Abstract
Needle-related procedures are often a source of pain, anxiety and fear in young patients. This systematic review aimed to investigate the effectiveness of virtual reality (VR) on reducing pain, fear and anxiety in pediatric patients undergoing needle-related procedures. Pain, anxiety, fear, changes in blood pressure and heart rate as well as satisfaction were evaluated as outcomes during needle-related procedures in VR compared with standard care conditions. A meta-analysis was performed, taking into account online databases. Two authors independently conducted literature searches in December 2020. The last search was conducted in March 2021 from a total of 106 records, 7 met our inclusion criteria. One study was excluded from the meta-analysis due to insufficient data. VR was applied as a distractor during venous access. Statistically significant benefits of using VR were shown in children’s pain scores, where VR significantly decreased symptoms (n = 3204 patients, MD = −2.85; 95% CI −3.57, −2.14, for the Wong–Baker Faces Pain Rating Scale and n = 2240 patients, MD = −0.19; 95% CI −0.58, 0.20, for the Faces Pain Scale—Revised). The analysis of fear, anxiety and satisfaction scores revealed no significant differences between the conditions, as the studies were too heterogeneous to be pooled. Distraction using virtual reality may be an effective intervention for reducing pain in children undergoing needle-related medical procedures. However, further research in the implementation of VR as a distractor for children and adolescents is required, due to the limited research into this field.
Highlights
Invasive procedures are an integral part of the diagnosis and treatment program in various diseases
Ethsteimtyapteesooffptahien,mthineistmarutmingclpinaiicnallleyvieml panordtaontthderifffearcetonrcse,(bMuCt ItDhe)ydetepnedndtos oranntghee tfyropme o1f0p%ainto, t2h5e%st—aritninogthpearin wHnfolomnoeooufivfarwsnoidettcdniealsaoveta,nnainesatfrtadds,ciicccohtgoehaheantalsiohnlisnyfinengigrcnoesteafhitfaignoeonacntrfftFmifoFdfiePorPeaccnSsSctta,eir-RnobteRhfnutaawetsmccderthoeoheeuaiesaeonnlussydngulpnttebrestaoeh,entitsinebde.taehnfAFFtcfeotPePa-scmrurSSmeta-s-epRnRteahtogaltewmlreh-etareefsoeenrtdausmoamsulmlpduyeletatrss1aabeii,ns0-nseab%.ibnanetyhnAacgtoaledfEyuum2sisalsj5imleensce%thxratsa—hsiahl-elneaoeetingytswnmteaaoie.elnmlydtt.Hhasefpnie-ooasaerowunndbwniseaiyntadvolaygterEtrasfdriiuiis,cjssstllt,ieiphscgacrhaaishnscoltailhiewifyenniatncgensfaatoidegslngr..e--t decrease in patient-reported pain and anxiety in pediatric patients undergoing a range of medical procedures with virtual reality (VR) used as a distractor
The large effect size could lead to the drawing of specific conclusions: as a method for reducing pain and anxiety in pediatric patients undergoing medical procedures, VR is an effective distraction intervention [22]
Summary
Invasive procedures are an integral part of the diagnosis and treatment program in various diseases. In many such interventions, needle use is required. The needlerelated procedures are frequently accompanied by anxiety or fear. It has been shown that psychological factors can affect in various ways the sensation of pain [1,2,3]. The literature suggests that stress, anxiety and fear may increase pain but can induce it [4,5]. For young patients, invasive interventions are very stressful. Children often report concerns even before the procedure. Such anticipatory fear may cause an increase in pain resulting in emotional distress [6]
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