Abstract
BackgroundGiven the high level of interest and increasing familiarity with virtual reality among adolescents, there is great potential to use virtual reality to address adolescents’ unique health care delivery needs while in hospital. While there have been reviews on the use of virtual reality for specific health conditions and procedures, none to date have reviewed the full scope of virtual reality hospital interventions for adolescents who are often combined with children as a homogenous group, despite the fact that adolescents experience virtual environments different from children.ObjectiveThe aim of this review was to systematically identify available evidence regarding the use of virtual reality interventions for adolescent patients in hospital settings to evaluate effectiveness, suitability, and safety and identify opportunities for future research.MethodsPubMed, PsycINFO, Medline, and Scopus databases were searched using keywords and phrases. Retrieved abstracts (n=1525) were double screened, yielding 276 articles for full-text screening. Of these, 8 articles met inclusion criteria. Data were extracted to a standardized coding sheet, and a narrative synthesis was performed due to the heterogeneity of the studies.ResultsFour RCTs and 4 single-case reports were identified for inclusion, all of which aimed to reduce pain or anxiety. The scenarios targeted were burn pain, venipuncture, chemotherapy, preoperative anxiety, and palliative care. Three out of 4 RCTs found significant reductions in pain or anxiety outcomes measures when using virtual reality compared to standard care or other distraction techniques; however, only 1 study combined self-reported experiences of pain or anxiety with any physiological measures. Single-case reports relied primarily upon qualitative feedback, with patients reporting reduced pain or anxiety and a preference for virtual reality to no virtual reality.ConclusionsVirtual reality can provide a safe and engaging way to reduce pain and anxiety in adolescents while in hospital, particularly when virtual reality software is highly immersive and specifically designed for therapeutic purposes. As VR becomes more accessible and affordable for use in hospitals, larger and more diverse studies that capitalize on adolescents’ interest in and aptitude for virtual reality, and on the full range of capabilities of this emerging technology, are needed to build on these promising results.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42020198760; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020198760
Highlights
Interest in the use of virtual reality (VR) in the health sector has increased steadily over the past decade; recent advances have made VR technology more immersive, flexible, portable, and affordable
Of the 1525 records that remained after duplicate removal, 1249 were excluded because their titles and abstracts indicated that they were not about virtual reality interventions for adolescent patients in hospital settings, leaving 276 articles to be assessed for eligibility based on inclusion criteria
During the second stage of screening, 68 articles were excluded based on record type; 126 were excluded because the target population was not limited to adolescents; 68 articles were excluded because the intervention did not take place in hospital settings; and 6 were excluded because they did not use immersive VR
Summary
Interest in the use of virtual reality (VR) in the health sector has increased steadily over the past decade; recent advances have made VR technology more immersive, flexible, portable, and affordable. While there have been reviews into particular applications of VR for specific health conditions or in-hospital procedures (eg, burn management [14], procedural pain [1]), to date there has only been 1 systematic review, which included only RCTs, on the full scope of immersive VR use in hospital settings [13]. While there have been reviews on the use of virtual reality for specific health conditions and procedures, none to date have reviewed the full scope of virtual reality hospital interventions for adolescents who are often combined with children as a homogenous group, despite the fact that adolescents experience virtual environments different from children. Conclusions: Virtual reality can provide a safe and engaging way to reduce pain and anxiety in adolescents while in hospital, when virtual reality software is highly immersive and designed for therapeutic purposes. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020198760; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020198760
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