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Virtual Reality for Managing Procedural Pain in Children: A Concept Analysis with Walker and Avant Approach
Henny Suzana Mediani1, Sri Hendrawati1, Sukmawati Sukmawati2
1Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia.
Insights
Virtual Reality (VR) offers immersive, engaging interventions to manage children's procedural pain and anxiety. This concept analysis clarifies VR's attributes, supporting its use in child-centered nursing care.
Area of Science:
- Pediatric Nursing
- Health Technology
- Pain Management
Background:
- Procedural pain and anxiety are significant challenges in pediatric care.
- Traditional interventions for pediatric procedural pain and anxiety are often insufficient.
- Virtual Reality (VR) shows promise as a non-pharmacologic approach, but its application in pediatric nursing requires conceptual clarity.
Purpose of the Study:
- To clarify the concept of Virtual Reality (VR) for managing procedural pain in children.
- To delineate the defining attributes, antecedents, and consequences of VR in pediatric pain management.
- To utilize the Walker and Avant framework for a rigorous concept analysis of VR in this context.
Main Methods:
- Systematic literature search (2005-2025) across major databases (PubMed, Scopus, CINAHL, Web of Science).
- Application of Walker and Avant's eight-step concept analysis framework.
- Synthesis of 28 eligible studies through iterative comparison and conceptual coding.
Main Results:
- Key VR attributes include immersion, presence, distraction, cognitive engagement, and emotional regulation.
- Antecedents involve painful procedures, VR technology availability, trained staff, and child readiness.
- Consequences encompass reduced pain/anxiety, enhanced cooperation, and increased satisfaction for children, parents, and providers.
Conclusions:
- Virtual Reality is an immersive, interactive nursing intervention for pediatric procedural pain and anxiety.
- Clarifying the concept of VR supports its integration into evidence-based, atraumatic nursing care.
- This analysis provides a foundation for utilizing VR effectively in pediatric settings.
Background:
Procedural pain and anxiety are common among children undergoing medical procedures. Traditional pharmacologic and behavioural interventions may not fully alleviate pain and distress in young children. Virtual Reality (VR) has emerged as a promising nonpharmacologic approach, yet conceptual ambiguity persists regarding its defining characteristics within paediatric nursing practice.
Purpose:
To clarify the concept of Virtual Reality for the management of procedural pain in children by delineating its defining attributes, antecedents, consequences, and empirical referents utilizing the Walker and Avant framework.
Methods:
Walker and Avant's eight-step concept analysis framework was employed. Literature published between 2005 and 2025 was systematically identified from PubMed, Scopus, CINAHL, and Web of Science. Twenty-eight eligible studies were synthesized through iterative comparison and conceptual coding to identify defining attributes, antecedents, consequences, and empirical referents of Virtual Reality for managing procedural pain in children.
Results:
Three defining attributes were identified: (1) immersion and presence, referring to a sense of being within a three-dimensional simulated environment; (2) distraction and cognitive engagement, involving active redirection of attention away from pain stimuli; and (3) emotional regulation and anxiety reduction, promoting calmness and procedural cooperation. Antecedents include the presence of a painful procedure, availability of VR technology, trained providers, and child readiness. Consequences include reduced pain and anxiety, improved procedural cooperation, and increased satisfaction among children, parents, and healthcare providers. Empirical referents include pain intensity measure, fear and anxiety assessments, and presence related instruments.
Conclusion:
Virtual reality represents an immersive, interactive, and emotion-focused nursing intervention for managing procedural pain and anxiety in children. Clarifying this concept supports its integration into evidence-based, child-centred, atraumatic nursing care.
