Digi-PEPP

The aim of this research project is to evaluate the effectiveness of digital solutions for assessment and treatment of pain and its related emotions in pediatric patients and their parents.

Project information

Project duration

-

Project funder

TERTTU, Stiftelsen Alma & K.A. Snellman Foundation, Päivikki and Sakari Solhberg Foundation, Pediatric Research Foundation

Funding amount

103 000 EUR

Project coordinator

University of Oulu

Project description

The aim of the research project is to evaluate the effectiveness of digital solutions for assessment and treatment of pain and its related emotions in pediatric patients and their parents. The assessment of pain utilizes multimodal methods, which can be used to reliably and early identify the pain of critically ill children who are especially unable to communicate their pain. Pain management interventions are focused on non-pharmacological methods, because they create the basis of pain relief according to Käypä treatment recommendations. The research project includes several parts, such as (1) Monitoring and evaluation of pain in pediatric patients using the multimodal methods, (2) Treatment of pain and its related emotions in pediatric patients, and (3) Treatment of emotions in parents whose child is hospitalized. In order to develop pain assessment, we utilize new multimodal methods (e.g. NIRS, EMG) to identify the pain indicators of critically ill children who are unable to communicate their pain, and develop the algorithms at the same time. The interventions will focus on the effectiveness of (a) multisensorial nature-based intervention for children undergoing venous blood sampling, (b) “nucu” intervention including mother’s recorded heartbeat and feeling its vibration in infants requiring intensive care, and (c) mobile intervention based on trauma-informed care for parents who has hospitalized child. In addition, the project evaluates the effectiveness of (d) a new immersive game intervention (VR) when preparing children for magnetic resonance imaging (MRI), and the use of (e) a social robot when preparing children for pediatric day surgery using AI in alleviating their anxiety, fear, and pain. The effectiveness of the above interventions is evaluated through RCT or cross over study designs using valid measurements.

Project results

The results of the project's parts have been mainly reported as systematic literature reviews so far. The technology-based interventions used for pain management in neonates vary widely, ranging from playing a recording to a robot utilizing more demanding technology. Their effectiveness in relieving neonatal pain, either as a standalone method or in combination with another non-pharmacological method, was mixed. Instead, a meta-analysis about the effectiveness of preparation interventions for children’s day surgery showed a significant impact on parents’ anxiety, but none of the studies dealt with parental stress or fear in children. More RCT studies are needed about the effectiveness of digital interventions in pediatric nursing.

The most important published papers:

Palomaa A-K, Huhtala S, Tuomikoski A, Pölkki T. The effectiveness of technology-based interventions compared to other non-pharmacological interventions for relieving procedural pain in hospitalized neonates: a systematic review. JBI Evid Synth 2023; Aug 1;21(8): 1549–1581, doi: 10.11124/JBIES-22-00179. https://pubmed.ncbi.nlm.nih.gov/37218335/

Huhtala S, Palomaa A-K, Tuomikoski A, Pölkki T. Effectiveness of distraction-based interventions for relieving anxiety, fear and pain in hospitalized children during venous blood sampling: a systematic review protocol. JBI Evid Synth 2023; doi: 10.11124/JBIES-22-. https://pubmed.ncbi.nlm.nih.gov/37921627/

Kerimaa H, Hakala M, Haapea M, Vähänikkilä H, Serlo W, He H-G, Pölkki T. Effectiveness of a mobile app intervention for preparing preschool children and parents for day surgery: a randomized controlled trial. J Med Internet Res2023; 29;25:e46989. doi: 10.2196/46989. https://pubmed.ncbi.nlm.nih.gov/37773624/

Kerimaa H, Ruotsalainen H, Kyngäs H, Miettunen J. Pölkki T. Effectiveness of interventions used to prepare preschool children and their parents for day surgery: A systematic review and meta-analysis of randomized controlled trials. J Clin Nurs 2023; 32(9-10): 1705-1722. doi: 10.1111/jocn.16156. https://pubmed.ncbi.nlm.nih.gov/34870345/

Palomaa A-K, Tuomikoski A.M, Huhtala S, Pölkki T. The effectiveness of technology-based interventions compared to other non-pharmacological interventions for relieving procedural pain in hospitalized neonates: a systematic review protocol. JBI Evid Synth 2021; Jul 22;19(10):2770-776. doi 10.11124/JBIES-21-00010. https://pubmed.ncbi.nlm.nih.gov/34310486/

Partners

The research collaboration is doing with multidisciplinary team and local companies.

Most important partners: University of Oulu (Research Unit of Health Sciences and Technology, Research Unit of Clinical Medicine, Optoelectronics and Measurement Techniques (OPEM) research unit, Center for Ubiquitous Computing), University of Eastern Finland, National University of Singapore, Kyushu University (Japan), Oulu University Hospital, Kuopio University Hospital, Firstbeat Technologies Oy, Nucu Oy.