放松性音乐应用于缓解复杂阻生智齿拔牙焦虑的效果评价

目的 评价放松性音乐用于缓解复杂阻生智齿拔牙焦虑的效果.方法 选择需在门诊拔除复杂阻生智齿的患者200例,按照随机数字表法分为A组和B组,A组患者术前倾听放松性音乐30 min后再在音乐氛围中拔牙,B组患者门诊常规拔牙;于病情告知后、拔牙前用贝克焦虑量表（BAI）评定患者的心理状态并监测患者的血压、心率、呼吸频率;拔牙后运用视觉模拟疼痛评分法（VAS）对患者术中的疼痛程度进行评分.结果 病情告知后A、B两组患者BAI评分分别为（52.18±10.75）,（52.41±14.08）分,差异无统计学意义（t=0.13,P＞0.05）,但在倾听放松性音乐30 min后,A、B两组患者BAI评分分别为（38.24±6.59）,（54.12±9.95）分,A组优于B组,差异有统计学意义（t=13.31,P＜0.05）;术后A、B两组VAS评分分别为（1.96±0.84）,（3.42±0.91）分,A组优于B组,差异有统计学意义（t=11.79,P＜0.05）.结论 放松性音乐能有效缓解复杂阻生智齿拔除患者的术前焦虑;并能较好地减轻术中的疼痛及不适.     

虚拟现实技术减轻成人烧伤病人创面换药操作性疼痛的效果

[目的]探讨虚拟现实技术应用于成人烧伤病人换药期间对创面操作性疼痛辅助镇痛的效果。[方法]选择2017年1月—12月在我院烧伤整形科住院治疗的112例烧伤病人为研究对象,按入院先后顺序分为试验组57例和对照组55例,所有病人换药前常规进行创面水疗,由指定医师根据换药规范操作实施创面换药。试验组病人在换药前5 min使用虚拟现实系统分散病人注意力,对照组病人听音乐分散注意力。比较两组病人换药期间的3个疼痛主观评分。[结果]试验组换药中最痛得分为(5.0±1.8)分,疼痛关注时间为(3.7±1.9)min,疼痛不适得分为(4.3±2.0)分,对照组最痛得分为(7.7±1.7)分,疼痛关注时间为(7.5±1.8)min,疼痛不适得分为(6.6±1.4)分,两组比较差异均有统计学意义(P0.05)。[结论]虚拟现实技术能够有效缓解成人烧伤病人换药操作性疼痛,是一种有效的非药物性护理干预措施。     

虚拟现实技术减轻初产妇自然分娩时疼痛和焦虑的效果观察

[目的]观察应用虚拟现实技术(VR)减轻初产妇自然分娩时疼痛和焦虑的效果。[方法]将入院初产妇随机分为对照组及试验组,各80例。对照组初产妇采取常规护理措施,试验组产妇在分娩时采用VR干预。使用简版McGill疼痛问卷和焦虑自评量表调查产妇分娩时的疼痛和焦虑情况,比较两组产妇在分娩时的疼痛和焦虑情况。[结果]试验组产妇分娩时的视觉模拟疼痛评分、疼痛分级指数和现实疼痛强度得分分别为(6.93±1.63)分、(21.5±4.21)分、(3.57±0.63)分,明显低于对照组的(8.13±2.17)分、(27.3±3.17)分、(4.76±0.78)分(P0.01);试验组产妇分娩时的焦虑自评量表评分为(48.2±4.27)分,低于对照组的(59.8±6.16)分(P0.001)。[结论]应用VR干预可以有效减轻初产妇自然分娩时的疼痛,缓解分娩时的焦虑情绪。     

虚拟现实技术应用于超声波龈上洁治术对病人疼痛的效果研究

[目的]探讨在口腔科超声波龈上洁治术中应用虚拟现实技术对病人疼痛的影响。[方法]将160例接受超声波龈上洁治术的病人采用随机数字表法分为对照组和观察组。对照组采用常规的超声波龈上洁治术护理措施,观察组在常规的超声波龈上洁治术护理基础上使用虚拟现实技术进行干预。使用中文版Coach′s牙科焦虑量表、中文版简版McGill疼痛问卷对两组病人在洁治术过程中的焦虑状态和疼痛感受进行评估。[结果]观察组、对照组病人洁治术后的焦虑得分分别为(8.35±1.77)分、(13.67±2.75)分,经比较差异有统计学意义(t=14.55,P0.05);疼痛评估方面,观察组病人洁治术后疼痛分级指数(PRI)、视觉模拟量表(VAS)、现实疼痛强度量表(PPI)得分均低于对照组(P0.05)。[结论]超声波龈上洁治术中应用虚拟现实技术可以有效缓解病人的疼痛。     

微创拔牙术在特勤疗养员下颌智齿拔除术中的临床应用

目的观察微创拔牙技术在特勤疗养员下颌智齿拔除术中的临床应用效果。方法选择需拔除下颌智齿的特勤疗养员280例,随机分为两组,每组140例,即实验组(微创组)及对照组(传统组),分别用微创拔牙刀结合高速涡轮牙钻拔牙和传统拔牙器械拔除患牙,准确记录两种方法的手术时间、术后患者张口度、感染、肿胀、疼痛、满意度、干槽症等发生情况。结果运用微创拔牙刀结合高速涡轮牙钻拔牙与传统拔牙器械拔除患牙相比,拔牙时间明显缩短,差异具有高度统计学意义(P0.01),术后患者张口度、感染、肿胀、疼痛、满意度、干槽症等发生率的差异具有统计学意义(P0.05)。结论运用微创拔牙刀结合高速涡轮牙钻拔除特勤疗养员下颌智齿可达到无痛、安全、微创的效果;明显降低智齿拔除并发症。     

聚焦解决模式在慢性乙型肝炎护理中的应用

目的探讨聚焦解决模式在慢性乙型肝炎护理中的应用。方法 135例慢性乙型肝炎患者被随机分为试验组69例和对照组66例,试验组实施聚焦解决模式护理干预,对照组使用常规护理。比较2组患者干预前后的精神状态、社会支持、用药依从性及生活质量。结果干预后试验组焦虑得分(6.89±2.56)分低于对照组(10.95±3.80)分(P0.05);抑郁得分(3.11±1.59)分低于对照组(7.92±2.98)分(P0.05);总社会支持得分(35.87±4.38)分高于对照组(33.92±4.85)分(P0.05);用药依从性高于对照组(P0.05);生活质量各领域评分高于对照组(P0.05)。结论慢性乙型肝炎患者存在严重的焦虑抑郁情绪,治疗依从性较差。聚焦解决模式护理干预可缓解患者焦虑抑郁情绪,提高用药依从性和生活质量。     

高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术中的应用

目的:探讨在阻生智齿拔除术中应用高速涡轮牙钻及微创拔牙刀的效果。方法:选取66例于2015年1月~2016年12月我院接收的需要拔除阻生智齿的患者,随机分为对照组(n=33,采用常规拔牙方法拔牙)与观察组(n=33,采取微创拔牙法,术中使用高速涡轮牙钻及微创拔牙刀进行拔牙),观察两组患者手术效果。结果:观察组患者手术时间、拔牙完整性相比于对照组患者显著要优(P<0.05),其张口受限度、肿胀度及VAS评分显著低于对照组(P<0.05);同时观察组患者术中牙根折断、邻牙松动、牙龈撕裂、舌侧骨板骨折、术后干槽症的发生率均低于对照组(P<0.05)。结论:在阻生智齿拔除术中应用高度涡轮牙钻和微创拔牙刀可缩短手术时间,手术创伤小,术后反应轻,并发症少,具有推广价值。     

虚拟现实分散患者注意力减轻下肢血管性溃疡换药疼痛的效果观察

目的探讨虚拟现实分散患者注意力对下肢血管性溃疡换药的减痛效果。方法将90例下肢血管性溃疡患者,按首次换药的先后顺序,随机分为观察组和对照组各45例,观察组使用虚拟现实分散注意力,干预过程中患者观看3 D电影,对照组听音乐分散注意力,两组换药采用现有的常规方法由同一名伤口治疗师完成,采用数字疼痛计分尺和国际通用的0~10评分法评估换药时的疼痛及专注程度,并测定血压、心率。结果两组换药中的疼痛评分较换药前均降低,观察组明显低于对照组(P0.05),专注评分观察组明显高于对照组(P0.05);两组血压、心率均较换药前平稳(P0.05),组间比较基本一致(P0.05)。结论虚拟现实和听音乐均能缓解下肢血管性溃疡患者换药时的疼痛,稳定血压、心率,但虚拟现实因能提高专注程度,能获得更好的疼痛控制效果。     

认知松弛训练对改善口腔种植手术患者心理状况及术中疼痛的研究

目的探讨认知松弛训练对口腔种植手术患者焦虑恐惧、疼痛程度及生理指标的影响。方法将186例接受口腔种植的患者随机分为对照组和干预组各93例,2组均接受常规护理,干预组手术中给予认知松弛训练。采用改良牙科焦虑量表(modified dental anxiety scale,MDAS)测评患者焦虑程度,采用疼痛视觉模拟量表(visual analogue scale,VAS)测评患者疼痛程度,同时记录血压、心率。结果术前2组患者MDAS评分无统计学意义,术后干预组MDAS评分(10.46±0.95)分低于对照组的(12.23±0.81)分,2组比较,差异有统计学意义(t=-13.672,P=0.000);患者术中VAS疼痛评分干预组(4.86±1.01)分低于对照组的(5.94±1.12)分,2组比较差异有统计学意义(t=-6.906,P=0.000);患者术中心率低于对照组(t=-5.595,P=0.000),2组血压比较,差异无统计学意义。结论术中进行认知松弛训练能有效缓解口腔种植手术患者焦虑、恐惧情绪,减轻患者疼痛。     

优质护理在急性冠脉综合征患者急诊介入治疗中的临床效果分析

目的探索优质护理在急性冠脉综合征患者急诊介入治疗中的临床效果。方法选取2016年1月-2017年12月在本院接受急诊介入治疗的急性冠脉综合征患者92例为研究对象,随机分为试验组和对照组各46人。试验组开展优质护理,对照组开展常规护理,比较两组患者术后卧床时间、住院时间、术后并发症、焦虑情况及护理满意度评分情况。结果试验组和对照组患者术后卧床时间分别为(27.91±4.73)、(30.93±3.52)h;住院时间分别为(5.65±4.81)、(9.37±2.23)d;术后并发症的发生率分别为13.04%、39.13%;两组患者在三项临床指标上差异均有统计学意义(t=3.478,P=0.001;t=4.751,P0.001;χ~2=8.118,P=0.004)。试验组和对照组患者术后焦虑评分分别为(11.85±3.02)分、(14.61±4.18)分,两组的差异有统计学意义(t=3.631,P0.001)。试验组护理满意度得分为(91.89±5.03)分,对照组得分为(87.11±4.39)分,试验组高于对照组,二者差异有统计学意义(t=4.862,P0.001)。结论优质护理可以减轻急性冠脉综合征患者的心理负担,降低术后并发症的发生,提高护理满意度。     

Can virtual reality reduce pain and anxiety in pediatric emergency care and promote positive response of parents of children? A quasi-experimental study

AimTo evaluate the effectiveness of virtual reality to reduce pain and anxiety in pediatric patients during venipuncture procedure in emergency care and the behavioral response of their parents/companions.BackgroundVirtual reality is being used as a source of distraction in children undergoing invasive procedures.MethodsQuasi-experimental study with 458 children (from 2 to 15 years) who attended a pediatric emergency service from September 2019 to April 2021. An intervention based on virtual reality as a distraction method during venipuncture procedure was applied. The level of pain and anxiety of children and attitude of parents/companions were assessed. Ordinal and binary logistic regressions were applied.ResultsA protective effect of using virtual reality was observed in the intervention group both for the absence of pain (−4.12; 95 % CI: −4.85 to −3.40) and anxiety (−1.71; 95 % CI: −2.24 to −1.17) in children aged between 2 and 15 years. A significant reduction in the blocking response of the accompanying parents (−2.37; 95 % CI: −3.017 to −1.723) was also observed.ConclusionsVR is effective in reducing pain and anxiety in children during venipuncture in emergency care. A positive attitude of the parents during the invasive procedure to their children was found.     

Implementation of virtual reality technology to decrease patients' pain and nervousness during colonoscopies: a prospective randomised controlled single-blinded trial

BackgroundImproved patient satisfaction in endoscopy is worthy of study as it is an invasive and potentially uncomfortable procedure. There is growing literature on patient satisfaction assessment in endoscopy as part of improving quality assurance. This study aimed to determine whether virtual reality (VR) technology can decrease patients'' pain and nervousness during colonoscopies.MethodsPatients enrolled without sedation were randomly categorised into groups that watched VR (VR group; n=58) and those that did not watch VR (control group; n=59). The primary outcomes were pain score and skin conductance. Secondary endpoints included heart rate, systolic and diastolic arterial pressures, overall patient satisfaction, willingness to repeat the procedure, the difficulty of the procedure, the procedure duration, and bowel preparation.ResultsThe median (interquartile range (IQR)) pain scores were 7 (6–8) and 5 (4–6) in the control and VR groups, respectively (p<0.001). The median (IQR) skin conductance values after colonoscope insertion were 0.660 (0.490–0.840) and 0.390 (0.280–0.600) in the control and VR groups, respectively (p<0.001). Overall, patient satisfaction was significantly improved with the use of VR, along with a significant reduction in the difficulty perceived by the endoscopist.ConclusionVR technology helped to reduce patients'' pain and nervousness and to improve patients'' satisfaction during colonoscopies.KEYWORDS: colonoscopy, virtual reality, pain, satisfaction     

虚拟现实技术对初产妇第一产程进展的促进作用

目的 探讨虚拟现实技术(VR)应用于初产妇分娩过程中是否可以缩短产程时间及减轻产妇疼痛.方法 选择2017年12月至2018年12月在淮安市第一人民医院分娩的单胎足月初产妇,采用随机抽样的方法将产妇分为观察组和对照组,各90例.对照组产妇给予常规护理,观察组产妇在常规护理基础上给予VR辅助分娩,制定分娩时所需要营造的虚...     

Stereoscopic virtual reality does not improve knowledge acquisition of congenital heart disease

Advances in virtual reality have made it possible for clinicians and trainees to interact with 3D renderings of hearts with congenital heart disease in 3D stereoscopic vision. No study to date has assessed whether this technology improved instruction compared to standard 2D interfaces. The purpose of this study was to assess whether stereoscopic virtual reality improves congenital heart disease anatomy education. Subjects in a prospective, blinded, randomized trial completed a pre-test assessing factual and visuospatial knowledge of common atrioventricular canal and were randomized to an intervention or control group based on their score. The intervention group used a 3D virtual reality (VR) headset to visualize a lecture with 3D heart models while the control group used a desktop (DT) computer interface with the same models. Subjects took a post-test and provided subjective feedback. 51 subjects were enrolled, 24 in the VR group & 27 in the DT group. The median score difference for VR subjects was 12 (IQR 9–13.3), compared to 10 (IQR 7.5–12) in the DT group. No difference in score improvement was found (p?=?0.11). VR subjects’ impression of the ease of use of their interface was higher than DT subjects (median 8 vs 7, respectively, p?=?0.01). VR subjects’ impression of their understanding of the subject matter was higher than desktop subjects (median 7 vs 5, respectively, p?=?0.01). There was no statistically significant difference in the knowledge acquisition observed between the stereoscopic virtual reality group and the monoscopic desktop-based group. Participants in virtual reality reported a better learning experience and self-assessment suggesting virtual reality may increase learner engagement in understanding congenital heart disease.

     

The Effect of Using Virtual Reality During Breast Biopsy on Pain and Anxiety: A Randomized Controlled Trial

PurposeVirtual reality (VR) is a nonpharmacological method used in healthcare settings. This study aimed to determine the effectiveness of distraction through VR on pain and anxiety during fine needle aspiration (FNA) breast biopsy.DesignThis was a randomized controlled trial.MethodsA total of 60 Turkish females undergoing FNA breast biopsies were randomly divided into two groups. The patients in the experimental group (n = 30) viewed a specific scenario using VR from one minute before the procedure to the end of the procedure. The patients in the control group (n = 30) were subject to a standard protocol in which no anesthetic was given during the procedure. Immediately after the implementation of the FNA breast biopsy, the pain scores of all patients in groups were measured with the Visual Analogue Scale (VAS), and their anxiety levels were assessed with the State-Trait Anxiety Inventory.FindingsA statistically significant difference was determined between the post-procedure mean pain scores and average state anxiety scores of the patients in the experimental and control groups (P < .001).ConclusionsThe use of VR during FNA breast biopsy is effective in reducing pain and anxiety in adult female patients.     

Use of Virtual Reality for Reducing Pain and Anxiety After Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial

AimThe present study aimed to evaluate the effect of virtual reality on pain and anxiety in patients who had undergone laparoscopic sleeve gastrectomy.MethodThe study was conducted between September 1, 2019, and December 31, 2019, in the surgical intensive care unit at a government hospital. The participants were 110 patients who met the inclusion criteria and agreed to participate in the study. According to the study procedure, while the control group received standard care, the intervention group watched a virtual reality video. Data were collected with a personal information form, the Numeric Pain Rating Scale, and the Faces Anxiety Scale.ResultsThe mean post-test Numeric Pain Rating Scale score was significantly lower in the intervention group than in the control group (p < .001). However, the mean Faces Anxiety Scale scores did not differ significantly between the groups (p = .087).ConclusionsVirtual reality can effectively reduce pain and anxiety in patients who have undergone laparoscopic sleeve gastrectomy in intensive care units.     

Efficacy of Cartoon Viewing Devices During Phlebotomy in Children: A Randomized Controlled Trial

PurposeThe purpose of this study was to examine the efficacy of different cartoon viewing devices during phlebotomy in children.DesignThis study was a prospective, randomized controlled trial.MethodsThe study included inpatients from the Biochemical Laboratory of a private university hospital in Turkey and was conducted between September 2017 and April 2018. A computer-based random number generator was used to randomly assign the patients into three groups (virtual reality [VR], tablet, and control) with 40 children each. Data were collected using the Wong-Baker FACES Pain Rating Scale and the Children's Fear Scale. Pain and anxiety scores were reported by children, parents, and observers in tablet and control groups. In the VR group, pain and anxiety were determined only by children's reports.FindingsAccording to the children reports, the VR group reported significantly less pain and anxiety than those in the tablet and control groups (P < .05).ConclusionsThe cartoon distraction performed using a VR device reduced the perception of pain and anxiety during phlebotomy in school-age children.     

A Systematic Review of Virtual Reality Therapeutics for Acute Pain Management

ObjectivesThe purpose of this systematic review is to examine the delivery and clinical efficacy of virtual reality (VR) therapeutics for acute pain management in adults and identify practical considerations of VR deployment, as well as current gaps in the literature.DesignA systematic review.Data sourcesA search of PubMed, CINAHL, PsychINFO, Embase, Compendex, and Inspec was completed using Medical Subject Headings (MeSH) and keyword search terms related to acute pain and VR.Review/Analysis methodsA systematic review of all pertinent articles published between January 1, 2000, and August 1, 2020, was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.ResultsTwenty-three articles met final inclusion criteria and were included in this review. Studies utilized VR in a variety of settings for wound care, procedure-induced pain, physical or occupational therapy, dental treatment or generalized acute pain. A likely mechanism by which VR promoted analgesia in these studies is distraction. Of the reviewed studies, 19 (83%) reported decreases in pain intensity while using VR compared with no VR use or with a non-VR group.ConclusionsThis systematic review found VR to be an effective tool for acute pain management. Findings from this review also underscore the importance of addressing the patient's sense of presence and levels of immersion, interaction, and interest when deploying VR. Future VR studies should consider incorporation of anxiety, presence, and VR side effect measures in addition to acute pain metrics.     

Manipulating presence influences the magnitude of virtual reality analgesia

Excessive pain during medical procedures performed in unanesthetized patients is frequently reported, but can be reduced with virtual reality (VR) distraction. Increasing the person's illusion of going into the virtual world may increase how effectively VR distracts pain. Healthy volunteers aged 18-20 years participated in a double-blind between-groups design. Each subject received a brief baseline thermal pain stimulus, and the same stimulus again minutes later with either a Low Tech or a High Tech VR distraction. Each subject provided subjective 0-10 ratings of cognitive, sensory and affective components of pain, and rated their illusion of going inside the virtual world. Subjects in the High Tech VR group reported a stronger illusion of going into the virtual world (VR presence) than subjects in the Low Tech VR group, (4.2 vs. 2.5, respectively, P = 0.009) and more pain reduction (reduction of worst pain is 3.1 for High Tech VR vs. 0.7 for Low Tech VR, P < 0.001). Across groups, the amount of pain reduction was positively and significantly correlated with VR presence levels reported by subjects ( r = 0.48 for 'worst pain', P < 0.005).     

基于虚拟现实技术的功能锻炼对术后脑出血患者神经功能康复的作用

目的探讨基于虚拟现实技术的功能锻炼对脑出血后的老年患者神经功能康复的作用。 方法2017年1月至2018年6月前瞻性收集张家港市中医医院收治的脑出血患者110例,随机分为观察组和对照组,各55例。观察组给予基于虚拟现实技术的功能锻炼,对照组给予常规功能锻炼,2组治疗时间均为6个月。采用简化Fugl-Meyer运动功能评分法、Berg平衡量表评估患者的运动和平衡功能,采用Barthel指数和简易精神状态检查（MMSE）量评价患者的生活能力和认知功能,采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评估患者的心理健康状况。 结果2组治疗前简化Fugl-Meyer运动功能、Berg平衡量表评分差异无统计学意义（P＞0.05）,治疗后2组上述功能评分均较治疗前增高（P＜0.05）,且观察组高于对照组（P＜0.05）。2组治疗前Barthel指数和MMSE评分差异无统计学意义（P＞0.05）,治疗后2组评分均较治疗前增高（P＜0.05）,且观察组高于对照组（P＜0.05）。2组治疗前SAS和SDS评分差异无统计学意义（P＞0.05）,治疗后2组评分较治疗前降低（P＜0.05）,且观察组低于对照组（P＜0.05）。 结论基于虚拟现实技术的功能锻炼可以显著改善脑出血后的老年患者神经功能康复情况,提高患者生存质量。