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Interactive video games to improve pediatric procedural pain and anxiety: a systematic review and meta-analysis

Interactive video games to improve pediatric procedural pain and anxiety: a systematic review and meta-analysis
Interactive video games to improve pediatric procedural pain and anxiety: a systematic review and meta-analysis
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 to standard care in children (0-18 years) 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 2,185 studies screened, 36 were eligible (n=3,406 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 = -0.43, 95% CI -0.67, -0.20) and anxiety (SMD = 0.61, 95% CI -0.88, -0.34), and caregivers’ procedural anxiety (SMD = -0.31, 95% CI -0.58, -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 to 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.
0007-0912
Sajeev, Mona F
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Kelada, Lauren
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Nur, A'tikah Binte Yahya
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Wakefield, Claire E
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Wewege, Michael A
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Karpelowsky, Jonathan
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Akimana, Benedict
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Darlington, Anne-Sophie
472fcfc9-160b-4344-8113-8dd8760ff962
Signorelli, Christina
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Sajeev, Mona F
2e657600-047a-488e-b615-6464eaded3ee
Kelada, Lauren
1a610d32-0668-4d1b-bff3-740885e5e482
Nur, A'tikah Binte Yahya
f16dbc0c-ef3c-4ca2-9f9d-03bdfb3a07bf
Wakefield, Claire E
dd1d48aa-9e06-483f-8464-06f2d983f026
Wewege, Michael A
63bdd804-4d64-4ae3-a2fd-eaff21f5175a
Karpelowsky, Jonathan
b984a92b-8b45-431b-be3a-14d93c0a27d3
Akimana, Benedict
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Darlington, Anne-Sophie
472fcfc9-160b-4344-8113-8dd8760ff962
Signorelli, Christina
471893a8-b2bc-4394-ae4a-2298f0bf0d59

Sajeev, Mona F, Kelada, Lauren, Nur, A'tikah Binte Yahya, Wakefield, Claire E, Wewege, Michael A, Karpelowsky, Jonathan, Akimana, Benedict, Darlington, Anne-Sophie and Signorelli, Christina (2021) Interactive video games to improve pediatric procedural pain and anxiety: a systematic review and meta-analysis. British Journal of Anaesthesia. (In Press)

Record type: Article

Abstract

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 to standard care in children (0-18 years) 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 2,185 studies screened, 36 were eligible (n=3,406 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 = -0.43, 95% CI -0.67, -0.20) and anxiety (SMD = 0.61, 95% CI -0.88, -0.34), and caregivers’ procedural anxiety (SMD = -0.31, 95% CI -0.58, -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 to 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.

Text
Interactive video games to improve paediatric procedural pain and anxiety - Accepted Manuscript
Restricted to Repository staff only until 9 June 2022.
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More information

Accepted/In Press date: 9 June 2021

Identifiers

Local EPrints ID: 450114
URI: http://eprints.soton.ac.uk/id/eprint/450114
ISSN: 0007-0912
PURE UUID: 6ddacca5-4cd1-460e-8839-57cdf94768a6

Catalogue record

Date deposited: 12 Jul 2021 16:30
Last modified: 18 Aug 2021 16:33

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Contributors

Author: Mona F Sajeev
Author: Lauren Kelada
Author: A'tikah Binte Yahya Nur
Author: Claire E Wakefield
Author: Michael A Wewege
Author: Jonathan Karpelowsky
Author: Benedict Akimana
Author: Christina Signorelli

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