Calming Children When Drawing Blood Using Breath-based Biofeedback

Abstract

Blood sampling is a common and necessary procedure in the treatment and diagnosis of a variety of diseases. However, it often results in painful and stressful experiences for children. Designed together with domain experts, Pufferfish is a breath-controlled biofeedback game technology with bespoke airflow sensor that aims to calm children during blood sampling procedures. An initial randomized controlled trial was conducted in which 20 children aged 6-11 were assigned to one of two conditions involving either passive distraction (watching a video) or active distraction using the Pufferfish prototype. Medical staff rated Pufferfish significantly more useful in facilitating the blood sampling procedure compared to passive distraction. Qualitative feedback from patients, parents, and medical staff identified aspects that impact the acceptance of breath-based active distraction. Our study highlights the potential of non-pharmacological assistive technology tools to reduce fear and pain for children undergoing painful or stressful medical treatment.

Exploring the Role of Self-efficacy in Biofeedback Video Games

“…Especially for youth it is important to keep them engaged and motivated and games are seen as an ideal way to achieve this [22][23][24][25]. Promising results of game-based biofeedback have been found for emotion regulation and the treatment of stress and anxiety in youth [20][21][26][27][28][29][30] with some games even being just as effective as a gold-standard treatment [31].…”

MindfulNest: Strengthening Emotion Regulation with Tangible User Interfaces

“…Prior work with TUIs to guide children's breathing has shown that active calming techniques are more effective than passive ones [25]. Sonne initially designed the "ChillFish" to calm children with ADHD and later tested it as a means of calming children while they had blood drawn [23][24] [25].…”

SpiroPlay, a Suite of Breathing Games for Spirometry by Kids & Experts

“…There are also commercial systems for respiratory muscle training for children with lung-related diseases [61,68]. Furthermore, various studies on breathing games target Positive Expiratory Pressure (PEP) physiotherapy for people with Cystic Fibrosis (CF) [41,67], relaxation exercises [1,43,51] 3 including an attempt of calming children during drawing blood [52], and investigating entertainment-purposes [24,35,54].…”

“…Building on the related work, a variety of applied practical principles, and the co-design sessions we made SpiroPlay. Similar to [52], SpiroPlay is a real-time responsive app created in Unity running on an Android tablet with a Bluetooth connection. We use Air Next (NuvoAir) a commercially available affordable turbinebased spirometer handheld device.…”