Maimonides Evening of Research
Staff Winner
Mahlaqa Butt
TAKE-PAUSE: Efficacy of Mindfulness as an Intervention in the Pediatric Emergency Department
Submitter
Mahlaqa Butt, MPH (Medical Student and/or Staff): Mentor: Jared Brazg, MD Department of Emergency Medicine
Mahlaqa Butt, MPH; Sarah Kabariti, MPH; Dumeetha Luthra; Antonios Likourezos, MA, MPH Rukhsana Hossain, MPH; Sergey Motov, MD; Jared Brazg, MD
Objectives
Emergency Department (ED) visits can be a particularly stressful experience for pediatric patients. We hypothesize that mindfulness-based virtual reality is more effective than standard distraction techniques in alleviating anxiety levels in adolescent patients presenting to the ED.
Methods
A prospective, randomized, single-blinded trial was conducted evaluating pediatric ED patients aged 13 to 17 years with acute pain. Enrolled patients were randomized to two groups: Group 1 (standard of care): 5 minutes of play time on a hospital iPad (passive distraction technique); and Group 2: 5 minutes of Take-Pause virtual reality simulation (mb-VR intervention arm) shown through a virtual reality headset. The primary outcome was decrease in situational anxiety level on the Spielberger State-Trait Anxiety Inventory (STAI: Y-6 Item). The STAI: Y-6 Item ranges from a total score of 20 to 80 with a higher score indicating severe anxiety. Secondary outcomes included respiratory rate (RR) and heart rate (HR) changes. Follow-up was conducted at 5-minute post-intervention.
Results
We enrolled 110 subjects (55 per group) based on sample size calculation. The demographic characteristics were similar for both groups (P>.05). The mean anxiety score improved for both groups, however, the biggest improvement was for Group 2; a reduction difference of 10 points vs. 6 points for Group 1 (P<.05; 95% CI:.43 to 7.6). At baseline the anxiety score for Group 2 was 42 and Group 1 was 41 (P=.628) and at 5 minutes improved to 32 and 35 respectively (P=.144). A trend was noticed of mean difference reduction in HR for Group 2; a difference of 3 points vs 0 points for Group 1 (P=.061; 95% CI:-.15 to 6.3). At baseline the HR for Group 2 was 84 and Group 1 was 83 (P=.540) and at 5 minutes was 81 and 83 respectively (P=.311). No difference between the groups for RR (P>.05)
Conclusion Implication
Take-Pause, a virtual reality-based mindfulness tool, is more effective than passive distraction techniques to significantly lower anxiety levels and heart rate in adolescent patients presenting to the pediatric emergency room. Pediatricians everywhere may use Take-Pause to significantly reduce pediatric patient’s anxiety and improve patient compliance and care.