By Susan Pedwell
Seeing how fascinated her own children were with electronic devices such as smartphones, Jennifer Stinson wondered if the technology could teach adolescents with chronic diseases how to optimally control their symptoms.
“If adolescents with painful chronic health conditions could learn how to better manage their pain, they might be able to reduce pain throughout their lifetime and have fewer limitations,” said the Bloomberg Nursing associate professor (status).
Dr. Stinson went on to develop e-health (Internet-based) programs and m-health (mobile-phone) apps that she hopes more physicians and nurses will prescribe to their patients. The health care providers in the Chronic Pain Program at the Hospital for Sick Children, where Stinson practises one day a week, are already writing prescriptions for her app.
Make it a game
Stinson’s Pain Squad app invites adolescents with cancer to join a fantasy police unit that hunts down pain. Twice a day, police headquarters sends an alert to their smartphones to tell them it’s time for their pain-recording mission, which they fulfil by completing a questionnaire on their pain intensity, duration, location and impact. They also record how medications and psychological strategies affected their pain.
While undergoing radiation and chemotherapy, patients can be too tired to even hold a pen, let alone write a description of their pain. But an amazing 85 per cent of the youth in Stinson’s study found Pain Squad so compelling that twice a day for two weeks they turned to their phones to record their pain experiences.
To encourage this level of compliance, Stinson asked the development company to build a reward system into the app. As users complete the questionnaires they collect points, allowing them to work their way up the ranks from Rookie to Silver Star.
Then, Stinson invited the casts of Canada’s top police dramas – “Rookie Blue” and “Flashpoint” – to be part of Pain Squad. The videos that Stinson’s team filmed are interspersed throughout the app, inspiring kids to put pain in its place. “Your squad is still fighting,” says famed actor Enrico Colanti in one clip. “We couldn’t have done it without you. Way to go.”
From their smartphones, the youth can email a report to their doctor or nurse, or print it to take to their next appointment. “The app facilitates communication,” says Stinson, a clinician scientist in Child Health Evaluative Sciences at SickKids.
Now Stinson is modifying the app for teens with juvenile idiopathic arthritis and those with chronic pain. She’s also developing Pain Squad+, which will help teens with cancer not only track their pain but help them manage it by providing advice in real time.
And this spring, Stinson carried a two-foot-tall robot into SickKids. The robot can hold your hand and speak, and is named Medi – short for Medicine and Engineering Designing Intelligence. Cute and cheerful, Medi has an uncanny way of captivating a child’s attention.
Dr. Tanya Beran, a researcher at Alberta Children’s Hospital in Calgary, tested Medi with children getting a flu vaccination. “They barely noticed they were having a needle,” she reports, adding that Medi reduced the pain from the needle by half in four- to nine-year-olds.
Beran is developing software for Stinson’s study that will examine Medi’s effect on children undergoing a needle to access a subcutaneous port. In the study of 20 children aged four to nine, the robot will dance to distract half of them from the needle. For the other children, Medi will talk them through the procedure using evidence-based distraction strategies, starting off by saying, “I’m here to help you today. The nurse will wipe down your skin. Why don’t we take a deep breath now?”
At the end of each intervention, Medi will raise his robotic arm and say: “Give me a high-five!”
This story originally appeared in the Spring/Summer 2015 issue of Pulse Magazine.
MEDI PHOTO: Robert Teteruck, The Hospital for Sick Children
COVER PHOTO: Stephen Uhraney