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Virtual reality, pre-procedural anxiety, and post-procedural pain in children outpatient care: A randomised
Giulia Ciolini1, Simone Cosmai1, Donata Dini2
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy.
Insights
Virtual Reality (VR) effectively reduces procedural pain in chronically ill children, offering a safe, non-pharmacological approach. While it did not lower pre-procedural anxiety, VR is a valuable tool for pediatric pain management.
Area of Science:
- Pediatric Pain Management
- Medical Technology Integration
- Non-pharmacological Interventions
Background:
- Managing pain and anxiety in chronically ill children presents significant challenges, often lacking standardized protocols.
- Virtual Reality (VR) emerges as a promising immersive distraction technique for pain reduction without medication.
Purpose of the Study:
- To evaluate the efficacy of VR in alleviating pain and anxiety in pediatric patients with chronic conditions during outpatient procedures.
- To assess VR's potential as a non-pharmacological intervention in pediatric healthcare settings.
Main Methods:
- A randomized controlled trial involving 247 children (aged 3-17) with chronic diseases was conducted.
- Participants were assigned to either a VR intervention group or a standard care control group.
- Pain and anxiety were measured using validated scales (Wong-Baker, NRS, M-YPAS, VAS-A), with statistical analysis including robust regressions.
Main Results:
- VR intervention resulted in a statistically significant reduction in perceived procedural pain (p < 0.001).
- The study found no significant reduction in pre-procedural anxiety with VR.
- Maternal anxiety emerged as a key predictor of child anxiety; older children and males reported lower anxiety.
Conclusions:
- Virtual Reality (VR) is a safe and effective strategy for managing pediatric procedural pain.
- VR can be integrated into routine pediatric outpatient care as a low-cost, non-pharmacological pain management solution.
- Further research is recommended to explore VR's impact on peri-procedural anxiety and its optimal clinical integration.
Introduction:
The management of pain and procedural anxiety in chronically ill children is a complex challenge, often without standardised protocols. Virtual Reality (VR) is becoming an effective immersive distraction strategy to reduce pain without resorting to medication.
Objectives:
This study evaluated the effectiveness of VR in reducing pain and anxiety in children with chronic conditions undergoing minimally invasive procedures in outpatient or Day Hospital settings.
Materials And Methods:
A single-centre randomised controlled trial was conducted in a hospital in Florence, Italy. Participants (n = 247), aged 3-17 years, suffering from chronic diseases, were assigned to the intervention (Virtual Reality) or control (standard care) group. Pain was measured with the Wong-Baker and NRS scales and anxiety with the M-YPAS and VAS-A scales. Statistical analysis included robust regressions to assess the role of factors such as age and maternal anxiety.
Results:
The intervention led to a statistically significant reduction in perceived pain (p < 0.001), confirming its effectiveness as a non-pharmacological analgesic tool. While VR did not reduce pre-procedural anxiety, regression analysis identified maternal anxiety as a key predictor of child anxiety. Older children and males showed lower anxiety levels.
Conclusions:
VR is a safe and effective strategy for managing paediatric procedural pain, potentially extendable to home settings. Further research should explore its impact on peri-procedural anxiety and strategies for optimal clinical integration.
Implications To Practice:
Virtual reality can be integrated into routine paediatric outpatient care as a simple, low-cost, non-pharmacological strategy to reduce procedural pain, supporting nurses in improving children's procedural experiences.
