Uporaba navidezne resničnosti za obvladovanje bolečine in tesnobe pri otrocih in mladostnikih med lumbalno punkcijo : magistrsko delo

Prezelj, Tjaša (avtor), Gosar, David (mentor), Kreft, Ivana (komentor)

Invazivni medicinski posegi, med drugim lumbalna punkcija, pri pacientih vzbujajo veliko anticipatornega strahu, tesnobe in bolečine. Kot alternativni pristop za lajšanje negativnih vidikov se je razširila uporaba navidezne resničnosti (VR), predvsem v obliki distrakcije, ki predstavlja obetaven nefarmakološki način obvladovanja bolečine in tesnobe. Namen magistrske raziskave je bil preučiti učinkovitost izbrane VR intervencije v eksperimentalnem okolju in raziskati možnosti njene implementacije med lumbalno punkcijo v realnem bolnišničnem okolju. V eksperimentalni študiji je sodelovalo 28 otrok in mladostnikov, starih med 10 in 15 let, ki so izvedli preizkušnjo z izpostavitvijo hladni vodi v treh pogojih: brez VR, s standardnim VR okoljem in z možnostjo izbire VR okolja. S pomočjo bayesovske analize smo ugotovili, da je uporaba VR distrakcije pozitivno vplivala tako na toleranco kot na intenzivnost bolečine, medtem ko za mero tesnobe ni bilo dovolj močnih dokazov za zanesljive zaključke. Možnost izbire navideznega okolja ni dodatno prispevala k učinkovitosti VR distrakcije. Vsa vključena VR okolja so se izkazala kot ustrezna, zato smo jih uporabili tudi v kliničnem delu študije. VR smo uspešno implementirali pri dveh pacientih, starih 11 in 15 let, med posegom lumbalne punkcije na Kliničnem oddelku za otroško hematologijo in onkologijo na Pediatrični kliniki UKC Ljubljana. Oba udeleženca sta uporabo VR opisala pozitivno, izrazila željo po ponovni uporabi in nista poročala o neželenih učinkih, povezanih z uporabo VR opreme. Intervencijo so pozitivno ovrednotili tudi starši in prisotno medicinsko osebje. Ugotovitve torej podpirajo uporabo VR distrakcije kot potencialne dodatne alternativne strategije za obvladovanje bolečine in tesnobe med lumbalno punkcijo, pri čemer sta za njeno učinkovitost potrebni tudi ustrezna predpriprava pacienta in tehnična izvedba. Za zanesljivejše zaključke pa so potrebne nadaljnje večje študije in potencialno razvoj VR aplikacije, primernejše za položaj in specifike posega lumbalne punkcije.

• Jezik: Slovenski jezik
• Ključne besede: navidezna resničnost, obvladovanje bolečine, obvladovanje tesnobe, medicinsko zdravljenje, mladostniki
• Vrsta gradiva: Magistrsko delo/naloga
• Tipologija: 2.09 - Magistrsko delo
• Organizacija: FF - Filozofska fakulteta
• Kraj izida: Ljubljana
• Založnik: [T. Prezelj]
• Leto izida: 2026
• Št. strani: 76 str.
• PID: 20.500.12556/RUL-188765
• UDK: 159.97:616-08-053.2/.6(043.2)
• COBISS.SI-ID: 294644483
• Datum objave v RUL: 27.09.2026

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Use of virtual reality for pain and anxiety management in children and adolescents during lumbar puncture

Izvleček

Invasive medical procedures, including lumbar puncture, cause patients to experience significant anticipatory fear, anxiety, and pain. As an alternative approach to alleviating these negative effects, the use of virtual reality (VR) has become widespread, primarily as a form of distraction, which represents a promising non-pharmacological method for managing pain and anxiety. The aim of this thesis was to examine the effectiveness of a selected VR intervention in an experimental setting and to explore the possibilities for its implementation during lumbar punctures in a real-world hospital setting. The experimental study included 28 children and adolescents aged 10 to 15 years who underwent a cold-pressor test under three conditions: without VR, with a standard VR environment, and with the option to choose a VR environment. Using Bayesian analysis, we found that the use of VR distraction had a positive effect on pain tolerance and reduced pain intensity, while there was insufficient evidence regarding anxiety levels to draw reliable conclusions. The option to choose a virtual environment did not further enhance the effectiveness of VR distraction. All included VR environments proved to be appropriate, so we also used them in the clinical study. We successfully implemented VR in two patients, aged 11 and 15, during a lumbar puncture procedure at the Clinical Department of Pediatric Hematology and Oncology at the Pediatric Clinic of the University Medical Center Ljubljana. Both participants described their VR experience positively, expressed a desire to use it again, and reported no adverse effects related to the use of VR equipment. The intervention was also positively evaluated by the parents and the medical staff present. The findings thus support the use of VR distraction as a potential additional alternative strategy for managing pain and anxiety during lumbar puncture, although its effectiveness also requires appropriate patient preparation and technical execution. However, further large-scale studies and potentially the development of a VR application better suited to the position and specifics of the lumbar puncture procedure are needed to draw more reliable conclusions.

• Ključne besede: virtual reality, pain management, anxiety management, medical treatment (general), adolescents