Distraction Group Research Articles

Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study.

Objectives and methodsChildren, in the age-group of 6 to 8 years, with moderate level of anxiety, (measured with M-DAS), requiring inferior alveolar nerve block (IANB) for mandibular tooth extraction were selected. Informed consent was obtained from parents. Selected children were allocated randomly into 3 groups virtual reality (VR) distraction group, audio distraction group and Tell-show-do (TSD) group. Pre- and post- distraction anxiety level of children was measured subjectively with facial image scale and objectively with pulse rate and oxygen saturation (measured with pulse oxymeter).ResultsThere was a statistically significant decrease in pulse rate after distraction (with a p < 0.01) in all the three groups. Postdistraction pulse rate was lowest in the VR distraction group when compared to other groups. While comparing postdistraction pulse rate values in the three groups, the difference in pulse rate between TSD and VR distraction group was significant. But while comparing the pulse rate between audio distraction and TSD group (p = 0.06), and audio distraction and VR distraction group (p = 0.24) was not statistically significant. Oxygen saturation increased in all the three groups which was statistically significant (p < 0.01). There was a statistically significant difference in the postdistraction oxygen (O2) saturation levels between TSD and audio distraction groups (p < 0.05) with more O2 saturation in audio distraction group. But while comparing the audio distraction with VR group and TSD with VR group, the difference was not significant. Facial image scale (FIS) scores decreased in all the three groups (p < 0.01).ConclusionThe overall results revealed by all the parameters indicate that children were most relaxed in VR group, followed by audio group and were least relaxed in TSD group during dental visits. Hence VR distraction can be considered as a useful technique for behavior management of pediatric patients during a conventional dental treatment.How to cite this articleSG G, George S, S A, et al. Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(S-2):S173–S178.

Effectiveness of Auditory Distraction and Brief Relaxation Therapy in Reducing Anxiety in Dental Patients Undergoing Extraction: A Randomized Controlled Trial

Objective: This study compared the effectiveness of auditory distraction and brief relaxation therapy for reducing anxiety in patients undergoing tooth extraction. Methods: A non-blind, three-armed, randomized control trial was carried out. The targeted study population were patients who needed extraction of a non-restorable and non-mobile molar tooth. Eighty-six patients were recruited; the brief relaxation therapy and auditory distraction groups had 32 participants each, while 10 of the 22 participants in the control group were excluded due to missing data. The Hierarchical Anxiety Questionnaire was used to assess the anxiety level. The Mann–Whitney U or Kruskal–Wallis test was performed to compare means between the groups. The before and after comparisons in each group were carried out using the Wilcoxon Signed-Rank test. The alpha value was set at 0.05, and data were analyzed using SPSS version 24. Results: The mean anxiety score after brief relaxation therapy and auditory distraction had significantly decreased (p &lt; 0.001). Although not significant (p = 0.13), there was a slight increase in the anxiety score of the study participants in the control group just before the extraction procedure. Brief relaxation therapy was significantly effective in reducing anxiety scores in comparison to the control group (MD = 5.87, 95% CI = 2.58, 9.17; p = 0.001), but auditory distraction was not (p = 0.14). Conclusion: Both auditory distraction and brief relaxation therapy were effective in reducing patient anxiety before a dental procedure. Furthermore, it would be interesting to learn if these findings remain consistent for more complex dental procedures, such as surgical removal of an impacted third molar.

Effectiveness of Virtual Reality for Pediatric Pain and Anxiety Management during Skin Prick Testing

This study investigated the effectiveness of virtual reality (VR) distraction, compared to comic book distraction and no distraction, in reducing pain and anxiety during a medical procedure in a pediatric population: the skin prick test. Although this test has many advantages and is considered to be minimally invasive, it causes anxiety and painful discomfort in children. Ninety-two children aged 7 to 17 years consulting for an allergic test received VR distraction, comic book distraction, or no distraction. Outcome measures included pain score, level of anxiety, and VR measures. The results showed that there were no significant differences between the three groups regarding sex, age, and preprocedural anxiety level. In the distraction groups (VR and comic book), children reported significantly lower pain and procedural anxiety scores than children with no distraction; VR distraction had a more significant effect than comic book distraction. A decrease in anxiety before and during the skin prick test is significantly more significant in VR distraction. This study suggested the effectiveness and feasibility of VR to reduce pain and anxiety during the pediatric skin prick test.

Is tablet-based interactive distraction effective on pain and anxiety during circumcision in children? A randomized controlled trial.

Distraction is a nonpharmacological method commonly used during painful procedures in children. However, there are a few studies investigating the effectiveness of active distraction on pain and anxiety in children during circumcision. The purpose of this study was to evaluate the effectiveness of tablet-based interactive distraction on pain and anxiety in children during circumcision. To evaluate how tablet distraction could improve children's outcomes during circumcision, a single-center, nonblinded, randomized controlled, parallel group trial research design was employed. In this study, 35 children were included in tablet distraction group, which have a control group (n ¼ 35). The primary outcome measure was the Numeric Rating Scale for pain. Secondary outcome measure was the State- Trait Anxiety Scale for Children, and other outcome variables were physiological parameters and satisfaction levels. During and after the surgical procedure, pain scores (P < .001, P < .001, respectively) and pulse rates (P < .001, P < .001, respectively) were significantly lower in the tablet distraction group, whereas O2 saturation was higher than the control group (P < .001, P < .001, respectively). After the procedure, the anxiety scores were significantly lower in the tablet distraction group (P < .001), whereas the satisfaction scores were higher than control group (P < .001). This study concluded that the use of tablet distraction during circumcision has a positive effect on children's pain, anxiety, satisfaction levels, and physiological parameters.

Investigation of The Effectiveness of Using Virtual Reality as A Distraction Technique in Children During Local Anesthesia Injection For Extraction of Primary Mandibular Molars

ABSTRACT Background: Local anesthesia injection for tooth extraction of primary molars is one among the causes of avoiding dental visits in children. Voice control and hand over mouth exercise are invasive and considered the least accepted techniques, a more accepted technique for children and their parents was needed. Aim:To evaluate the efficacy of virtual reality (VR) distraction on dental anxiety and pain perception to local anesthesia injection in pediatric dental patients during primary teeth extraction. Material and Methods: A prospective, parallel two arms randomized; clinical trial was performed on seventy-two children. Patients were (7-11) years old with unilateral carious non-restorable mandibular primary first molars required local anesthesia (LA) for extraction. Group (A) received treatment wearing virtual reality (VR) device and Group (B) received treatment using tell, show and do behavior management technique. Anxiety levels were measured using heart rate (HR) measuring before and after the injection while pain perception was assessed immediately after the injection using the Face, Legs, Activity, Crying and CONSOL ability scale (FLACC)and Facial Image Scale (FIS). Results: There was a statistically significant difference in heart rate mean values between both groups. Virtual reality (VR) distraction group showed better results in lowering anxiety during dental treatment. Conclusion: Virtual reality (VR) device for reducing anxiety to local anesthetic injection in children undergoing extraction of primary teeth.

79. Does facet distraction affect patient outcomes after ACDF?

<h3>BACKGROUND CONTEXT</h3> Intervertebral distraction in anterior cervical discectomy and fusion (ACDF) leads to indirect nerve decompression but has been associated with facet joint over-distraction that may lead to postoperative axial neck pain. <h3>PURPOSE</h3> The aim of this study is to determine if there is a correlation between the amount of facet distraction and postoperative patient-reported outcomes after ACDF. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort study. <h3>PATIENT SAMPLE</h3> All patients over age 18 who underwent one- to three-level ACDF for cervical spondylosis with associated radiculopathy and/or myelopathy at a single academic institution between 2010- 2015 were retrospectively identified. Patients with a traumatic injury, infection, malignancy, revision procedures or incomplete medical records were excluded. <h3>OUTCOME MEASURES</h3> Postoperative short- and long- term health-related quality of life outcomes: Neck Disability Index (NDI), Short Form-12 (SF-12), VAS Neck pain, and VAS Arm pain scores. Delta outcome, recovery ratio and %MCID achievement. <h3>METHODS</h3> A retrospective cohort analysis of patients undergoing ACDF for degenerative pathologies at a single academic center was performed. Each patient received upright, lateral cervical spine x-rays at the immediate postoperative time point from which interfacet distance (facet distraction) was measured. Patient-reported outcome measures were obtained preoperatively and at short-term (<3 months) and long-term (>1 year) follow-up. Receiver operating curves were generated to evaluate the possibility of a critical interfacet distraction distance. Univariate and multivariate analysis were performed to compare outcomes between groups based on the degree of facet distraction. <h3>RESULTS</h3> A total of 229 patients met the inclusion criteria. Receiver operating curves failed to yield a critical interfacet distraction distance associated with worse post-operative outcomes. Patients were instead grouped based on facet distraction distance below and above the third quartile (0.8mm-2.0mm, 2.0mm-3.7mm), with 173 and 56 patients in each respective group. Univariate analysis did not detect any statistically significant differences in outcome measures, recovery ratio, or % MCID achievement at short- and long-term follow-up between groups. Multivariate analysis also failed to demonstrate any significant differences between the facet distraction groups. <h3>CONCLUSIONS</h3> Increased interfacet distance did not correlate with increased neck pain or disability after an ACDF. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study.

BackgroundManaging a child's anxiety is most critical for the success of treatment in the pediatric dental setup. Present trend advocates the use of non-aversive behavior management techniques.Aim and objectiveTo compare and evaluate the efficacy of aromatherapy using orange essential oil with that of music distraction in the management of anxious pediatric dental patients.DesignOne hundred and fifty children of the age 6–8 years were divided into three groups of 50 each and performed restorative treatment under aromatherapy, with music distraction, without aromatherapy, or music distraction, respectively. Venham's picture test and facial image scale (FIS), pulse rate, respiratory rate, and oxygen saturation were recorded before and after the procedure.ResultsCompared with controls, both the aromatherapy group and music distraction group showed significant posttreatment change in anxiety levels with respect to Venham's picture test and FIS, along with the reduction in pulse rate and respiratory rate. When compared between music distraction and aromatherapy, it did not yield statistical significance, though music distraction showed better results compared to aromatherapy.ConclusionBoth music distraction and aromatherapy using orange essential oil are effective in anxiety management of which music distraction presents a comparatively better result. Either these non-invasive techniques alone or a combination of both may be employed in the dental setup of pediatric dentists for molding cooperative patients.How to cite this articleJames J, Retnakumari N, Vadakkepurayil K, et al. Effectiveness of Aromatherapy and Music Distraction in Managing Pediatric Dental Anxiety: A Comparative Study. Int J Clin Pediatr Dent 2021;14(2):249–253.

Preoperative video distraction alleviates separation anxiety and improves induction compliance of preschool children: a randomized controlled clinical trial

Objective: To explore the effect of video distraction on preoperative separation anxiety and induction compliance of preschool children receiving strabismus surgery under general anesthesia. Methods: In this prospective trial, 80 children aged 3 to 6 years scheduled for strabismus surgery under inhalation anesthesia were randomly allocated to one of two groups, a control group and a video distraction group, with 40 cases in each group. Children in the video distraction group continuously watched videos from waiting in the holding area, separating with parents, entering the operating room and induction of anesthesia, while children in the control group didn't watch videos during the same process. The modified Yale Preoperative Anxiety Scale (mYPAS) of children were recorded upon arriving at the holding area(T1)and separating with parents(T2). Induction Compliance Checklist (ICC) score was recorded when the anesthesia induction was performed. The emergence time, the occurrence rate of adverse events in post-anesthesia care unit (PACU) including nausea and vomiting, laryngospasm, severe cough, hypoxemia and sinus bradycardia, incidence of postoperative adverse reactions such as pain, dizziness, nausea and vomiting and lethargy, the parents' satisfaction of anesthesia were also assessed. Results: There were no significant difference in mYPAS score and the proportion of mYPAS score>30 between 2 groups at T1 (all P>0.05). At T2, the mYPAS score and the proportion of mYPAS score>30 in video distraction group were (34.41±13.23) and 52.50%, which were lower than those in control group (50.64±20.96, 87.50%) with statistically significant difference (all P<0.05). The ICC score of video distraction group was lower than that of the control group, which was (1.83±2.26) vs (4.03±2.99), and the difference was statistically significant (P<0.05). The proportion of children with ICC score=0 in video distraction group was 37.50%, which was higher than that in the control group (12.50%), while the proportion of children with ICC score=4-10 was lower than that of the control group, which was 17.50% vs 45.00%, and the difference was statistically significant (P<0.05). No significant intergroup differences were observed in emergence time, incidence of adverse events in PACU, and incidence of postoperative adverse reactions (P>0.05). The parents' satisfaction of anesthesia in the video distraction group was (9.23±0.89), which was higher than that in the control group (8.63±1.23), with statistically significant (P<0.05). Conclusion: Preoperative video distraction alleviates separation anxiety, improves induction compliance of preschool children receiving strabismus surgery under general anesthesia, and increases the parents' satisfaction of anesthesia.

Efficacy of Distraction for Reducing Pain and Distress Associated With Venipuncture in the Pediatric Posttransplant Population: A Randomized Controlled Trial.

Distraction can reduce pain and distress associated with painful procedures but has never been studied in children with solid organ transplants. We aimed to determine whether there is a difference in pain and distress associated with venipuncture in pediatric posttransplant patients who receive distraction compared with those who do not. Randomized controlled trial of children aged 4 to 17 years with solid organ transplants undergoing venipuncture in the outpatient setting. Patients were randomized to receive distraction or no distraction. The primary outcome was the Faces Pain Scale-Revised. Secondary outcomes were the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale. Exploratory outcomes included the number of venipuncture attempts, time to successful venipuncture, and satisfaction of phlebotomists and parents. Median age of the 40 children enrolled was 11.5 years. Type of transplants included the heart (67.5%), kidney (22.5%), liver (7.5%), and more than 1 organ (2.5%). There was no difference between the Faces Pain Scale-Revised scores in distraction and no distraction groups (1.4; 95% confidence interval, 0.9-1.9; and 1.3, 95% confidence interval, 0.5-2.1, respectively). There was also no difference in the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale scores, number of venipuncture attempts, or time to successful venipuncture. Phlebotomists were more satisfied with the venipuncture when distraction was implemented. In children with solid organ transplants, there was no difference in pain and distress associated with venipuncture between those who did and did not receive distraction. There was also no difference in other procedure-related outcomes except for greater phlebotomist satisfaction when distraction was implemented.

Accessibility of the metatarsal head comparing distraction and plantarflexion in a 2‐portal technique for first metatarsophalangeal (MTP 1) joint arthroscopy

Introduction/Purpose Arthroscopic treatment of osteochondral lesion of the first metatarsophalangeal (MTP1) joint is an established procedure. Non-invasive distraction is most commonly applied when a dorsal 2-portal technique is used. Alternatively, plantarflexion can be utilized. In order to compare the arthroscopic reachability of the first metatarsal head, a laboratory study in anatomical specimens was performed. Methods Twenty matched pairs (n=40) of fresh-frozen lower leg specimens were obtained and randomly assigned into two groups, a distraction (DIS) and a plantarflexion (PF) group, respectively. A standard 2-portal approach (dorsolateral and dorsomedial portals) with a 1.9mm 30° scope was used. The arthroscopic accessibility of the first metatarsal head was evaluated using chondral picks. Markings at the metatarsal heads were made intraoperatively and measured after exarticulation. Results In the DIS group the mean accessible area was 58.03%, while the accessible area in the PF group was 55.93%. Though there is a small difference between the two groups, this difference was not statistically significant (p=0.51). Range of motion of the MTP 1 joint did not affect reachability. In one specimen (2.5%) the dorsomedial hallucal nerve was injured during arthroscopy. Conclusion Access to the MTP1-joint for the treatment of osteochondral lesions is similar using distraction or plantarflexion during arthroscopy. The plantarflexion technique has the advantage of less surgical equipment needed. The dorsomedial hallucal nerve is at danger at the medial portal.

Effects of Using Music Methods, 3D Glasses and Behavioral Control on Children’s Anxiety during Dental Treatment

Introduction: Dental anxiety in children is a challenge in managing patients. The effect of this anxiety may continue until adolescence and be a reason for avoiding dental treatments. The aim of this study was compare the effectiveness of using music, 3D glasses and behavioral control methods on children’s anxiety during dental treatments. Materials and Method: This Experimental cross sectional study carried out on 96 children aged between 5-8 years without any systemic. The children were divided into three groups; control (basic behavior guidance techniques without distraction), audio (basic techniques plus music) and AV (basic techniques plus 3D AV) distraction groups. The anxiety score was assessed by using MCDASf method, before local anesthesia, after LA and after restoration. Pain rate measured with VAS and the behavior of children during dental treatment measured with Houpt index. Data were analyzed by one-way ANOVA with the 0.05 level of significance. Results: The mean of anxiety in different stages before starting work, after anesthesia and after repair, was significantly different in the 3D glasses group (p value = 0.004), using music (p value = 0.018) and behavioral control (p value = 0.002). The lowest anxiety level in the 3D glasses group and the highest anxiety in the control group was. The best group in reducing the amount of pain after anesthesia and cooperation was the 3D glasses group. Conclusion: Use of 3D glasses in dental treatment can decrease dental anxiety in children. And children cooperation with 3D glasses was better than other methods.

The effect on pain and anxiety levels of using DistrACTION® Cards to distract children during a skin-prick test: a randomized controlled experimental study.

The effect of using DistrACTION® Cards (MMJ Labs, Atlanta, GA, USA) to distract children aged 6-10 during a skin-prick test on their levels of pain and anxiety was explored in this study. The study was conducted as randomized, controlled, experimental research with a total of 104 children presenting at a hospital for a skin-prick test, 52 of whom comprised in the experimental and 52 in the control group. DistrACTION® Cards (MMJ Labs) were employed in the experimental group of children to distract their attention during a skin prick test by observer nurse. The observer nurse asked each child to look at the pictures on the cards and answer her questions. The pictures on the cards portray various details. The children's pain and anxiety levels were independently assessed on the basis of the feedback provided by the children, the observer nurse and the parents. The children's pain levels were assessed with the Wong-Baker Pain Scale (W-BPS) and their anxiety levels with the Children's Fear Scale (CFS). No intervention was carried out for the children in the control group. It was found that the children's pain scores during (distraction group [D]: 0.57±1.14; control group [C]: 3.15±3.07) and after the procedure (D: 0.05±0.23; C: 2.32±3.42) were significantly lower than those of the control group. It was seen that the anxiety scores of the experimental group during (D: 0.63±0.97; C: 2.69±1.26) and after the procedure (D: 0.11±0.37; C: 1.82±1.53) were significantly lower than those of the control group. It was observed that the use of DistrACTION® Cards (MMJ Labs) during a skin prick test was effective in reducing children's pain and anxiety levels.

Does Facet Distraction Affect Patient Outcomes After ACDF?

Retrospective cohort study. The aim of this study is to determine if there is a correlation between the amount of facet distraction and postoperative patient-reported outcomes after ACDF. A retrospective cohort analysis of patients undergoing 1 to 3 level ACDF for degenerative pathologies at a single academic center was performed. Each patient received upright, lateral cervical spine x-rays at the immediate postoperative time point from which interfacet distance (facet distraction) was measured. Patient-reported outcome measures including NDI, PCS-12, MCS-12, VAS Neck, and VAS Arm pain scores were obtained preoperatively and at short-term (<3 months) and long-term (>1 year) follow-up. Receiver operating curves were generated to evaluate the possibility of a critical interfacet distraction distance. Univariate and multivariate analysis were performed to compare outcomes between groups based on the degree of facet distraction. A total of 229 patients met the inclusion criteria. Receiver operating curves failed to yield a critical interfacet distraction distance associated with worse post-operative outcomes. Patients were instead grouped based on facet distraction distance below and above the third quartile (0.8mm-2.0mm, 2.0mm-3.7mm), with 173 and 56 patients in each respective group. Univariate analysis did not detect any statistically significant differences in outcome measures, recovery ratio, or % MCID achievement at short- and long-term follow-up between groups. Multivariate analysis also failed to demonstrate any significant differences between the facet distraction groups. Increased interfacet distance did not correlate with increased neck pain or disability after an ACDF.

Investigating the Effect of Axial Compression and Distraction on Cervical Facet Mechanics During Supraphysiologic Anterior Shear.

Bilateral cervical facet dislocation (BFD) with facet fracture (Fx) often causes tetraplegia but is rarely recreated experimentally, possibly due to a lack of muscle replication. Intervertebral axial compression (due to muscle activation) or distraction (due to inertial loading), when combined with excessive anterior translation, may influence interfacet contact or separation and the subsequent production of BFD with or without Fx. This paper presents a methodology to produce C6/C7 BFD+Fx using anterior shear motion superimposed with 300 N compression or 2.5 mm distraction. The effect of these superimposed axial conditions on six-axis loads, and C6 inferior facet deflections and surface strains, was assessed. Twelve motion segments (70 ± 13 yr) achieved 2.19 mm of supraphysiologic anterior shear without embedding failure (supraphysiologic shear analysis point; SSP), and BFD+Fx was produced in all five specimens that reached 20 mm of shear. Linear mixed-effects models (α = 0.05) assessed the effect of axial condition. At the SSP, the compressed specimens experienced higher axial forces, facet shear strains, and sagittal facet deflections, compared to the distracted group. Facet fractures had similar radiographic appearance to those that are observed clinically, suggesting that intervertebral anterior shear motion contributes to BFD+Fx.

Hydroxyapatite Nanoparticles Facilitate Osteoblast Differentiation and Bone Formation Within Sagittal Suture During Expansion in Rats.

BackgroundThe potential of relapse of craniofacial disharmony after trans-sutural distraction osteogenesis is high due to the failure to produce a stable bone bridge in the suture gap. The aim of this study is to evaluate whether hydroxyapatite nanoparticles (nHAP) have the effect of promoting osteoblast differentiation of suture-derived stem cells (SuSCs) and bone formation in sagittal suture during expansion.MethodsSuSCs were isolated from sagittal sutures and exposed to various concentrations of nHAP (0, 25, 50, and 100 μg mL−1) to determine the optimal concentration of nHAP in osteoblast differentiation via performing Western Blotting and RT-qPCR. Twenty 4-week-old male Sprague–Dawley rats were randomly assigned into 4 groups: SHAM (sham-surgery), distraction, ACS (absorbable collagen sponge) and ACS+nHAP groups. In the ACS and ACS+nHAP groups, saline solution and nHAP suspended in a saline solution were delivered by ACS placed across the sagittal suture, respectively. In the latter three groups, the suture was expanded for 14 days by 50 g of constant force via a W shape expansion device. Suture gap area, bone volume fraction (BV/TV) and bone mineral density (BMD) of sagittal sutures were assessed via micro-CT, while the mechanical properties of sagittal sutures were evaluated via nanoindentation test. The efficacy of nHAP on bone formation in sagittal suture was also evaluated via BMP-2 immunohistochemistry staining.ResultsThe expression of osteoblast related genes and proteins induced by 25μg mL−1 nHAP were significantly higher than the other groups in vitro (p<0.05). Furthermore, treating with 25μg mL−1 nHAP in vivo, the suture gap area was significantly reduced when compared with the distraction group. Correspondingly, the BV/TV, BMD, hardness and modulus of sagittal sutures were significantly increased in the ACS+nHAP group (p<0.05).ConclusionThe 25μg mL−1 dose of nHAP delivered by ACS can facilitate bone formation into the sagittal suture during expansion via inducing osteoblast differentiation of SuSCs.

Effect of Virtual Reality Distraction on Pain and Anxiety in Children during Local Anesthesia

The purpose of this study was to evaluate the effect of virtual reality distraction on pain and anxiety in children during local anesthesia. Local anesthesia was administered to 3 groups: a control group without distraction, a group watching TV, and a group using a virtual reality device. The pulse rate and oxygen saturation rate were measured before and at the time of local anesthesia to assess the patients’ pain and anxiety, and the Wong-Baker Faces Pain Rating Scale was completed after local anesthesia. The group using the virtual reality device had a significantly lower heart rate change and lower Wong-Baker Faces Pain Rating Scale score than those in the control group and the group watching TV (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The greatest difference in heart rate change and Wong-Baker Faces Pain Rating Scale score, between the control and virtual reality distraction groups, was seen in 5 - 7-year-olds and a Frankl’s behavior rating scale grade of 3. The virtual reality device alleviated pain and reduced anxiety in children during local anesthesia.

The effect of distraction on the quality of patient handoff: a randomized study.

The number of patient handoffs has increased in recent years. In addition, technology has advanced in the medical field, leading to most providers carrying smartphones at work. Little is known about the effect of mobile devices and quality of patient handoffs. The objective of this study was to determine whether distraction affects the quality of sign-out among obstetrical providers. A randomized, prospective study was conducted. Hospital. Obstetrical providers listened to a recorded sign-out vignette. Provider groups either were or were not exposed to a distraction while listening to the vignette. All providers had been told that they would be participating in a trial of two methods of sign-out, although in actuality they were all assigned to a single method. In the distraction arm, the participants were exposed to a 'distracting event' (a phone ring, which was answered by the proctor and followed by a brief conversation) that occurred midway through the vignette. Providers answered a 14-question survey testing recall of facts included in the vignette. The results of each group were analyzed using Fisher's exact test and Student's t-test. Eighty-eight providers were randomized, 44 in the distraction group and 44 in the non-distracted group. The average scores on the survey were similar between groups (11.0 and 10.8, P = 0.57). In addition, the average scores for questions that occurred after the distraction did not differ between the distracted and non-distracted groups (6.4 vs 6.2, P = 0.42). We observed that a phone ring and brief response did not affect the obstetrical providers' recall of details of a standardized sign-out. More studies are warranted to determine if more frequent or longer distractions would change results.

Evaluation of children's pain expression and behavior using audio visual distraction.

ObjectivesDental anxiety distresses children and their families with consequent poor oral health and costly pediatric dental services. Children's behaviors could be modified using a distraction technique for improved dental treatment. The study evaluates the effects of an audio‐visual distraction on children's behaviors and pain expressions during dental treatment.Material and MethodsOne hundred healthy children, between 4 and 6 years of age, were randomly assigned to one of two groups: audio visual distraction (AVD, N = 61) group and control (CTR, N = 39) group. The pre and post pain expression was collected using a faces pain rating scale from the participated children. Children's behavior was evaluated using the Frankl behavior rating scale by the assigned dentist. Data was analyzed using chi‐squared tests and analysis of variance.ResultsThe AVD group demonstrated more “definitely positive” behavior (91.8%) compared to the CTR group (35.9%) based on the Frankl scale evaluation from pre‐ and post‐treatment (p < 0.0001). The pain rating scale did not demonstrate a significant difference in post‐treatment pain scales (p = 0.2073) or changes in pain (p = 0.1532) between the AVD group and CTR group.ConclusionsThe AVD is an effective distraction tool for young children during dental treatment regardless of child's subjective pain expression.

Comparing the Effect of Aromatherapy and Distraction on the Pain Caused by Venipuncture in Hospitalized Children: Evidence from a Clinical Trial Study

Background: Pain is defined as an unpleasant sensory experience associated with actual or potential damage to body tissues. Therapeutic procedures cause fear in children, which in turn leads to physical and mental stress. Objectives: This study aimed to investigate and compare the effects of aromatherapy and distraction on the pain caused by venipuncture among hospitalized children. Methods: In this clinical trial study, 90 children hospitalized in the pediatric ward of Ali-Ebne-Abitaleb Hospital in Zahedan in 2018 are examined. The eligible children were selected using the convenience sampling technique and were divided into three groups (n = 30) using stratified permuted block randomization. In the distraction group, a Kolah Ghermezi (Red Hat) puppet was used to play with the children before and during venipuncture. In the aromatherapy group, lavender essence was used 20 minutes before the beginning of venipuncture. No intervention was provided in the control group. The children’s pain intensity was measured using OUCHER standard instrument 10 minutes after the end of venipuncture. Data were analyzed by SPSS version 24 using descriptive statistics, one-way ANOVA, Kruskal-Wallis, and post-hoc tests analyses. Results: A significant difference was found between the two intervention groups and the control group. Accordingly, both interventions could significantly decrease the pain intensity (P &lt; 0.001). However, there was no significant difference between the two intervention groups concerning the impacts of interventions on the pain intensity. Conclusions: A significant difference was found between the two intervention groups and the control group. Accordingly, both interventions could significantly decrease the pain intensity (P &lt; 0.001). However, there was no significant difference between the two intervention groups concerning the impacts of interventions on the pain intensity.

A Comparison of the Effect of Visual and Auditory Distractions on Physiological Indicators and Pain of Burn Dressing Change Among 6–12-Year-Oldchildren: A Clinical Trial Study

PourposeThis study aimed to compare the effect of audiovisual distraction on physiological indicators and pain of burn dressing change among 6–12 year-old children. Design and methodsThe study was a single-blind clinical trial with a three-group that sample size was 120 children aged 6–12 years admitted to the burn ward of Hamadan Besat Hospital. Data collection tools were the Oucher pain scale, a Cheklist form of the physiological Indicators, and apulse oximetry device. The cartoons were shown for visual group and the melodic poems were played for the auditory group 2 min before the dressing until the end of the procedure (at 2-min intervals). Data were analyzed by SPSS-16 software one-way, variance analysis and post-hoc Bonferroni test. ResultsTherewere statistically significant differences between visual, auditory and control groups in the mean pain intensity scores at all measurement times, the mean arterial blood oxygen saturation percentage at all measurement times except for the10 min before the dressing and the start of the procedure and the mean heart rate at all measurement times except for 10 min before dressing (p < 0.001). Post-hoc tests showed that the difference in the mean heart rate was related to the difference between the visual and auditory distraction groups during and at the end of the dressing (p < 0.05), the visual and control groups at all measurement times (P < 0.001) and the auditory and control groups at all measurement times (p < 0.05). ConclusionAudiovisual distraction is effective in reducing the fluctuations of physiological indicators and the burn dressing pain intensity in children at all times of measurement, especially during changedressing. Practice implicationsThe findings of this study are relevant to clinical practice because they suggest preparing children before and during a burning procedure situation.