Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Wong, Cho Lee; Choi, Kai Chow

doi:10.1001/jamanetworkopen.2023.0001

Cited by 31 publications

(16 citation statements)

References 51 publications

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“…The IVR arm provided visual and auditory stimuli alongside procedural information tailored to age via a head-mounted display. Pain and anxiety were assessed using reliable and validated self-scoring systems: Faces Pain Scale–Revised and Visual Analogue Scale 4…”

Section: Effects Of An Immersive Virtual Reality Intervention On Pain...mentioning

confidence: 99%

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Clarke,

Alawiye,

Anderson

et al. 2023

Emerg Med J

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Section: Effects Of An Immersive Virtual Reality Intervention On Pain...mentioning

confidence: 99%

Journal update monthly top five

Clarke,

Alawiye,

Anderson

et al. 2023

Emerg Med J

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“…However, music interventions may require interventionists to receive adequate professional training to develop tailored music experiences, which may be limited in some health care settings. Distraction approach interventions, such as videos, multifaceted programs, interactive games, virtual reality (VR), and low sensory stimulation, have also been studied in the context of managing anxiety, particularly in children undergoing medical procedures and surgical procedures . However, the evidence for their effectiveness in the adult population remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality–Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery

Chiu,

Li,

Yap

et al. 2023

JAMA Netw Open

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IMPORTANCEPreoperative anxiety is common among adult patients undergoing elective surgery and is associated with negative outcomes. Virtual reality (VR)–based interventions have been considered simpler, safer, and more effective for reducing anxiety in patients undergoing surgery than conventional care.OBJECTIVETo examine the effectiveness of a VR-based intervention with preoperative education in reducing preoperative anxiety among adult patients undergoing elective surgery.DESIGN, SETTING, AND PARTICIPANTSAn assessor-blinded prospective randomized clinical trial was conducted to recruit adult patients aged 18 years or older who were scheduled for their first elective surgery procedure under general anesthesia within the next 2 to 4 weeks at a preanesthesia assessment clinic in Hong Kong from July to December 2022.INTERVENTIONSParticipants were randomly assigned to either an intervention group (an 8-minute immersive 360° VR video tour in the operating theater via a head-mounted display console) or a control group (standard care).MAIN OUTCOMES AND MEASURESThe primary outcome of preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (range, 6-30; higher scores indicate greater anxiety), and the secondary outcomes (ie, stress, preparedness, and pain) were assessed by Visual Analog Scale at 3 time points: baseline at beginning of clinical session (T0), at the end of the clinical session immediately after the intervention (T1), and before the surgery (T2). Pain, satisfaction levels, and postoperative length of stay were evaluated after the surgery (T3). Simulation sickness was assessed after the intervention by use of the Simulation Sickness Questionnaire. A generalized estimating equations model was applied to compare changes in outcomes over time.RESULTSA total of 74 participants (mean [SD] age, 46.34 [14.52] years; 38 men [51.4%] and 36 women [48.6%]) were recruited and randomized to the control group (37 participants) and intervention group (37 participants). Compared with the control group, the VR-based intervention group showed significantly decreased preoperative anxiety at T1 (β, −5.46; 95% CI, −7.60 to −3.32; P &lt; .001) and T2 (β, −5.57; 95% CI, −7.73 to −3.41; P &lt; .001), lower stress at T1 (β, −10.68; 95% CI, −16.00 to −5.36; P &lt; .001) and T2 (β, −5.16; 95% CI, −9.87 to −0.45; P = .03), and higher preparedness at T1 (β, 6.60; 95% CI, 0.97 to 12.19; P = .02). Satisfaction levels were significantly increased in the intervention group vs the control group (mean [SD] score, 81.35 [9.24] vs 65.28 [8.16]; difference, 16.07; 95% CI, 12.00 to 20.15; P &lt; .001). No significant differences in pain and postoperative length of stay were found.CONCLUSIONS AND RELEVANCEThe findings of this study suggest that a VR-based intervention is a feasible and effective way to reduce preoperative anxiety in adult patients undergoing elective surgery. Given the promising results of this study, further study in the form of large-scale, multicenter, randomized clinical trials with broader implementation is warranted.TRIAL REGISTRATIONChinese Clinical Trial Registry Identifier: ChiCTR2100051690

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“…Increasingly, non-pharmaceutical interventions have been explored for procedural pain management, with virtual reality (VR) being one of these promising interventions [8]. Numerous studies have found that VR significantly decreases procedural pain and anxiety [9][10][11][12][13]. VR is hypothesized to have effective pain management by creating a 3-dimensional distraction that limit the user's perception of painful stimuli [14].…”

Section: Introductionmentioning

confidence: 99%

Pilot randomized clinical trial of virtual reality pain management during adult burn dressing changes: lessons learned

Armstrong

Coffey²,

Luna

et al. 2023

Preprint

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Opioids are the most frequently used pain medications by US burn centers to control severe procedural pain during wound care. Concerns for long-term opioid use have prompted the exploration of non-pharmaceutical interventions, such as virtual reality (VR), for procedural pain management. The primary objective of this pilot study was to evaluate the feasibility and efficacy of VR pain alleviation treatment on reducing adult burn patients’ perceived pain during burn dressing changes. Adult patients aged 18-70 years were recruited from the inpatient unit of a single American Burn Association–verified burn center between May 2019 and February 2020 and randomly assigned to one of three arms. Active VR participants played four VR games; passive VR participants were immersed in the same VR environment without the interaction elements; and a standard of care control group. 71 patients were screened for eligibility and 33 were deemed eligible to approach for informed consent, with 14 agreeing to participate in this study. Of these 14 patients, 4 were randomly assigned to the active VR, 4 to the passive VR, and 6 to the control group. Self-reported overall pain was lowest among participant in the active VR (dressing 1= 41.3, dressing 2= 61.0, and dressing 3= 72.7) and highest among participants in the passive VR (dressing 1= 58.3, dressing 2= 74.5, and dressing 3= 89.0) across all three dressing changes. Self-reported worst pain was lowest among the active VR at the first and last dressing (64.3 and 92.2, respectively), but the control group has the lowest self-reported worst pain at the second dressing (71.3). VR is a useful non-pharmacological tool for pain distraction but designing and implementing clinical research studies face many challenges in real-world medical settings. Lessons from this study have important implications for future VR studies by other researchers.

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Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Cited by 31 publications

References 51 publications

Journal update monthly top five

Journal update monthly top five

Virtual Reality–Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery

Pilot randomized clinical trial of virtual reality pain management during adult burn dressing changes: lessons learned

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