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VR-guided deep breathing during needle procedures in children
Elina Karppa1,2,3, Kaija Puura4,5, Ilmari Jyskä6
1TamCAM Research Center, Faculty of Medicine and Health Technology, Tampere University, Elämänaukio 2, 33521, Tampere, Finland. elina.karppa@tuni.fi.
Insights
Virtual reality (VR) deep breathing exercises effectively reduced children's stress and fear during needle procedures. This VR intervention significantly enhanced parasympathetic nervous system activity, indicating a calming effect.
Area of Science:
- Pediatric medicine
- Psychophysiology
- Virtual Reality applications
Background:
- Virtual reality (VR) shows promise in reducing pediatric procedural anxiety.
- However, its impact on the autonomic nervous system (ANS) and heart rate variability (HRV) during needle procedures requires further investigation.
Purpose of the Study:
- To assess the feasibility and effectiveness of VR-mediated deep breathing exercises in managing pediatric stress and fear during venipuncture.
- To evaluate the effects of this intervention on ANS activity using HRV measurements.
Main Methods:
- A feasibility study involving 45 children undergoing venipuncture.
- Comparison between a VR group performing 6-minute deep breathing exercises in a virtual natural environment and a control group receiving standard care.
- Assessment of stress response via HRV measurements, including respiratory rate and high-frequency normalized units (HFnu).
Main Results:
- The VR deep breathing group exhibited a significantly lower median respiratory rate (14 vs. 20, p < .001), indicating good compliance.
- HRV measurements showed significantly greater parasympathetic nervous system activation (mean HFnu 61.57 vs. 40.46, p < .001) in the VR group compared to the control group.
- The intervention was deemed feasible for managing procedural stress and fear.
Conclusions:
- Virtual reality-mediated guided deep breathing is a viable non-pharmacological option for alleviating stress and fear in children during needle procedures.
- This VR approach positively influences the autonomic nervous system, promoting relaxation.
Abstract:
Virtual reality-based treatment has been found to be effective at reducing stress and fear in children during procedures involving needles, but its effects on the autonomic nervous system and heart rate variability remain uncertain. This feasibility study compared a virtual reality-mediated deep breathing exercise with treatment as usual in managing the stress and fear of children during a venipuncture. We included 45 children who underwent a needle procedure as part of their routine treatment. The study patients performed 6 min of deep breathing training in a virtual natural environment during the needle procedure. The stress response in the autonomic nervous system was determined by heart rate variability measurements. The median respiratory rate was significantly lower during the intervention in the deep breathing training group (median 14 [Q1-12, Q3-16.5]) than in the control group (20 [18, 20.88]), (p < .001), confirming good compliance with exercise. In a 6-min heart rate variability measurement, mean high frequency in normalised unit (HFnu, 0.15-0.4 Hz) indicates a significantly greater level of activation in the parasympathetic nervous system during exercise (mean 61.57 [SD 16.29]) than in the control (40.46 [16.10]), (p < .001). Virtual reality-mediated guided deep breathing is a feasible nonpharmaceutical treatment option for stress and fear relief when treating child patients undergoing a needle procedure.
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