Distraction Method Research Articles

Venipuncture in pediatric emergency department by using Koala Attachment Distraction method: Randomized clinical trial

ObjectiveTo assess, compare and relate the toddler’s pain and anxiety during venipuncture by using either the Koala Attachment Distraction method or the physical restraint method and to evaluate the level of anxiety perceived by the companions in both groups. MethodRandomised, single-blind, controlled clinical trial in two arms (control and intervention group) conducted in the paediatric emergency department of a tertiary university hospital. The study variables were pain and stress of the child and anxiety perceived by the accompanying persons in both groups at the time before and during the technique. The pain rating scale Face, Leg, Activity, Cry, Consolability; the Groningen stress scale and the STAI questionnaire were used. ResultsA total of 113 participants aged 3 to 4 years participated in the trial (n=113). 50% (55) were girls, mean total age 3.83±0.59 years and accompanying persons 37.17±6.96. During the technique the mean pain in control and intervention groups was 5.64±3.30 and 3.87±3.01; stress, 3.25±1.22 and 2.67±1.24, respectively. No statistically significant differences were found in the assessment of anxiety between the groups. ConclusionsPatients who underwent the Koala Attachment Distraction method venipuncture show a lower level of pain and anxiety than those who received physical restraint, and the anxiety perceived by the companion is similar in both groups.

Enhancing Pediatric Dental Care: The Influence of Virtual Reality.

The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children. The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB. The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety. This study concluded that VR reduced pain and anxiety levels in its passive and active forms.

A randomized clinical trial comparing the effects of music and informative videos on patient anxiety during root canal treatment and retreatment.

This randomized clinical trial compared the effectiveness of music and informative videos as distraction tools to reduce the anxiety of patients during root canal treatment and retreatment. A total of 90 patients were enrolled in the study. The patients were randomly allocated to three groups: Group 1 listened to music during the treatment (n = 30), Group 2 watched an informative preoperative video (n = 30), and a control group underwent treatment without a distraction method (n = 30). Prior to treatment, the Corah Dental Anxiety Scale (CDAS) and a visual analog scale for pain were used to assess anxiety and preoperative pain. Systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation were recorded before the intervention (T1), after the local anesthetic (T2), following pulp extirpation or removal of root fillings (T3), and immediately following rubber dam removal (T4). One-way ANOVA, followed by post-hoc Bonferroni tests for multiple comparisons, were used to compare mean values of systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation among the groups. A P value of 5% was considered as significant. Listening to music reduced systolic blood pressure, heart rate (P .001), and diastolic blood pressure (P = .003) in patients undergoing root canal treatment and retreatment at T4 compared to the baseline (T1). Music (P .001) and informative video (P = .003) groups had significantly lower postoperative visual analog scale pain scores. Listening to music during root canal treatment and retreatment reduced anxiety levels in patients compared to informative preoperative videos and no distraction technique.

Intraoperative use of virtual reality decreases anxiety during surgery under local anaesthesia in the head and neck region

The availability of virtual reality (VR) in the medical field has been rapidly increasing in the past years. Here we investigate to which extent the VR headset can lead to a reduction in anxiety and pain in patients during surgical procedures under local anesthesia in the head and neck region. Patients were divided into a study group (N = 67) and a control group (N = 28). The study group used a VR headset during surgical procedures in the head and neck region under local anaesthesia. Before and after surgery, the influence of the VR headset on perioperative anxiety was assessed using the State-Trait-Anxiety-Inventory (STAI) in both groups. The use of a VR headset leads to a significant reduction in perioperative anxiety. The anxiety scores measured by means and ranks of the STAI were significantly decreased (p = .002). However, 14/67 (20.9%) of the patients wearing the VR headset also reported higher intraoperative tension. No technical complications occurred intraoperatively. 48/67 (71.7%) of the patients would be less apprehensive about a future operation when using a VR headset and 58/67 (86.6%) would further recommend the use of a VR headset to other patients. In addition to a trusting surgeon-patient relationship and the use of sufficient local anaesthesia, the use of a VR headset as a method of distraction can further reduce the intraoperative anxiety of patients.

The impact of two methods on pain and anxiety during short peripheral cannula placement: A randomized controlled trial.

This study aimed to determine the impact of virtual reality glasses and ball squeezing methods on reducing pain and anxiety in adult patients undergoing short peripheral cannula placement. The pretest-posttest parallel group randomized controlled experimental study was conducted in a university hospital with 111 patients. Patients were randomly assigned to one of three groups: the VR group (n = 37), the ball squeezing group (n = 37), and the control group (n = 37). Descriptive information form, Numeric Rating Scale, Visual Analogue Scale for Anxiety, and State-Trait Anxiety Inventory-State were used for data collection. There was no statistically significant difference between the groups in terms of sociodemographic characteristics (p > 0.05). The pain score of the patients in the control group was found to be statistically significantly higher than that of the patients in the virtual reality glasses and ball squeezing groups (p < 0.05). While the mean anxiety scores of the virtual reality glasses and ball squeezing groups significantly decreased after the intervention, they increased significantly in the control group (p < 0.05). The study found that virtual reality glasses and ball squeezing were effective distraction methods to reduce pain and anxiety in patients undergoing short peripheral cannula placement.

The effect of virtual reality glasses used in dental treatment on anxiety and fear in children: A randomized controlled study

IntroductionVirtual reality glasses can be used as a distraction method in dental practices for children. This study was carried out to evaluate the effect of virtual reality glasses used during tooth extraction and extirpation treatment under local anesthesia on anxiety and fear in children aged 7–10 years. MethodsThis study is a randomized controlled trial. The sample of the study consisted of 120 seven to ten-year-old children, including 60 in the EG and 60 in the CG, who received tooth extraction and extirpation treatment in the pediatric dental clinic. Data collection tools included the Children's Fear Scale, the Child Anxiety Scale-State. Data were analyzed using the Chi-square test, t-test, Shapiro-Wilk, mean and percentage distributions. ResultsThe assessments made by the researcher and the children indicated a statistically significant difference between experimental and control groups in terms of their mean anxiety and fear scores following tooth extraction and extirpation treatment (p < 0.001). After tooth extraction and extirpation treatment, it was determined that the children in the EG had lower mean anxiety and fear scores than the children in the CG. ConclusionIt was found that virtual reality glasses used during tooth extraction and extirpation treatment in children aged 7–10 years were effective in reducing their anxiety and fear levels. Virtual reality glasses can be used as a distracting method to relieve children's anxiety and fears during dental treatment procedures.

The effect of rational therapy on modifying irrational thoughts among university students

The current research aims to identify the effect of the thinking distraction method in reducing existential frustration among university students at the College of Physical Education and Sports Sciences/Al-Qasim Green University. The researcher has dealt with a theoretical framework that includes all the variables of the research, and to achieve the goal of the research, an existential frustration scale was built, using a statistical analysis sample. The number of items in this scale was (200) and after verifying its validity and reliability, the number of items in this scale reached (30) distributed across the scale’s areas. To test the research hypotheses, the researcher chose a sample of (14) male students only, who were intentionally selected from those who obtained the highest scores on the scale. Existential frustration scale: They were divided into two groups (experimental and control) with (7) students in each group. After parity was achieved for the two groups. As well as building the therapeutic program according to the problems posed in the scale according to the method (the thinking-distraction method), one session of the therapeutic program was taken, and after completing the application of the therapeutic program using the group therapy method on the research sample, the results showed that the program was effective in reducing existential frustration among university students.

Atraumatic care practice from the child and parent perspective: The case of a pediatric phlebotomy unit

PurposeThis study aimed to determine the effect of the child's self-selected distraction methods used during the phlebotomy procedure on the feeling of fear and pain in children and parental satisfaction. MethodsThe study, planned as a randomized controlled trial, was conducted with 219 children aged 5–10 years and their parents in the pediatric phlebotomy unit between March and June 2023. Different distraction methods (foam balloon, stress ball, musical book) were applied to the children in the intervention group during the phlebotomy procedure. The data were analyzed with the SPSS 22.0 package program. ResultsThere was a statistically significant difference between the scores of the children in the intervention and control groups on the Children's Fear Scale before the phlebotomy, and on the Wong-Baker Faces Pain Rating Scale after phlebotomy according to self- and parental assessment (p < 0.05). A statistically significant difference was found between the satisfaction levels of the parents after the procedure in the intervention and control groups with the health care service provided during the phlebotomy process (p < 0.05). ConclusionDistraction methods, one of the atraumatic nursing interventions used before the phlebotomy procedure, were determined to be effective in reducing the child's fear and the pain experienced due to the procedure. The study also showed that the satisfaction of parents was positively affected by the atraumatic care provided to their children. Practice implicationsThe atraumatic care approach should be used to prevent anxiety and fear experienced by parents and children and to reduce the child's pain.

Distracting children with virtual reality during otomicroscopy: A randomised control trial

ObjectivesVirtual Reality (VR) is a successful distraction method for reducing procedure-related pain in children, though it has never been studied during otomicroscopy. Therefore, we investigated the efficacy of VR as a distraction method during otomicroscopy. MethodsThis Randomised Control Trial (RCT) included 60 children aged 4–15 years. The patients were randomised to receive distraction by VR, tablet, or no distraction. Procedure-related pain was scored by patients and compared with previous examinations. ResultsPatients’ experience with otomicroscopy was significantly improved with VR compared to tablet (p < 0.05) and no distraction (p < 0.01). Pain scores did not differ significantly between groups. ConclusionVR did not reduce pain scores, but it improved the children's experience with otomicroscopy without causing significant adverse outcomes.

Analysis of Pain and Effectiveness in Digital Block of the First Toe Using Syringe vs. Carpule: Frost's H vs. Modified Frost's H Randomized Clinical Trial.

Background: Currently, there is no scientific evidence regarding pain in the anesthetic block of the first toe according to the method of application. However, clinical evidence has highlighted the use of the carpule due to the low pain it causes during the administration of the anesthetic. Most studies on anesthesia and pain, especially using the carpule and distraction methods, belong to the field of dentistry. Objective: To compare the pain and effectiveness between the anesthetic block of the first toe using a carpule and syringe with Frost's H technique and the modified Frost's H technique. Method: A total of 564 subjects were selected and divided into four groups. Subjects were subjected to experimental conditions (randomization through the Random Allocation Software program 2.0), and divided into group 1 = 138 subjects, corresponding to the block with syringe and Frost's H, group 2 = 141 subjects, corresponding to the syringe group and modified Frost's H, group 3 = 141 subjects, corresponding to the carpule group and modified Frost's H, and group 4 = 144 subjects, corresponding to the carpule group and Frost's H. The same researcher generated the random allocation sequence, enrolled the participants, and assigned them to the interventions. Each subject was unaware of the anesthetic procedure assigned by the researcher. Outcome parameters were pain after anesthetic infiltration and its effectiveness. Results: The anesthetic block with carpule showed a lower pain score compared to the anesthetic block with syringe (2.8 vs. 5.3; p < 0.001). However, when analyzing effectiveness, a higher efficacy rate was obtained in the anesthetic blocks performed using the modified Frost's H technique (97.5% vs. 88.1%; p < 0.001). Conclusions: The anesthetic block with carpule and the modified Frost's H technique is less painful and more effective than the traditional anesthetic block.

Comparing the use of colored Trace Images in Kids' Books with passive distractions to decrease pain and fear during cannulation in children: A randomized clinical trial

IntroductionCannulation can be frightening and a source of pain and fear for pediatric patients. The study evaluated the effectiveness of Trace Image and Coloring for Kids-Book (TICK-B) as active distraction with two passive distractions in reducing children's pain and fear during cannulation. MethodsThis study employed a prospective, controlled, randomized experiment conducted from January 2023 to April 2023 at Heevi Pediatric hospital in the Kurdistan region of Iraq. A total of 176 participants were randomly assigned in to one of four study groups, with 44 participants assigned to each group. The interventions were administered 2–3 min before continued until the cannulation procedure finished. Data were collected through interviews conducted before and after the procedure. Children reported pain using Wong-Baker FACES® scale, and fear evaluated with the Child Fear Scale as an outcome after the cannulation procedure. Children's outcomes during and after procedure were measured 2–3 min after completed procedure. ResultsAll distraction methods significantly reduced children's pain and fear compared to the control group. TICK-B showed large effects in reducing average pain (mean difference = -4.65, 95 % CI: -5.67 to -3.65) and fear (mean difference = -2.18, 95 % CI: -2.67 to -1.69) during cannulation. Post-procedure, TICK-B maintained large pain relief (mean difference = -4.10, 95 % CI: -4.98 to -3.22) and fear reduction (mean difference = -1.89, 95 % CI: -2.39 to -1.39) effects. Music listening and cartoon watching both showed improvements compared to the control group, with minimal differences between them in terms of pain and fear during the procedure. Also, the differences were the same after the procedure. No adverse events were reported. ConclusionAll distraction techniques effectively and safely decreased children's pain and fear during cannulation. The TICK-B technique most effectively reduced children's pain and fear during cannulation procedures compared to music-listening and cartoon-watching techniques. Trial registrationNCT04977323.

The Effect of Virtual Reality, Music Therapy, and Stress Ball Application on Pain and Anxiety During Outpatient Gynecological Procedures: A Randomized Controlled Trial

PurposeThe aim of this study was to determine the effect of virtual reality, music therapy, and stress ball applications, which are methods of distraction, on pain, anxiety, and patient satisfaction during outpatient gynecological procedures. DesignThis study was a randomized controlled trial with control and intervention groups, pre-test and post-test. MethodsThe study was conducted with 200 women who underwent gynecological surgical procedures without sedation in a state hospital on the European side of Istanbul between October 2022 and March 2023. There were four groups in the study: Virtual Reality (n = 50), Music Therapy (n = 50), Stress Ball (n = 50), and Control group (n = 50). Data were collected using a Descriptive Information Form, Visual Analog Scale, State-Trait Anxiety Inventory, Life Information Follow-up Form, and Patient Satisfaction Evaluation Form. The scales were completed separately by the investigator before the procedure, 10 minutes after the procedure, and 1 hour after the procedure. FindingsA statistically significant difference between the intervention groups and control groups of women who underwent a gynecological procedure at the 10th minute after the procedure (P=.000) and at the 1st hour after the procedure (P=.000) was significant. State-Trait Anxiety Inventory of women by groups decreased after the procedure and showed a statistically significant difference (P =.000). Satisfaction scores of the women with the intervention according to the groups also showed a significant difference (P =.000). When the satisfaction scores of the women with the intervention were compared by groups, the satisfaction scores ranged from the highest to the lowest, as virtual reality, music therapy, and stress ball application, respectively. ConclusionsVirtual reality, music therapy, and stress ball applications, which are methods of distraction during the outpatient gynecological procedure, were effective in reducing anxiety and pain and increasing patient satisfaction.

The effect of virtual reality glasses applied during intrauterine device insertion on pain, anxiety and satisfaction: Randomized controlled study.

This study was carried out to determine the effect of the use of "virtual reality glasses," on anxiety, pain, and satisfaction level in order to reduce anxiety and pain during intrauterine device (IUD) insertion, which is a painful and stressful procedure for women and to divert attention to increase satisfaction. This randomized controlled study in the gynecology clinic of a state hospital with 80 women who were accepted to participate in the study. Data were collected using structured patient information form, numerical pain rating scale, state-trait anxiety inventory, patient satisfaction evaluation form, and virtual reality glasses. Post-procedural pain scores in the control group after IUD application were higher than post-procedural pain in the virtual reality group. Measurements of post-procedure anxiety in the control group were higher than measurements of post-procedural in the virtual reality group. Satisfaction levels of women with virtual reality glasses during IUD insertion were also found to be high. It was determined that the use of virtual reality glasses, one of the methods of distraction during IUD insertion, was effective in reducing pain and anxiety and increasing patient satisfaction.

Preoperative anxiety management in pediatric patients: a systemic review and meta-analysis of randomized controlled trials on the efficacy of distraction techniques.

This study addresses the pervasive issue of heightened preoperative anxiety in healthcare, particularly among pediatric patients. Recognizing the various sources of anxiety, we explored both pharmacological and nonpharmacological interventions. Focusing on distraction techniques, including active and passive forms, our meta-analysis aimed to provide comprehensive insights into their impact on preoperative anxiety in pediatric patients. Following the PRISMA and Cochrane guidelines, this meta-analysis and systematic review assessed the efficacy of pharmaceutical and distraction interventions in reducing pain and anxiety in pediatric surgery. This study was registered on PROSPERO (CRD42023449979). This meta-analysis, comprising 45 studies, investigated pharmaceutical interventions and distraction tactics in pediatric surgery. Risk of bias assessment revealed undisclosed risks in performance and detection bias. Distraction interventions significantly reduced preoperative anxiety compared to control groups, with notable heterogeneity. Comparison with Midazolam favored distraction techniques. Subgroup analysis highlighted varied efficacies among distraction methods, with a notable reduction in anxiety levels. Sensitivity analysis indicated stable results. However, publication bias was observed, suggesting a potential reporting bias. Our study confirms distraction techniques as safe and effective for reducing pediatric preoperative anxiety, offering a valuable alternative to pharmacological interventions. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=449979, PROSPERO [CRD42023449979].

Research Trends and Highlights Toward Virtual Reality in Patients With Cancer: Bibliometric Analysis.

This retrospective bibliometric analysis was conducted to explore research trends and identify studies in fields of nursing, virtual reality, and cancer. Data were obtained from the Web of Science database using an advanced search strategy. The study data were analyzed using the R Studio software and visualized using VOSviewer. A total of 594 studies were retrieved and analyzed from January 1995 to December 2021. It was determined that 59.4% of the studies were research articles and that these studies had been conducted by 2771 authors. The reviewed studies were produced by researchers from 25 countries and were published in 29 different journals. Of these, 169 were conducted by researchers in the United States. "Virtual reality" and "nursing" were found to be prominent topics. Studies on virtual reality in patients with cancer in the field of nursing have increased over the past 8 years. Researchers have actively conducted studies in this field. Prominent studies have covered various patients with cancer in all age groups and palliative care processes. It was seen that the majority of the studies were randomized controlled trials, reviews, and systematic reviews. In addition, studies have used virtual reality as a distraction method in the management of symptoms in patients with breast, lung, and pediatric cancers undergoing chemotherapy treatment. This study provides a detailed and up-to-date analysis of the findings obtained from the Web of Science database by emphasizing bibliometric models of virtual reality technologies in nursing patients with cancer. We believe that the current data on the use of virtual reality applications in patients with cancer will guide the clinical practice and scientific studies of healthcare professionals.

Effect of Virtual Reality on Dental Pain in Children during Local Anesthesia Administration

ABSTRACT Background: Dental procedures often generate anxiety and fear in children. Virtual reality (VR) is a novel method of distraction for behavior management during dental treatment. Aim: To evaluate the effect of using VR eyeglasses on anxiety/pain during local anesthesia (LA) administration for children. Materials and Methods: Children aged 6–12 years, rated to be Frankl +(positive) or −(negative) without any systemic background were included. Children receiving inferior alveolar nerve block anesthesia were randomized into two groups: Control group (n = 20) exposed to Tell-Show-Do (TSD) alone and study group (n = 20) exposed to TSD with VR through the use of head-mounted immersive type of display powered by a smartphone VR box. Oxygen saturation (SpO2), pulse rate (PR), and anxiety/pain were monitored preoperatively, during LA administration and postoperatively. Results: SpO2 showed no significant difference between the groups, whereas PR and perceived pain levels were significantly different between the groups. Conclusions: PR and pain scores were reduced with the use of VR in children during the administration of LA. VR can be an effective tool in managing behavior of children rated Frankl positive and negative.

Application of magic distraction therapy for the alleviation of dental fear and anxiety in children younger than 12 years: a systematic review and meta-analysis of randomized controlled trials

Dental fear and anxiety (DFA) in children leads to increased pain sensitivity and challenging behaviors that complicate treatment. Employing magic as a distraction therapy utilizes children’s imagination and curiosity to mitigate these effects, yet its systematic evaluation is lacking. This study aimed to evaluate the effect of magic distraction therapy (MDT) in reducing DFA in children and identify the determinants of its efficacy. This study adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY202420074). We searched Embase, MEDLINE, Scopus, the Cochrane Central Register of Controlled Clinical Trials, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for randomized controlled trials (RCTs) involving children under 12 years receiving dental treatment with MDT. Studies that combined multiple distraction methods or used hypnosis were excluded. The meta-analysis analyzed the data using a random effects model, with subgroup analysis and meta-regression. The methodological quality of the studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The analysis included four RCTs involving a total of 180 children aged 2 to 11 years. Overall, 25.0% of the included studies had a low risk of bias, 75.0% had some risk of bias, and none had a high risk of bias. Magic significantly reduced dental anxiety (Hedges’ g = −1.236, 95% confidence interval (CI): −1.798 to −0.673, p &lt; 0.001), particularly during treatments involving local anesthesia (p = 0.006), performed concurrently during treatment (p = 0.008), and in younger children (coefficient = −0.2077 per year, p &lt; 0.001). This study supports MDT as an effective approach for reducing DFA in children, highlighting the importance of timing, anesthesia and patient age in optimizing anxiety reduction strategies.

Effect of a Distraction Method on Pain, Anxiety and Behavioral Distress among Children during Venipuncture

Effect of a Distraction Method on Pain, Anxiety and Behavioral Distress among Children during Venipuncture

Hemi one-piece distraction osteogenesis for unilateral coronal craniosynostosis

IntroductionIt was the aim of the study to assess the efficacy of the hemi one-piece distraction osteogenesis and to compare it to the traditional one-piece distraction osteogenesis technique. MethodsTwo different surgical techniques were used; the one-piece distraction and the hemi one-piece distraction. The principal distinction between the two techniques is that in the hemi style approach, the intact sutures on the contralateral side were left undisturbed, with no osteotomy performed. ResultsThe hemi one-piece group had a significantly lower median value of plastic surgery time, total operation time, and transfusion rate (plastic surgery time 69 min (range 65–120) vs. 20 min (range 17–32.5), p < 0.001; transfusion 80 mL (range 0–150) vs. 0 mL (0–60), p = 0.1. Nasofrontal advancement was successful with no major complications. Median endocranial angulation improved (one-piece: 166.1°–176.0°, hemi: 162.9°–173.0°, p = 0.023 & p = 0.012 respectively). ConclusionThis study reveals less invasive, highly effective techniques for craniosynostosis treatment, notably a unilateral osteotomy with distraction method. Nevertheless, to confirm their long-term efficacy and durability, more studies with longer follow-ups are essential.

The effect of virtual reality on pain, fear and emotional appearance during blood draw in pediatric patients at the hematology-oncology outpatient clinic: A randomized controlled study

ObjectiveInvasive attempts can be very painful and stressful for pediatric patients. Virtual Reality (VR) can be used to distract patients undergoing such procedures in pediatric hematology oncology patients. MethodsA parallel trial design approach was adopted for this randomized controlled trial, guided by the CONSORT checklist. The study sample (n = 69) was divided into a VR group (n = 34) and a control group (n = 35) using stratified randomization. For the blood draw attempt, no distraction method was applied to the control group, while the children in the VR group were distracted from the procedure with the Epic Roller Coasters VR application. The primary variable assessed was pain, while secondary variables were fear and emotional appearance. The scores of emotional appearance, fear, and pain were compared with a Mann-Whitney U Test. ResultsThe pre-procedure emotional appearance score was 11.3 ± 4.3 in the VR group and 11.0 ± 5.0 in the control group, and the post-procedure score was 6.5 ± 3.3 in the VR group and 11.8 ± 5.3 in the control group, indicating a difference in emotional appearance after the procedure. VR group had lower negative emotional appearance, lower pain, and lower fear scores after procedure compared to the control group. ConclusionVR can be considered an effective approach to reducing the negative emotional appearance and for relieving pain and fear in children aged 4–12 years undergoing blood draw procedures in pediatric hematology and oncology outpatient unit (ClinicalTrials.gov: NCT05675358).