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Impact of Virtual Reality Technology on Pain and Anxiety in Pediatric Burn Patients: A Systematic Review and
Kathryn L Smith1, Yang Wang1,2, Luana Colloca1,2,3
1Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States.
Insights
Virtual reality (VR) effectively reduces pain and anxiety in pediatric patients during burn wound care. This technology shows moderate to large effects, supporting its integration into standard treatment protocols for children with burn injuries.
Area of Science:
- Pediatric Medicine
- Pain Management
- Medical Technology
Background:
- Burn wound care procedures are often associated with significant pain and anxiety in pediatric patients.
- Novel technological interventions are needed to address population-specific variables in pediatric pain management.
- Virtual reality (VR) presents a promising tool for mitigating procedural pain and distress.
Purpose of the Study:
- To systematically review and evaluate the effectiveness of virtual reality (VR) in reducing pain experienced by pediatric patients during burn wound care procedures.
- To assess the impact of VR on pain-related anxiety in children undergoing burn treatments.
Main Methods:
- A systematic literature review was conducted using PubMed and CINAHL databases (January 2010–July 2021).
- Keywords included: "pediatric," "burn," "virtual reality," and "pain."
- Meta-analysis was performed on ten selected experimental studies (six RCTs, four repeated-measures) to determine the effect size (SMD) of VR on procedural pain.
Main Results:
- Ten studies met the inclusion criteria, providing evidence for VR's efficacy in pain and anxiety reduction during burn care.
- VR demonstrated moderate to large effect sizes in reducing pain intensity (SMD=0.60) and situational anxiety (Cohen's d = 0.575).
- The positive effects were observed for both preprocedural preparation and procedural interventions.
Conclusions:
- Virtual reality (VR) is an effective intervention for decreasing pain and anxiety in pediatric patients undergoing burn wound care.
- The moderate to large effect sizes support the integration of VR into established pediatric burn pain management protocols.
- VR offers a valuable, technology-driven approach to enhance patient comfort and care in pediatric burn treatment.
Introduction:
Virtual reality (VR) has the potential to lessen pain and anxiety experienced by pediatric patients undergoing burn wound care procedures. Population-specific variables require novel technological application and thus, a systematic review among studies on its impact is warranted.
Objective:
The objective of this review was to evaluate the effectiveness of VR on pain in children with burn injuries undergoing wound care procedures.
Methods:
A systematic literature review was performed using PubMed and CINAHL databases from January 2010 to July 2021 with the keywords "pediatric," "burn," "virtual reality," and "pain." We included experimental studies of between- and within-subjects designs in which pediatric patients' exposure to virtual reality technology during burn wound care functioned as the intervention of interest. Two researchers independently performed the literature search, made judgements of inclusion/exclusion based on agreed-upon criteria, abstracted data, and assessed quality of evidence using a standardized appraisal tool. A meta-analysis was conducted to evaluate the effectiveness of the VR on burning procedural pain in pediatric population. Standardized mean difference (SMD) was used as an index of combined effect size, and a random effect model was used for meta-analysis.
Results:
Ten articles published between January 2010 and July 2021 passed the selection criteria: six randomized controlled trials and four randomized repeated-measures studies. Consistent results among the studies provided support for VR as effective in reducing pain and potentially pain related anxiety in children undergoing burn wound care through preprocedural preparation (n = 2) and procedural intervention (n = 8). VR effects on pain intensity ratings were moderate to large (SMD=0.60, 95%CI=0.28-0.93, p=0.0037 with no significant heterogeneity of VR intervention effects between studies. Only one study reported direct influence of VR intervention on pre-procedural situational anxiety with a moderate effect size (Cohen's d = 0.575, 95%CI = 0.11-1.04).
Conclusion:
Children's exposure to VR during burn care procedures was associated with lower levels of pain and pain related anxiety. Moderate to large effect sizes support the integration of VR into traditional pediatric burn pain protocols irrespective of innovative delivery methods and content required for use in burned pediatric patients.
