Virtual Reality for IMMunisation (VRIMM) pain in young children: Results of a randomised controlled trial in general practice
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Kirrily Ellerton1, Harishan Tharmarajah2, Domenico Puleio3
1MBBS (Hons), FRACGP, BSc (Hons), GDPPC, General Practitioner, Wellness on Wellington, Melbourne, Vic.
Insights
Virtual reality (VR) did not reduce self-rated pain in children during immunizations. However, VR improved observer and parent ratings of pain and enjoyment, suggesting benefits for needle-based procedures.
Area of Science:
- Pediatric Pain Management
- Virtual Reality Applications
- Immunization Practices
Background:
- Virtual reality (VR) shows potential for mitigating needle-induced pain and distress in children.
- Routine immunizations in four-year-olds present an opportunity to assess pain management strategies.
- Comparing VR interventions with standard care is crucial for evidence-based pediatric healthcare.
Purpose of the Study:
- To evaluate the efficacy of virtual reality (VR) compared to standard care in reducing pain and distress during routine immunizations for four-year-old children.
- To assess primary outcomes of self-rated pain and secondary outcomes including observer-rated pain, distress, and overall enjoyment.
Main Methods:
- A randomized controlled superiority trial was conducted in a suburban general practice.
- Participants were children aged four undergoing routine immunizations.
- Intervention group received a VR marine adventure; control group received standard care (parental comfort, distraction).
Main Results:
- No significant difference was found in primary self-rated pain scores between the VR and standard care groups (median IQR 2 vs 2).
- Observer ratings of pain and distress, and overall enjoyment of the immunization experience, favored the VR group.
- No significant adverse events were reported in either group.
Conclusions:
- Virtual reality (VR) was not superior to standard care in reducing self-reported pain for four-year-olds during immunizations.
- Parent and observer perceptions of pain, distress, and overall enjoyment were significantly improved with VR.
- VR may offer benefits in managing the emotional and experiential aspects of pediatric immunizations, despite not altering self-rated pain.
Background And Objectives:
Virtual reality (VR) may be useful for reducing needle-based pain and distress. Our objective was to compare VR against standard care for children undergoing routine four-year-old immunisations.
Method:
This was a randomised controlled superiority trial conducted in a single suburban general practice, comparing a VR sequence of an interactive marine adventure to standard care (parental comfort, distraction of child). Our primary outcome was self-rated pain scores (Faces Pain Scale - Revised and the poker chip tool). Secondary outcomes included observational ratings (visual analogue scales) of pain and distress from caregivers and an observing healthcare provider, and overall enjoyment of the immunisation experience for the parent and child.
Results:
In all, 42 children received VR and 45 received standard care. There was no difference in the primary outcome, with median interquartile range self-rated pain scores of 2 (0-8) in the standard care group and 2 (0-6) in the VR group. Observer ratings of pain and distress, as well as ratings of overall enjoyment, favoured VR. There were no significant adverse events.
Discussion:
VR was not superior to standard care for self-rated pain and distress in children aged four years receiving routine immunisations. However, parent and observer ratings of pain and distress and overall ratings of enjoyment all favoured VR.
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