Developing BrightHearts: a pediatric biofeedback mediated relaxation app to manage procedural pain and anxiety

Objective The objective of this study was to develop a child-friendly biofeedback mediated relaxation device called “BrightHearts”. Methods Qualitative data were collected at a tertiary pediatric hospital to inform an iterative design process. Clinicians participated in expert group interviews to identify practical considerations which would facilitate the use of BrightHearts during procedures and provide feedback on prototype designs. Children aged 7-18 years participated in interactive exhibitions of the prototypes and were interviewed about their experience using BrightHearts. Results Twenty-four clinicians participated in 6 group interviews. Thirty-nine children participated in interactive exhibitions and 21 were interviewed. Clinicians placed high value on the following factors in the management of procedural pain: providing children with an element of control, the use of relaxation techniques, the use of portable electronic devices such as iPads (Apple Inc Cupertino CA). They highlighted the need for BrightHearts to be cost effective, portable and capable of engaging childrens’ interest. They confirmed the utility of developing a biofeedback assisted relaxation device for children. Based on the factors identified by clinicians BrightHearts was developed as an iPad app paired with a wireless heart rate monitor. The BrightHearts heart rate biofeedback application displays a digital geometric artwork which responds to changes in heart rate. Children aged 7 to 17 years understood the concept of biofeedback and operate the app by slowing their heart rate. Conclusion The BrightHearts app can be used to teach children biofeedback assisted relaxation. Ongoing studies are evaluating its efficacy for the management of procedural pain in children. This article is protected by copyright. All rights reserved.