Pediatrik Hastalarda Ağrı Yönetiminde Sanal Gerçeklik Uygulamalarının Etkinliği: Sistematik Derleme

Yıl 2021, Cilt: 1 Sayı: 3, 96 - 106, 29.12.2021

Esin Keskin , Emel Buldur Hatice Bal Yılmaz

Öz

Amaç: Bu sistematik derleme, pediatrik hastalarda ağrı yönetiminde sanal gerçeklik uygulamalarının etkinliğini incelemek ve pediatrik hastaların ağrı düzeyleri üzerine etkilerini bilimsel olarak ortaya koymak amacıyla yapılmıştır.
Yöntem: Pediatrik hastalarda ağrı yönetiminde sanal gerçeklik uygulamalarının etkinliğini belirlemek için Scholar, PubMed, Science Direct ve Web Of Science veri tabanları taranmıştır. Tarama aşamasında "pediatric", "pain management", "virtual reality", "randomized controlled" anahtar sözcükleri kullanılarak 2015-2020 yılları arasındaki araştırmalar incelenmiştir.
Bulgular: Yapılan veri tabanı taraması ile konu ile ilgili “1236” çalışmaya ulaşılmıştır. Çalışmada başlık ve özete göre bir ön değerlendirme yapılmış ve 1218 çalışma dahil edilme kriterlerine uymadığı için çıkarılmıştır. Dahil edilme kriterlerine uyan 18 çalışma dört veri tabanından elde edilmiş ve ortak çalışmaların çıkarılmasıyla beraber değerlendirmeye alınan makale sayısı 11 olarak bulunmuştur. 1 makale ücretli erişim olduğundan tam metnine ulaşılamamış ve araştırma dışı bırakılarak 10 makale karşılaştırma ve sonuçlar açısından değerlendirilmiştir. Değerlendirmeye alınan 10 çalışma, 2015-2020 yılları arasında yayınlanmış, pediatrik hastaların örneklem grubunu oluşturduğu, randomize kontrollü çalışmalardır. Çalışmalardan elde edilen bulgular doğrultusunda, sanal gerçekliğin pediatrik hastalarda nonfarmakolojik yöntem olarak kullanımı ve ağrıyı gidermede etkin bir araç olduğu sonuçları ortaya konulmuştur.
Uygulamada Kullanım: Sanal gerçeklik uygulamasının pediatrik hastalarda ağrıyı gidermek için non-farmakolojik bir yöntem olarak kullanılmasının yaygınlaştırılması ve alandaki yeniliklerin takip edilerek hemşirelik uygulamalarına dahil edilmesi önerilmektedir.

Anahtar Kelimeler

pediatrik, ağrı yönetimi, sanal gerçeklik, randomize kontrollü

Effectiveness of Virtual Reality Applications in Pain Management in Pediatric Patients: A Systematic Review

Öz

Purpose: This systematic review was conducted to evaluate the effectiveness of virtual reality applications in pain management on pediatric patients. Method: Scholar, PubMed, Science Direct and Web of Science databases were scanned to evaluate the effectiveness of virtual reality applications in pain management on pediatric patients. The keywords; "pediatric", "pain management", "virtual reality", "randomized controlled" were used during the scanning phase.
Results: "1236" studies on the subject were reached by the database search. In the study, a preliminary evaluation was made according to the title and abstract, and 1218 studies were excluded because they did not meet the inclusion criteria. 18 studies that met the inclusion criteria were obtained from four databases, and the number of articles included in the evaluation was found to be 11. Since 1 article is paid access, the full text could not be accessed and 10 articles were excluded from the research and evaluated in terms of comparison and results. The 10 studies included in the evaluation are randomized controlled studies published between 2015 and 2020, in which pediatric patients constitute the sample group. In 10 studies evaluated, the results of the use of virtual reality as a non-pharmacological method in pediatric patients and to be an effective tool for pain relief have been revealed.
Practice Implications: It is recommended to use virtual reality application as a non-pharmacological method to relieve pain in pediatric patients and to include them in nursing practices by following the innovations in the field.

Anahtar Kelimeler

Pediatric; pain management; virtual reality; randomized controlled

Kaynakça

• 1 Anand, K. J., Aranda, J. V., Berde, C. B., Buckman, S., Capparelli, E. V., Carlo, W., ... & Walco, G. A. (2006). Summary proceedings from the neonatal pain-control group. Pediatrics, 117(Supplement 1), S9-S22.
• 2 Andolsek, D.L. (1995). Virtual reality in education and training: International journal of instructional media 22.2: 145-55.
• 3 Argoff, C. (2019). Mechanisms of pain transmission and pharmacologic management: Cur med res opin 27:2019.
• 4 Berde, C.B., Sethna, N.F. (2002). Analgesics for the treatment of pain in children: N Engl J Med, 347 (14):1094-1103.
• 5 Caruso, T.J., George, A., Menendez, M., De Souza, E., Khoury, M., Kist, M.N., Rodriguez, S.T. (2020). Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial: Paediatr anaesth, 30(2):116-123.
• 6 Chan, E., Hovenden, M., Ramage, E., Ling, N., Pham, J.H., Rahim, A., Lam, C., Liu, L., Foster, S., Sambell, R., Jeyachanthiran, K., Crock, C., Stock, A., Hopper, S.M., Cohen, S., Davidson, A., Plummer, K., Mills, E., Craig, S.S., Deng, G., Leong, P. (2019).Virtual reality for pediatric needle procedural pain: Two randomized clinical trials: J pediatr, 209:160-167.
• 7 Friedrichsdorf, S. J., Giordano, J., Desai Dakoji, K., Warmuth, A., Daughtry, C., & Schulz, C. A. (2016). Chronic pain in children and adolescents: diagnosis and treatment of primary pain disorders in head, abdomen, muscles and joints. Children, 3(4), 42.
• 8 Gardner, E. (2020) Using virtual reality to improve perioperative skills: AORN J., 111(3):281-283.
• 9 Gerçeker, G.Ö., Binay, Ş., Bilsin, E., Kahraman, A., Yılmaz, H.B. (2018). Effects of virtual reality and external cold and vibration on pain in 7- to 12-year-old children during phlebotomy: a randomized controlled trial: J perianesth nurs, 33(6):981-989.
• 10 Gold, J.I., Mahrer, N.E. (2018). Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. J pediatr psychol, 1;43(3):266-275.
• 11 Goldman, R.D., Behboudi, A. (2020). Virtual reality for intravenous placement in the emergency department-a randomized controlled trial: Eur J pediatr, 180(3), 725-731.
• 12 Harbaugh, C. M., Lee, J. S., Hu, H. M., McCabe, S. E., Voepel-Lewis, T., Englesbe, M. J., ... & Waljee, J. F. (2018). Persistent opioid use among pediatric patients after surgery. Pediatrics, 141(1).
• 13 Waljee, J. F. (2018). Persistent opioid use among pediatric patients after surgery. Pediatrics, 141(1).
• 14 Hauer J. Identifying and managing sources of pain and distress in children with neurological impairment. Pediatr Ann 2010; 39:198.
• 15 Hua, Y., Qiu, R., Yao, W.Y., Zhang, Q., Chen, X.L. (2015). The effect of virtual reality distraction on pain relief during dressing changes in children with chronic wounds on lower limbs: Pain manag nurs,16(5):685-91.
• 16 Khadra, C., Ballard, A., Paquin, D., CotesTurpin, C., Hoffman, H.G., Perreault, I., Fortin, J.S., Bouchard, S., Théroux, J., Le May, S. (2020). Effects of a projector-based hybrid virtual reality on pain in young children with burn injuries during hydrotherapy sessions: A within-subject randomized crossover trial. Burns, S0305-4179(19)30635-7.
• 17 Kudubes, A. A., Bektas, I., & Bektas, M. (2021). Nursing Role in Children Pain Management/Cocuklarda Agri Yonetiminde Hemsirenin Rolu. Journal of Education and Research in Nursing, 18(1), 107-114.
• 18 Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS medicine, 6(7): e1000097.
• 19 Özkan, T.K., Polat, F. (2020). The effect of virtual reality and kaleidoscope on pain and anxiety levels during venipuncture in children: J perianesth nurs,35(2):206-211.
• 20 Schechter, W. (2020). Approach to the management of acute perioperative pain in ınfants and children. This topic last updated: Jun 16, 2020. https://www.uptodate.com/(Erişim:22.03.2021)
• 21 Semerci, R., Akgün, K.M., Eren, T., Avci, G. (2020). Effects of virtual reality on pain during venous port access in pediatric oncology patients: a randomized controlled study: J pediatr oncol nurs, 38(2),142-151.
• 22 Semerci, R., Kostak, M.A., Eren, T., Avci, G. (2021). Effects of virtual reality on pain during venous port access in pediatric oncology Keskin ve ark. Gün Hem Ar Derg | Jour Nurs Res 106 patients:A randomized controlled study: Journal of pediatric oncology nursing, 38(2), 142-151.
• 23 Tarakçı, D. (2015). Pediatrik rehabilitasyonda oyun konsolları ile sanal gerçeklik uygulamaları: Türkiye klinikleri physiotherapy and rehabilitation-special topics, 1(1), 30-34.
• 24 Verriotis, M., Chang, P., Fitzgerald, M., Fabrizi, L. (2016). The development of the nociceptive brain: Neuroscience, 338:207.
• 25 Walther-Larsen, S., Petersen, T., Friis, S.M., Aagaard, G., Drivenes, B., Opstrup, P. (2019). Immersive virtual reality for pediatric procedural pain: A randomized clinical trial. Hosp pediatr. 2019 Jul;9(7):501-507.