Virtual reality may reduce pain, anxiety in children undergoing blood draws

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Hong Kong-based researchers have investigated the effects of immersive virtual reality (IVR) interventions for pediatric patients undergoing blood draws and found that such distractions may benefit patients. The study, published Thursday in JAMA Network Open, concluded that IVR intervention significantly reduced patient-reported pain and levels of anxiety.

The researchers conducted a two-group randomized clinical trial, recruiting pediatric patients ages 4 to 12 undergoing venipuncture at a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March 2022 to May 2022. Participants were randomly allocated to an age-appropriate IVR intervention group offering distraction and procedural information, or a control group receiving standard care only.

The primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure. Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure.

A total of 149 pediatric patients were recruited, with a mean age of 7.21 years. There were 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group, the 75 participants in the IVR group reported significantly less pain and anxiety immediately after the intervention.

Healthcare professionalsā€™ satisfaction in the IVR group (mean score 34.5 of 40) was significantly higher than that in the control group (mean score 32.9 of 40). Moreover, the mean length of the venipuncture procedure in the IVR group (4.43 minutes) was significantly shorter than that in the control group (6.56 minutes).

Venipuncture is one of the most commonly performed needle-related procedures among hospitalized pediatric patients. Yet pediatric patients undergoing this procedure often experience high levels of procedural anxiety and self-reported pain. Poorly managed pain and anxiety can have consequences for patients, increase the time and resources needed to perform procedures, and decrease health care professionalsā€™ satisfaction with procedures.

Distractionsā€”such as watching cartoons, playing with toys, or adult soothingā€”are the most frequently used nonpharmacological interventions. Compared with interventions such as hypnosis and cognitive behavioral therapy, distractions are easy to implement, and require no specialized training. However, distractors often fail to draw childrenā€™s attention away from the anxiety-provoking sight of needles. Distractors such as IVR that completely block childrenā€™s attention to pain and anxiety stimuli may be more beneficial.

IVR users engage in a computer-generated three-dimensional virtual world through a head-mounted display. IVR interventions can be used at any time or place, without additional staff. IVR scenarios can be customized to accommodate individual preferences, offering visual and auditory stimuli that blocks anxiety stimuli, while providing procedural information that can enhance patientsā€™ sense of control.

The study researchers concluded that IVR intervention not only significantly reduced patient-reported pain but was more effective than standard care in improving pain among pediatric patients undergoing venipuncture. The results illuminate an IVR research trend, and point to its potential for clinical development as an intervention for blood draws and other painful and stressful medical procedures.

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