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Comparative Evaluation of Virtual Reality versus Standard Nursing Care in Managing Pain and Fear during Lumbar
Amer M Kasim1,2, Ahmed F Hassan2
1Ministry of Health, Al-Karkh Health Directorate, Al Yarmouk Teaching Hospital, Baghdad, Iraq.
Background:
Meningitis is a serious infectious disease that can cause significant morbidity and long-term neurological problems. Although a lumbar puncture is a necessary diagnostic procedure, it is often accompanied by discomfort, anxiety, and fear, which can severely impact the patient's experience. Although there is few data on its application prior to lumbar puncture in adult patients with meningitis, immersive virtual reality (VR) has become a promising non-pharmacological technique for lowering procedural distress. Thus, among individuals undergoing lumbar punctures, this randomized controlled research assessed how well pre-procedural VR reduced pain, anxiety, and fear while enhancing patient satisfaction.
Objective:
This study aims to evaluate the effectiveness of virtual reality (VR) in reducing pain and fear among adults undergoing lumbar puncture (LP) compared with standard care protocol.
Methods:
A randomised clinical trial was conducted from May to October 2025, using a single-blind, true experimental design. A total of 85 patients were randomly assigned to either the VR intervention group ( n = 41) or the control group receiving standard care ( n = 44). Pain levels were assessed using a visual analogue scale. Fear was assessed using the Multidimensional Fear-of-Injection Scale. Data were analysed using SPSS version 26.
Results:
According to the study, the findings revealed a significant reduction in pain levels among the study group following the VR intervention, with mean pain scores dropping from 7.54 ± 1.925 to 2.49 ± 0.675. In contrast, the control group showed increased pain intensity, with mean scores rising from 6.84 ± 1.842 to 8.36 ± 1.348. The VR group showed a significant reduction in fear scores across all domains, whereas no significant changes were observed in the control group. Direct fear decreased from 20.12 ± 1.71 to 9.44 ± 2.00, indirect fear from 17.24 ± 1.46 to 8.66 ± 2.24, physiological response improved from 0.34 ± 0.66 to 3.00 ± 1.00 and avoidance behaviour decreased from 16.71 ± 1.49 to 7.80 ± 1.85.
Conclusions:
The research shows that the use of VR prior to LP significantly reduces level of pain and fear compared to standard care. These results support VR as a non-pharmacological intervention for fear and pain to improve patient experience during invasive procedures. In contrast, the control group experienced no improvement.Trial Registration: The IRCT code for the trial was IRCT ID 20250803066743N1.
Insights
Virtual reality (VR) significantly reduced pain and fear during lumbar punctures in adults. This non-pharmacological approach improved patient experience compared to standard care, offering a promising alternative for invasive procedures.
Area of Science:
- Medical Interventions
- Patient Experience
- Neurology
Background:
- Meningitis poses significant risks, necessitating lumbar puncture (LP) for diagnosis.
- LP procedures often cause patient distress, including pain, anxiety, and fear.
- Immersive virtual reality (VR) shows potential for reducing procedural distress.
Purpose of the Study:
- To evaluate VR's effectiveness in reducing pain and fear during lumbar puncture (LP) in adults.
- To compare VR intervention against standard care for procedural distress management.
Main Methods:
- A randomized controlled trial involving 85 adult patients undergoing LP.
- Participants were assigned to either a VR intervention group (n=41) or a standard care control group (n=44).
- Pain assessed via Visual Analogue Scale; fear measured by Multidimensional Fear-of-Injection Scale.
Main Results:
- The VR group experienced a significant reduction in mean pain scores (7.54 to 2.49).
- The control group showed an increase in mean pain scores (6.84 to 8.36).
- VR intervention led to significant reductions in all fear domains, unlike the control group.
Conclusions:
- Pre-procedural VR significantly decreases pain and fear associated with lumbar puncture.
- VR serves as an effective non-pharmacological tool to enhance patient experience during invasive procedures.
- Standard care did not yield improvements in pain or fear levels.