Bedside Entertainment and Relaxation Theater: size and novelty does matter when using video distraction for perioperative pediatric anxiety

Rodríguez, Samuel; Caruso, Thomas J.; Tsui, Ban C. H.

doi:10.1111/pan.13133

Cited by 13 publications

(18 citation statements)

References 4 publications

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“…Although there are multiple alternative technology-based adjuncts for patient distraction during vascular access, including projectors, tablets, and phones, the novelty and immersivity of VR during these brief but high anxiety moments likely contributed to the users' high satisfaction. 21,22 Unlike previous studies which have reported motion sickness incidences as high as 5%, we had no episodes of nausea or motion sickness in the VR group. 9 This was likely secondary to VR experience selection and careful patient screening since those with a history of motion sickness were excluded.…”

Section: Discussioncontrasting

confidence: 66%

“…However, the intervention was associated with high patient satisfaction and providers. Although there are multiple alternative technology‐based adjuncts for patient distraction during vascular access, including projectors, tablets, and phones, the novelty and immersivity of VR during these brief but high anxiety moments likely contributed to the users' high satisfaction . Unlike previous studies which have reported motion sickness incidences as high as 5%, we had no episodes of nausea or motion sickness in the VR group .…”

Section: Discussionmentioning

confidence: 96%

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Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Caruso

George

Menéndez

et al. 2019

Pediatric Anesthesia

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Background Vascular access is a minor procedure that is associated with reported pain and fear in pediatric patients, often resulting in procedural incompliance. Virtual reality has been shown to be effective in adult populations for reducing pain and anxiety in various medical settings, although large studies are lacking in pediatrics. Aims The primary aim was to determine whether pain would be reduced in pediatric patients using virtual reality undergoing vascular access. The four secondary aims measured patient fear, procedural compliance, satisfaction, and adverse events. Methods A prospective, randomized, controlled trial was completed at a pediatric hospital, enrolling children 7‐18 years old undergoing vascular access in a variety of clinical settings, randomized to virtual reality or standard of care. Pain scores were measured using a numeric pain faces scale. The secondary outcomes of patient fear, procedural compliance, satisfaction, and adverse events were measured with the Child Fear Scale, modified Induction Compliance Checklist, and satisfaction surveys, respectively. Chi‐squared, t tests, and regression models were used to analyze the results. Results The analysis included 106 patients in the virtual reality group and 114 in the control. There were no significant differences in postprocedure pain (VR group estimated 0.11 points lower, 95% confidence interval: 0.50 points lower to 0.28 points greater, P = .59), postprocedure fear (VR group estimated 0.05 points lower, 95% confidence interval: 0.23 points lower to 0.13 points greater), or compliance (adjusted odds ratio 2.31, 95% confidence interval: 0.96‐5.56). Children in the virtual reality group were satisfied with the intervention. There were no adverse events. Conclusion This study demonstrates no reduction in pain while using Virtual reality (VR) across a heterogeneous pediatric inpatient population undergoing vascular access.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 96%

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Caruso

George

Menéndez

et al. 2019

Pediatric Anesthesia

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“…On presentation for the biopsy, she appeared anxious, clutching her mother and communicating only through her. We discussed various anxiolytic options with the patient and her mother, including oral medications, video tablets, video projection through the Bedside Entertainment and Relaxation Theatre (BERT), 2 and an interactive video game built on the BERT platform. The patient elected to try the interactive video game titled ''Sevo the Dragon''.…”

Section: To the Editormentioning

confidence: 99%

“…In contrast, the use of BERT's large theatrical screen is supported by studies that detailed an association between the large size of the images and patients' emotional engagement with them. 2 Other studies have shown the importance of novel vs familiar stimuli in capturing a patient's attention. 4 In our case, both mother and patient were completely engrossed throughout the process.…”

Section: To the Editormentioning

confidence: 99%

Interactive video game built for mask induction in pediatric patients

Rodríguez

Tsui

Jiang

et al. 2017

Can J Anesth/J Can Anesth

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“…Risk factors for preoperative anxiety are well‐characterized, including younger age, previous medical visits, quality of the parent‐child relationship, developmental delay, temperament, and parental anxiety 5 . Educational materials, parent‐present induction, premedication, the use of Child Life Specialists, and the use of distracting technology have been developed to reduce preoperative anxiety, but their targeted use often relies on clinical judgement 9,11‐13 . Despite a hypothesized relationship between preoperative anxiety and induction cooperation, factors influencing cooperation remain relatively poorly understood.…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study of predictors and interventions that influence cooperation with mask induction in children

Marquez

Wang

Rodríguez

et al. 2020

Pediatric Anesthesia

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Background Uncooperative pediatric mask induction is linked to perioperative anxiety. Although some risk factors for uncooperative inductions have been reported, there are no large cohort studies that identify intrinsic patient characteristics associated with cooperation. Aim The primary aim was to identify patient characteristics associated with cooperative mask inductions. The secondary aim was to determine whether preoperative interventions were associated with increased cooperation. Methods This retrospective cohort study included patients 2‐11 years old and ASA class I‐IV who underwent mask induction. Our primary outcome of interest was cooperation with mask induction, which was correlated against the Induction Compliance Checklist. The variables analyzed for association with cooperation were age, sex, ASA class, class of surgery, preferred language, and race. Interventions examined for association with induction cooperation included premedication with midazolam, exposure to distraction technology, parental presence, and the presence of a Child Life Specialist. Multivariate mixed‐effects logistic regression was used to assess the relationship between patient characteristics and cooperation. A separate multivariate mixed‐effects logistic regression was used to examine the association between preoperative interventions and cooperation. Results 9692 patients underwent 23 474 procedures during the study period. 3372 patients undergoing 5980 procedures met inclusion criteria. The only patient characteristic associated with increased cooperation was age (OR 1.20, p‐value 0.03). Involvement of Child Life Specialists was associated with increased cooperation (OR 4.44, p‐value = 0.048) while parental/guardian presence was associated with decreased cooperation (OR 0.38, p‐value = 0.002). Conclusion In this cohort, increasing age was the only patient characteristic found to be associated with increased cooperation with mask induction. Preoperative intervention by a Child Life Specialists was the sole intervention associated with improved cooperation.

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Bedside Entertainment and Relaxation Theater: size and novelty does matter when using video distraction for perioperative pediatric anxiety

Cited by 13 publications

References 4 publications

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Interactive video game built for mask induction in pediatric patients

A retrospective cohort study of predictors and interventions that influence cooperation with mask induction in children

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