Immersive Virtual Reality for Pediatric Procedural Pain: A Randomized Clinical Trial

Walther-Larsen, S; Petersen, T H; Friis, Susanne Molin; Aagaard, Gitte; Drivenes, Bergitte; Opstrup, Pernille

doi:10.1542/hpeds.2018-0249

Cited by 76 publications

(71 citation statements)

References 27 publications

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“…Distraction is one of the most effective nonpharmacological methods for reducing pain and anxiety experienced by pediatric patients receiving needle-related procedures (Gerçeker et al, 2020; Jibb et al, 2015; Uman et al, 2013; Wong et al, 2019). VR, which is a distraction method, is a very popular and innovative technology (Walther-Larsen et al, 2019). VR is a tool that helps users experience computer-simulated reality with visual, auditory, tactile, and olfactory dimensions (Matsangidou et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Koç Özkan & Polat (2020) investigated the effect of VR goggle and kaleidoscope during venipuncture among children aged 4 to 10 years, and they found that the children, their parents and the observer reported less pain and anxiety for children in VR goggles. In a randomized clinical trial by Walther-Larsen et al (2019), the effect of VR on patient satisfaction and pain reduction during venipuncture was investigated in children aged 7 to 16 years, and it was found that even though it was not effective on pain, the use of VR increased parents’ satisfaction. In light of these results, it can be said that VR is a useful distraction method for reducing procedural pain in children.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Semerci

Kostak

Eren

et al. 2020

J Pediatr Oncol Nurs

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Purpose: Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years. Method: Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children’s self-reports and parents’ proxy reports, using the Wong–Baker FACES Pain Rating Scale. Results: Descriptive characteristics of the children ( n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group ( n = 36; 5.03 ± 3.35) experienced more pain than the children in VR group ( n = 35; 2.34 ± 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 ± 2.46) were found to be lower than those in the control group (4.67 ± 2.56; p < .001). Conclusions/Implications for Practice: VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Semerci

Kostak

Eren

et al. 2020

J Pediatr Oncol Nurs

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“…Standard of care ranges from no intervention to certified child life specialist support with use of a variety of cognitive or behavioral strategies. Data on virtual reality (VR) have overall demonstrated improved pediatric pain and anxiety during venipuncture [ 1 - 4 ], although 1 study found no change in pain [ 5 ]. These studies evaluated VR games that cater to a medical procedure (eg, a field of view that minimizes head movement or interaction that does not require a hand controller) [ 1 - 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Coping During Venipuncture With Virtual Reality: Pilot Randomized Controlled Trial

Canares¹,

Parrish²,

Santos³

et al. 2021

JMIR Pediatr Parent

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Background Virtual reality (VR) has shown promise in reducing children’s pain and anxiety during venipuncture, but studies on VR lack objective observations of pediatric coping. Notably, the process of capturing objective behavioral coping data can be labor- and personnel-intensive. Objective The primary aims of this pilot trial were to assess the feasibility of conducting a trial of VR in a pediatric emergency department and the feasibility of documenting observed coping behaviors during pediatric procedures. Secondarily, this study examined whether VR affects child and caregiver coping and distress during venipuncture in the pediatric emergency department. Methods This stratified, randomized, controlled pilot trial compared coping and distress between child life–supported VR engagement and child life specialist support without VR during painful procedures in children aged 7-22 years in the pediatric emergency department. An external control (reference group) received no standardized support. Primary feasibility outcomes included rates of recruitment, rates of withdrawal from VR, and rates of completed Child Adult Medical Procedure Interaction Scale-Short Form (CAMPIS-SF) observations. Secondary clinical outcomes were applied to venipuncture procedures and included CAMPIS-SF coping and distress (range 0-1.0), pain and anxiety on a visual analog scale (range 0-10), and cybersickness symptoms. Results Overall recruitment was 93% (66/71), VR withdrawal rate was 27% (4/15), and of the completed procedures, 100% (63/63) CAMPIS-SF observations were completed. A total of 55 patients undergoing venipuncture in the pediatric emergency department were included in the analyses of clinical outcomes: 15 patients (15 caregivers) randomized to VR, 20 patients (15 caregivers) randomized to child life specialist support, and 20 patients (17 caregivers) in the reference group. Patient coping differed across groups with higher coping in the VR group and child life specialist group than in the reference group (P=.046). There were no significant differences in the distress and pain ratings for patients and caregivers between the groups. Caregivers rated the lowest perceived anxiety in the child life specialist group (P=.03). There was no apparent change in cybersickness symptoms before and after VR use (P=.37). Conclusions Real-time documentation of observed behaviors in patients and caregivers was feasible during medical procedures in which VR was utilized, particularly with the availability of research staff. VR and child life specialists improved coping in children during venipuncture procedures. Given the high participation rate, future studies to evaluate the efficacy of VR are recommended to determine whether an off-the-shelf VR headset can be a low-cost and low-risk tool to improve children’s coping during venipuncture or other related procedures. Trial Registration ClinicalTrials.gov NCT03686176; https://clinicaltrials.gov/ct2/show/NCT03686176

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“…A large proportion of the observed variation (I 2 92.72%) was found to reflect differences in true effect sizes. Six studies reported results in favor of the control/non-VR group (Hoge et al, 2012;Jeffs et al, 2014;Mitrakul et al, 2015;Bagattoni et al, 2018;Eijlers et al, 2019a;Walther-Larsen et al, 2019). Potential sources of heterogeneity are assessed in the 'Additional Analyses' section.…”

Section: Results Of Individual Studies and Syntheses Of Resultsmentioning

confidence: 99%

The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics: A Systematic Review and Meta-Analysis

Nordgård

Låg

2021

Front. Virtual Real.

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Distraction and procedural preparation techniques are frequently used to manage pain and anxiety in children undergoing medical procedures. An increasing number of studies have indicated that Virtual Reality (VR) can be used to deliver these interventions, but treatment effects vary greatly. The present study is a systematic review and meta-analysis of studies that have used VR to reduce procedural pain and anxiety in children. It is the first meta-analytic assessment of the potential influence of technical specifications (immersion) and degree of user-system interactivity on treatment effects. 65 studies were identified, of which 42 reported pain outcomes and 35 reported anxiety outcomes. Results indicate large effect sizes in favor of VR for both outcomes. Larger effects were observed in dental studies and studies that used non-interactive VR. No relationship was found between the degree of immersion or participant age and treatment effects. Most studies were found to have a high risk of bias and there are strong indications of publication bias. The results and their implications are discussed in context of these limitations, and modified effect sizes are suggested. Finally, recommendations for future investigations are provided.

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Immersive Virtual Reality for Pediatric Procedural Pain: A Randomized Clinical Trial

Cited by 76 publications

References 27 publications

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

Pediatric Coping During Venipuncture With Virtual Reality: Pilot Randomized Controlled Trial

The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics: A Systematic Review and Meta-Analysis

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