The Use of Virtual Reality to Reduce Preoperative Anxiety in First-Time Sternotomy Patients: A Randomized Controlled Pilot Trial

Hendricks, Tina M.; Gutierrez, Claudia; Stulak, John M.; Dearani, Joseph A.; Miller, Jordan D.

doi:10.1016/j.mayocp.2020.02.032

Cited by 35 publications

(47 citation statements)

References 24 publications

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“…Although the field of digital therapeutics has lacked scientific data to understand which VR systems are best suited for specific interventions, the findings of the current study reflect the increasing body of evidence supporting the benefits of specific VR systems (eg, Bear Blast) for the management of pain and anxiety associated with both blood sample collection and PIVC placement. 1 , 36 , 37 Given the rapidly evolving technological development of both VR hardware and software, the validation of a single VR system has inherent strengths and limitations. Although it is becoming increasingly feasible to integrate VR systems into clinical practice because of the reduced costs, availability of high-quality off-the-shelf technologies, and large number of VR environments, requirements remain regarding training and supervision of staff to operate the VR equipment, strict and vigilant hygiene practices based on hospital infectious disease standards, powering the equipment, and performance of routine updates on the operating systems and software.…”

Section: Discussionmentioning

confidence: 99%

Effect of an Immersive Virtual Reality Intervention on Pain and Anxiety Associated With Peripheral Intravenous Catheter Placement in the Pediatric Setting

et al. 2021

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Key Points Question Does a virtual reality (VR) intervention compared with standard care improve pain and anxiety outcomes among patients undergoing peripheral intravenous catheter (PIVC) placement in the pediatric setting? Findings In this randomized clinical trial of 107 patients undergoing PIVC placement in 2 pediatric clinical settings plus their caregivers and clinicians, a VR intervention significantly reduced mean patient-reported post-PIVC anxiety and pain, caregiver-reported perceptions of patients’ pain, and clinician-reported perceptions of patients’ pain and anxiety. Meaning In this study, a VR intervention significantly decreased pain and anxiety among patients undergoing PIVC placement in the pediatric setting.

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Section: Discussionmentioning

confidence: 99%

Effect of an Immersive Virtual Reality Intervention on Pain and Anxiety Associated With Peripheral Intravenous Catheter Placement in the Pediatric Setting

et al. 2021

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“…Recently, virtual reality (VR), a computer-generated simulation of a 3D environment that can be explored and interacted with by the use of a head-mounted display (HMD), has emerged as an effective solution for reducing anxiety in a variety of pediatric psychological applications [ 21 , 22 ], including preprocedural anxiety [ 23 - 32 ]. Although the use of VR in hospital settings is promising, to our knowledge, only one study has compared it with the CLP regarding anxiety [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing a Virtual Reality–Based Simulation App (VR-MRI) With a Standard Preparatory Manual and Child Life Program for Improving Success and Reducing Anxiety During Pediatric Medical Imaging: Randomized Clinical Trial

Stunden¹,

Stratton²,

Zakani³

et al. 2021

J Med Internet Res

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Background The experience of undergoing magnetic resonance imaging (MRI) can be anxiety provoking, particularly for pediatric patients and their families. Alternative methods to improve success and experiences without the use of sedation are needed. Objective This study aims to compare the effectiveness of a virtual reality (VR)—based simulation app (VR-MRI) with a standard preparatory manual (SPM) and a hospital-based Child Life Program (CLP) on success and anxiety during a simulated pediatric MRI scan. Our secondary aim is to compare caregivers’ reported anxiety, procedural data, caregiver usability, child satisfaction, and fun. Methods This unblinded, randomized, triple-arm clinical trial involved 92 children aged 4-13 years and their caregivers. Recruitment was conducted through posters, public libraries, community centers, and social media. At a 2-hour session, participants were instructed to prepare for a simulated MRI head scan using one of three randomly assigned preparation materials: the VR-MRI app, SPM, or the CLP. Data were collected before preparation, during a simulated MRI head scan, and after the simulated scan. The primary outcomes were the success of the simulated MRI scan (MoTrak head motion tracking system), and child-reported anxiety (Venham picture test). We secondarily measured caregivers’ reported anxiety (short State-Trait Anxiety Inventory), procedural data (minutes), usability (Usefulness, Satisfaction, and Ease of Use Questionnaire), and child-reported satisfaction and fun (visual analog scales). Results A total of 84 participants were included in the final analysis (VR-MRI: 30/84, 36%; SPM: 24/84, 29%; and CLP: 30/84, 36%). There were no clinically significant differences between the groups in terms of success during the MRI simulation (P=.27) or the children’s reported anxiety at any timepoint (timepoint 1, P=.99; timepoint 2, P=.008; timepoint 3, P=.10). Caregivers reported being significantly more anxious after preparing with the manual than caregivers in the other 2 groups (P<.001). Child and caregiver anxiety had a significant relationship, increasing together with moderate effect (r84=0.421; P<.001). Participants using VR-MRI took the most time to prepare (P<.001) and participants using the manual took the least time (P<.001). No statistically significant relationships were found between time preparing and time completing the simulated assessment (P=.13). There were no differences found in ease of use (P=.99), ease of learning (P=.48), and usefulness (P=.11) between the groups; however, caregivers reported being significantly more satisfied with the VR-MRI app and CLP than SPM (P<.001). Children reported the most satisfaction with the CLP (P<.001). There were no differences in how much fun the preparation materials were perceived to be (P=.37). Conclusions Digital preparation experiences using VR-based media could be a viable solution to improve the success of nonsedated MRI scans, with outcomes comparable with hospital-based in-person preparatory programs. Future research should focus on validating the results in a real MRI setting. Trial Registration Clinicaltrials.gov NCT03931382; https://clinicaltrials.gov/ct2/show/NCT03931382

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“…Another strength of this study lies in the VR-technique, which was approved in several studies [21,22,29,44,45]. Immersive VR experiences result in stronger analgetic effects than not-immersive VR.…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality improves symptom control in palliative care – a feasibility trial

Guenther

Görlich²,

Pogatzki-Zahn

et al. 2022

Preprint

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Background: Effective symptom control is the primary goal in palliative care (PC). Virtual reality (VR) allows a temporary escape from pharmacological resistant pain and enables experiences and journeys palliative patients are not capable of experiencing due to frailty or hospitalization. Patients can immerse in virtual worlds, be distracted by playing games or go on a journey once again. Another benefit of enabling unrealizable wishes in the virtual world is potentially an additional control of psychological and physical symptoms. We evaluated in a national single-center feasibility trial, whether a onetime VR experience is a feasible, satisfactory and effective tool for improving end of life-symptoms for hospitalized patients with palliative needs. Methods: 45 patients at the University Hospital of Muenster with inpatient palliative treatment were offered a one-time VR experience. We excluded patients with brain tumors, brain-metastases, seizure, motion sickness, claustrophobia, vertigo attacks, hearing or visual impairment and those who could not consent.A selection of several videos and games were offered by a VR system. The primary endpoint was patient-reported pain recorded by visual analogue scale. Pre-, during- and post-interventional pain scores were reported. Additionally, health-related quality of life (HRQOL) was measured by the EQ-5D-5L questionnaire. The Pain-Out questionnaire for postoperative pain was handed to the participants before and after the VR intervention.Results: Data of 21 women and 19 men were analyzed, their average age was 51.9 (SD: 15.8) years. Five patients were excluded for loss of glasses, a VR experience less than five minutes, claustrophobia, acute disorientation or hardly comparable environmental circumstances. The mean Karnofsky score was 45.5 (SD: 14.9) and self-reported health in EQ-5D-5L was 41.9 (SD: 23.1).A significant pain reduction could be shown during, directly post- and one hour postinterventional (VAS preinterventional 2.25 (SD: 0.4399), during 0.7 (SD: 0.2983, p<0.0001), postinterventional 0.9 (SD: 0.3354, p=0.0001), one hour postinterventional 1.15 (SD: 0.4163, p=0.0004). More than 80% evaluated the VR-experience as very good or good, as many as wanted to use the device again. No serious side effects were reported, but three patients felt nausea (7%), two headache (5%) and three stated dry eyes (7%). Conclusion: This pilot trial suggests that VR seems to be a feasible and effective tool to reduce pain and ameliorate the mood in PC. The usage of VR in PC has broad acceptance and might be a valuable future tool for symptom control. Trial registration: ClinicalTrials.gov Identifier: NCT03698526(https://clinicaltrials.gov/ct2/show/NCT03698526?term=virtual+reality&cond=palliative+care&cntry=DE&city=Münster&rank=1)

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The Use of Virtual Reality to Reduce Preoperative Anxiety in First-Time Sternotomy Patients: A Randomized Controlled Pilot Trial

Cited by 35 publications

References 24 publications

Effect of an Immersive Virtual Reality Intervention on Pain and Anxiety Associated With Peripheral Intravenous Catheter Placement in the Pediatric Setting

Effect of an Immersive Virtual Reality Intervention on Pain and Anxiety Associated With Peripheral Intravenous Catheter Placement in the Pediatric Setting

Comparing a Virtual Reality–Based Simulation App (VR-MRI) With a Standard Preparatory Manual and Child Life Program for Improving Success and Reducing Anxiety During Pediatric Medical Imaging: Randomized Clinical Trial

Virtual Reality improves symptom control in palliative care – a feasibility trial

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