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VR to Reduce Pain/Anxiety During IV Starts

28 de junio de 2021 actualizado por: Jeffrey I Gold, PhD, Children's Hospital Los Angeles

Effect of Immersive Virtual Reality on Pain and Anxiety in Pediatric Peripheral Intravenous Catheter Access: A Randomized Clinical Trial

This study aims to test the effectiveness of virtual reality (VR) as a non-pharmaceutical intervention to reduce pain and anxiety in children undergoing peripheral intravenous catheter (PIVC) access in the Department of Radiology and Imaging or the outpatient Infusion Center at CHLA, as measured by self- and proxy-report.

Descripción general del estudio

Estado

Terminado

Condiciones

Descripción detallada

Distraction is a form of non pharmacological intervention for reducing pain and anxiety in children during painful medical procedures (e.g., venipuncture, IV placement). Recent technological developments in the area of virtual reality (VR) provide new and potentially more effective ways of distracting children from the pain and anxiety associated with medical procedures. While initial studies of VR pain distraction are promising, few have studied the effectiveness of the technology in children, using a multi-method approach. The current study aims to recruit 115 children ages 10-21 years and their caregivers who arrive at the hospital for peripheral intravenous catheter (PIVC) access in the Department of Radiology and Imaging or the outpatient Infusion Center. Children and their parents will be randomly assigned to one of two treatment conditions: 1) existing hospital standard of care or 2) standard of care plus distraction via VR. Children and caregivers will be asked to complete measures assessing pain and anxiety both before and after the procedure. In addition, objective measures of child pain and distress during the PIVC access will be taken using coding of behavioral/verbal expressions. Univariate Analysis of Variance (ANOVA) will be used to compare differences in primary and secondary outcome variables in VR + standard of care to standard of care only conditions when pre and post-operative measures are available. Univariate ANOVA will be used to compare conditions on post-operative variables.

Tipo de estudio

Intervencionista

Inscripción (Actual)

107

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • California
      • Los Angeles, California, Estados Unidos, 90027
        • Children's Hospital Los Angeles

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

10 años a 21 años (Niño, Adulto)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria for Children:

  1. Children who are 10-21 years old
  2. Children who are English speaking (caregivers may be Spanish English speaking or Spanish speaking)
  3. Children who are undergoing PIVC access in the Department of Radiology and Imaging or the outpatient Infusion Center.
  4. Only children who are in the normal range of development will be recruited for this study. This will be assessed by report from the parents. The rationale for excluding patients with developmental delay is that due to their cognitive impairments, such children react to the stressors of surgery differently than do children without such developmental delay. It is unclear how such children would use the interventions included in this study, and it is likely that their responses on baseline and outcome measures will differ from children of normal developmental parameters.

Inclusion criteria for healthcare providers:

  1. Healthcare providers must be 18 years old or older
  2. Healthcare providers must be Children's Hospital Los Angeles staff
  3. Healthcare providers may participate if they have witnessed and/or administered the medical procedure

Exclusion Criteria:

  1. Children who are currently taking pain medication or anxiolytic medication will be excluded from this study.
  2. Children with a psychiatric disorder, organic brain syndrome, mental retardation, or other known cognitive/neurological disorders
  3. Children with visual, auditory, or tactile deficits that would interfere with the ability to complete the experimental tasks
  4. Children with a history of seizure disorder.
  5. Children currently sick with flu-like symptoms or experiencing a headache or earache.
  6. Children with known or suspected motion sickness

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Cuidados de apoyo
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Sin intervención: Standard of Care (No VR) Randomization
In the standard of care treatment condition, participants will receive the standard CHLA treatment protocol for PIVC placement (i.e., a topical numbing spray and Buzzy® Bee, a vibrating device placed near the PIVC site for pain distraction).
Experimental: VR Randomization
Children in the VR condition will undergo the invasive procedure while distracted by interaction with an immersive virtual environment (VE) presented via a head mounted display (HMD). The intervention group will receive standard CHLA treatment with VR distraction. Patients began gameplay <5 minutes before their PIVC placement and concluded after successful vascular access.
Participants 13 -21 years old can use the Samsung Gear VR. The VE is mobile based (Samsung with the Gear VR) and has active matrix LCDs with high pixel resolution, creating a bright, vibrant color and a quality image. Participants will engage with BearBlast (appliedVR™), a multi-sensory VR game in which users travel on a pre-set path through a colorful, highly-interactive 3-D environment filled with animated landscapes, buildings, and clouds, during which the user's gaze controls the direction of a firing cannon to knock down teddy bears. The VR game is equipped with a head-tracking system, enabling the player to look around the VE. Therefore, the child will be receiving distraction via 3-D visual and auditory sensory, thus supplying a multi-sensory immersive experience. While wearing these glasses, the children only can see the HMD screen so that the immersion and presence will be increased. The VR glasses will be sanitized before every use to minimize chance of infection.
Participants 10-21 years can use the Merge. The VE to be used in this study is mobile based (Pixel with the Merge) and has active matrix LCDs with high pixel resolution, creating a bright, vibrant color and a quality image. Participants will engage with BearBlast (appliedVR™), a multi-sensory VR game in which users travel on a pre-set path through a colorful, highly-interactive 3-D environment filled with animated landscapes, buildings, and clouds, during which the user's gaze controls the direction of a firing cannon to knock down teddy bears. The VR game is equipped with a head-tracking system, enabling the player to look around the VE. Therefore, the child will be receiving distraction via 3-D visual and auditory sensory, thus supplying a multi-sensory immersive experience. While wearing these glasses, the children only can see the HMD screen so that the immersion and presence will be increased. The VR glasses will be sanitized before every use to minimize chance of infection.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Faces Pain Scale-Revisada (FPS-R)
Periodo de tiempo: Aproximadamente 5 minutos a una hora antes del procedimiento
Revisada es una versión actualizada de la escala de calificación de dolor de caras de Wong-Baker que muestra la ausencia de dolor como una expresión neutra en comparación con la cara sonriente de la medida original. Se le pide al niño que señale la caricatura de la cara que representa cómo se siente actualmente debido a su dolor. Se cree que las medidas faciales miden la intensidad del dolor, y la medida Wong-Baker Faces ha demostrado una buena confiabilidad y validez.
Aproximadamente 5 minutos a una hora antes del procedimiento
Visual Analogue Scale (VAS)
Periodo de tiempo: Approximately 5 minutes to one hour before procedure
The VAS anticipatory anxiety measure is a vertical VAS, anchored with 0 at the bottom indicating the least amount and 10 at the top indicating the greatest amount, in response to the instruction to rate "how nervous, afraid, or worried" they were about the upcoming task. The scale also has color cues, graded from yellow at the bottom to dark red at the top, as well as a neutral face at the bottom and a face showing a negative expression at the top. Prior research used the VAS to rate anticipatory anxiety and pain in children
Approximately 5 minutes to one hour before procedure

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Índice de Sensibilidad a la Ansiedad Infantil (CASI)
Periodo de tiempo: Aproximadamente 5 minutos a una hora antes del procedimiento
Esta medida de 18 ítems utiliza una escala de Likert de tres puntos (ninguno (1), algo (2), mucho (3)) para evaluar cuán negativamente ven los pacientes los síntomas de ansiedad. Los ítems se suman con una puntuación más alta que indica una mayor sensibilidad a la ansiedad.
Aproximadamente 5 minutos a una hora antes del procedimiento
Gold & Rizzo Immersion/Presence (GRIP) Inventory
Periodo de tiempo: Approximately 5 minutes to one hour before procedure
Gold & Rizzo Immersion/Presence (GRIP) Inventory is a Child Presence Questionnaire was developed out of a content analysis of the entire domain of adult presence items and selection and adaptation of appropriate items for assessing the child's sense of believability of their experience. This 16-item measure is verbally administered to children and asks them to respond according to a 3-point Likert-like format. Items assess the child's sense of involvement, realism, and transportation into the experience. Patients in the VR condition will complete the Child Presence Questionnaire post-procedure to assess level of VR immersion.
Approximately 5 minutes to one hour before procedure

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Colaboradores

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

12 de abril de 2017

Finalización primaria (Actual)

24 de julio de 2019

Finalización del estudio (Actual)

24 de julio de 2019

Fechas de registro del estudio

Enviado por primera vez

18 de junio de 2021

Primero enviado que cumplió con los criterios de control de calidad

18 de junio de 2021

Publicado por primera vez (Actual)

28 de junio de 2021

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

1 de julio de 2021

Última actualización enviada que cumplió con los criterios de control de calidad

28 de junio de 2021

Última verificación

1 de junio de 2021

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • CHLA-15-00549_A

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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