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Interactive video games to reduce paediatric procedural pain and anxiety: a systematic review and meta-analysis
Mona F Sajeev1, Lauren Kelada1, A'tikah Binte Yahya Nur1
1School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
Insights
Interactive video games effectively reduce procedural pain and anxiety in children and caregivers. Easily accessible games can be integrated into routine practice to improve patient and family experiences during medical procedures.
Area of Science:
- Pediatric healthcare
- Medical psychology
- Interventional pain management
Background:
- Procedural pain and anxiety in children can lead to negative long-term health consequences.
- Caregiver anxiety can worsen pediatric procedural distress.
- Effective interventions are needed to manage pediatric procedural pain and anxiety.
Purpose of the Study:
- To evaluate the impact of interactive video game interventions on children's procedural pain and anxiety.
- To compare the effects of different types of video games on these outcomes.
- To assess the influence of these interventions on caregiver anxiety.
Main Methods:
- Systematic review and meta-analysis of studies involving children (0-18 years) undergoing painful procedures.
- Searched MEDLINE, Embase, and PsycINFO databases.
- Random-effects meta-analysis was performed to analyze pain and anxiety outcomes.
Main Results:
- Interactive video games significantly reduced children's procedural pain (SMD=-0.43) and anxiety (SMD=0.61).
- Caregiver anxiety was also reduced (SMD=-0.31).
- No significant differences were found between game types (preparatory vs. distracting, VR vs. non-VR) or for most medical outcomes, except for a reduced need for restraint.
Conclusions:
- Interactive video games are effective in minimizing pediatric procedural pain and anxiety.
- Distraction-based conventional video games are easily available and recommended for routine practice.
- Integrating video games can improve the experience for both children and caregivers during medical procedures.
Background:
Procedural pain and anxiety in children can be poorly controlled, leading to significant short- and long-term sequelae, such as longer procedure times or future healthcare avoidance. Caregiver anxiety can exacerbate these effects. We aimed to evaluate the effect of interactive video game interventions on children's procedural pain and anxiety, including the effect of different types of video games on those outcomes.
Methods:
We conducted a systematic review and meta-analysis of the effectiveness of interactive video games compared with standard care in children (0-18 yr) undergoing painful procedures. We searched the databases MEDLINE, Embase, and PsycINFO. We conducted random-effects meta-analysis using 'R' of children's procedural pain and anxiety and caregivers' anxiety.
Results:
Of 2185 studies screened, 36 were eligible (n=3406 patients). Studies commonly involved venous access (33%) or day surgery (31%). Thirty-four studies were eligible for meta-analyses. Interactive video games appear to reduce children's procedural pain (standardised mean difference [SMD]=-0.43; 95% confidence interval [CI]: -0.67 to -0.20), anxiety (SMD=0.61; 95% CI: -0.88 to -0.34), and caregivers' procedural anxiety (SMD=-0.31; 95% CI: -0.58 to -0.04). We observed no difference between preparatory and distracting games, or between virtual reality and non-virtual reality games. We also observed no difference between interactive video games compared with standard care for most medical outcomes (e.g. procedure length), except a reduced need for restraint. Studies reported minimal adverse effects and typically had high intervention acceptability and satisfaction.
Conclusions:
Our findings support introducing easily available video games, such as distraction-based conventional video games, into routine practice to minimise paediatric procedural pain and child/caregiver anxiety.
