etc.) and gray literature.
- Quantitative studies involving digital technology distraction for acutely painful conditions or procedures in children were included.
- Data extraction focused on child pain and distress outcomes, with meta-analysis performed on eligible randomized controlled trials (RCTs).
Main Results:
- Analysis of 106 studies (n=7820) found that digital distraction significantly reduced self-reported, observer-reported, and behavioral pain and distress in children undergoing procedures.
- Modest but clinically important reductions were observed across various pain and distress measures (SMD ranging from -0.35 to -0.68).
- No studies reported on digital distraction for painful conditions, only procedures.
Conclusions:
- Digital distraction offers a modest reduction in pain and distress for children undergoing painful procedures.
- The superiority of digital over non-digital distraction methods is not conclusively established.
- Clinical decisions regarding the use of digital distractors should consider patient context, preferences, and availability.
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 (n = 7820) that reported on digital technology distractors (eg, virtual reality and video games) used during common procedures (eg, venipuncture, dental, and burn treatments). No studies reported on painful conditions. For painful procedures, digital distraction resulted in a modest but clinically important reduction in self-reported pain (standardized mean difference [SMD] -0.48; 95% confidence interval [CI] -0.66 to -0.29; 46 randomized controlled trials [RCTs]; n = 3200), observer-reported pain (SMD -0.68; 95% CI -0.91 to -0.45; 17 RCTs; n = 1199), behavioral pain (SMD -0.57; 95% CI -0.94 to -0.19; 19 RCTs; n = 1173), self-reported distress (SMD -0.49; 95% CI -0.70 to -0.27; 19 RCTs; n = 1818), observer-reported distress (SMD -0.47; 95% CI -0.77 to -0.17; 10 RCTs; n = 826), and behavioral distress (SMD -0.35; 95% CI -0.59 to -0.12; 17 RCTs; n = 1264) compared with usual care.
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.
