Virtual Reality Distraction Research Articles

An Attempt to Use Virtual Reality as a Tool to Reduce Patient Anxiety During Dental Treatment

Background/Objectives: Dental fear and anxiety are prevalent issues in both children and adult patients, often leading to avoidance of dental care and deterioration in overall health. While virtual reality (VR) has been increasingly studied as a distraction tool in pediatric dentistry, its effectiveness among adults remains under-researched. This study aims to evaluate the impact of VR distraction on reducing anxiety and physiological stress indicators in adult dental patients. Methods: The study was conducted in a private dental office in Dobrodzień, Poland, involving 90 adult dental patients divided into three groups: two experimental (VR1 and VR2) and one control (C), with 30 patients each. Patients in the VR1 group experienced VR distraction during the first visit, and the second visit was conventional; the VR2 group experienced this in reverse; and the control group underwent traditional treatment in both visits. Physiological parameters (heart rate, saturation, and stress) and psychological anxiety levels (MDAS and STAI-X1) were measured at three time points during each visit. Results: Significant reductions in heart rate and stress levels were observed after VR exposure compared to the control group. VR also demonstrated a significant effect in decreasing anxiety levels (based on STAI-X1) during the visit with VR distraction. No significant changes were found in the saturation levels across the groups. Conclusions: The use of VR as a distraction tool during dental procedures effectively reduces physiological stress and anxiety in adult patients, suggesting its potential as a valuable tool in managing dental anxiety. Further research is recommended to explore the long-term benefits and patient satisfaction with VR-based interventions in dental care.

32 A randomized controlled trial of virtual reality-based distraction for intravenous cannulation-related distress in children

Abstract Background Children commonly experience under-treated pain and distress related to medical procedures, such as intravenous insertions (IVI), leading to both short- and long-term negative consequences for patients and their caregivers. Virtual reality (VR) has emerged as a promising tool to ameliorate procedure-related distress in the paediatric healthcare setting; however, existing evidence has largely employed custom VR software, which can be expensive and inaccessible. As such, we aimed to characterize whether commercially available VR applications are effective in reducing children’s procedure-related distress. Objectives To assess the effectiveness of commercially available VR-based distraction when added to standard of care (SOC, which included topical anesthetic cream), in reducing distress for children undergoing IVI in the paediatric emergency department (PED). Design/Methods Children aged 6 to 17 years requiring IVI in a Canadian PED were recruited for a two-arm randomized controlled trial. The primary outcome was child distress, measured using the Observational Scale of Behavioural Distress – Revised (OSBD-R, score range 0-23.5). Secondary outcomes included child pain intensity (measured with the Faces Pain Scale-Revised, score range 0-10) and caregiver anxiety [measured by the State-Trait Anxiety Inventory-State (STAI-S), score range 20-80] during the procedure. Trial registration number: NCT04291404C. Results 82 children and their caregivers were included. 41 children received VR distraction in addition to SOC (mean age 10.8 years, SD 3.0), while 41 children received SOC alone (mean age 11.3 years, SD 2.8). There was no significant difference between OSBD-R-measured distress in the VR arm (mean 1.05, SD 1.52) compared to the SOC arm (mean 0.71, SD 1.40) (p = 0.08). There was no significant reduction in procedural pain intensity in the VR group (mean 4.20,SD 3.10) compared to the SOC group (mean 4.10, SD 3.20) (p = 0.85). There was no difference in caregiver STAI-S score immediately following IVI in the VR arm (mean 32.3, SD 11.3) versus the SOC arm (mean 32.3, SD 11.9) (p = 0.86). Conclusion VR distraction therapy employing commercially available software was not associated with reduction in procedural distress or pain, above that provided with SOC in the PED, for children undergoing IVI. This result highlights the need for more accessible custom VR distraction software, created to meet the unique psychological needs of children undergoing medical procedures. Further study is needed to directly compare custom versus commercially available VR software for this application.

The effect of virtual reality distraction on haemodialysis patients' pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial.

Pain and anxiety during arteriovenous fistula (AVF) puncture are crucial factors affecting haemodialysis (HD) patients' quality of life. The aim of this study is to assess the effect of virtual reality (VR) distraction on pain, anxiety, satisfaction and haemodynamics during AVF puncture. This randomised controlled trial study was conducted in a Haemodialysis unit at Mansoura University Hospital. Ninety-six patients were randomly divided into the intervention (n = 48) and control (n = 48) groups. Six minutes prior to the puncture, patients in the intervention group used VR glasses to experience a 360° 'Relax River VR tour', whereas patients in the control group received no intervention. Following the intervention, pain, anxiety, systolic blood pressure and heart rate were significantly lower, and satisfaction scores were significantly higher in the intervention group than in the control group (p < 0.05). VR distraction may help alleviate pain, anxiety and increase satisfaction. It may be considered a safe and cost-effective non-pharmacological therapy for HD patients undergoing AVF puncture.

Commentary: The effect of virtual reality distraction on haemodialysis patients' pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial.

Commentary: The effect of virtual reality distraction on haemodialysis patients' pain and anxiety during arteriovenous fistula puncture: a randomised controlled trial.

3-Dimensional Virtual Reality Versus 2-Dimensional Video for Distraction During the Induction of Anesthesia in Children to Reduce Anxiety: A Randomized Controlled Trial.

Preoperative anxiety is common in children. It can contribute to negative experiences with anesthetic induction and may cause adverse physiological and psychological effects. Virtual reality (VR) and electronic tablet devices are 2 audiovisual distraction tools that may help to reduce anxiety and enhance the preoperative experience. This study aimed to compare the use of an immersive 3-dimensional (3D) VR to 2-dimensional (2D) video on anxiety in children during induction of general anesthesia. Two hundred children (4-13 years) undergoing elective or emergency surgery under general anesthesia were enrolled in this randomized, controlled trial. Participants were randomized to use either the 3D VR goggles (intervention) or 2D video tablet (control) during anesthetic induction. Anxiety, the primary outcome, was measured using the modified Yale Preoperative Anxiety Scale Short Form (mYPAS-SF) at 2 time points: in the preoperative holding area before randomization (T1) and during induction of general anesthesia (T2). The primary outcome was analyzed using a linear regression model, including demographic and other covariates, to investigate any differences in anxiety scores. Secondary outcomes included evaluating compliance during the anesthetic induction (Induction Compliance Checklist), emergence of delirium (Cornell Assessment of Pediatric Delirium), perceived usefulness of the device, and child satisfaction. Participant characteristics were similar between the 3D VR (n = 98) and 2D video (n = 90) groups, with a mean (±standard deviation) age 8. 8 ± 2.8 years. The median (lower quartile, upper quartile) mYPAS-SF scores for the 3D VR group at the preoperative holding area were 22.9 (22.9, 35.4), then 29.2 (24.0, 41.7) during induction. For the 2D Video group, the scores were 27.1 (22.9, 35.4) and then 30.2 (22.9, 41.1). No significant difference was observed in the increase in mYPAS-SF scores between groups (P = .672). Children in the 3D VR group were less likely to be rated as having a perfect induction (P = .039). There was no evidence of a difference between the groups in emergence delirium. Both devices were rated highly for usefulness and patient satisfaction. Children preferred VR, while anesthesiologists and parents felt the 2D was more useful. This randomized controlled trial demonstrated that preoperative anxiety was equally low and induction compliance high with both 3D VR and 2D video distraction in children with parental presence during anesthetic induction.

Is Virtual Reality Effective in Decreasing Pain during Clinical Procedures among Children: A Systematic Review and Meta-analysis.

Virtual reality (VR) refers to a computer-generated simulation or environment that can be experienced and interacted with by a person through special electronic equipment, such as a headset with a screen and motion-tracking sensors. VR has been used as a distraction technique to alleviate pain and discomfort during medical procedures or as an alternative to traditional pain medication. This article explores VR's effectiveness in reducing pain in pediatric patients undergoing painful clinical procedures. This systematic review and meta-analysis was performed as per the preferred reporting item for systematic review and meta-analysis guidelines. A systematic literature search was conducted for all articles published till December 2022 in four different databases: PubMed, Scopus, Embase, and LILACS, which yielded 6886 studies. Studies showing the effect of VR on pediatric patients undergoing clinical procedures were included in the study. Risk of bias (ROB) 2.0 was used to assess the ROB. Outcome data were pooled using a random-effects model and reported as standardized mean difference (SMD) with a 95% confidence interval (CI). The meta-analysis was performed on RevMan5.4. Subgroup analysis was done for the different clinical procedures. A total of 2477 participants from 34 studies were included in the meta-analysis. Children in whom VR was used had a significantly lower pain score as compared to the control group with an SMD of 0.87 (CI 95% -1.20, -0.53; (P < 0.00001). Subgroup analysis based on the type of intervention did not reveal any significant difference (P = 0.19). Heterogeneity for overall pain using a random effect model with I 2 was significant (P < 0.00001). This systematic review suggests that the use of VR distraction in children undergoing painful procedures is associated with significantly lower pain scores. Hence, VR can be a promising intervention for reducing pain experienced by pediatric patients during medical procedures.

Immersive Virtual Reality Versus Video Distraction for the Management of Emergence Delirium in Children: A Randomized Controlled Study

PurposeEmergence delirium (ED) presents challenges for both parents and health care providers in pediatric surgical settings. This study aims to evaluate the effectiveness of immersive virtual reality (VR) distraction and video distraction combined with parental presence in reducing ED in preschool-aged children undergoing elective surgery. DesignA prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. MethodsParticipants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care. FindingsImmersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27). ConclusionsThis study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.

Unsedated colonoscopy utilizing virtual reality distraction: a pilot-controlled study.

Sedation increases colonoscopy risks and prolongs recovery time. We examined whether virtual reality (VR) can substitute for sedation. The primary outcome was the overall satisfaction of patients who underwent colonoscopy with VR headset compared with patients who underwent standard sedation. Pain during the procedure, polyp detection rate (PDR), colonoscopy duration, post-colonoscopy adverse events, post-colonoscopy recovery, time-to-return to daily functions, and turnaround time at the endoscopy unit were secondary outcomes. The study was approved by Sheba Medical Center's ethics committee IRB number 21-8177-SMC. Sixty patients were sequentially enrolled in a 1:1 ratio to either standard sedated colonoscopy or VR-unsedated procedure, and all patients signed a written informed consent. 28/30 patients successfully completed the colonoscopy using VR headset. Overall satisfaction score was comparable between the groups. There was no difference between VR and controls in colonoscopy duration, or PDR. VR patients had numerically lower rate of post-colonoscopy adverse events than controls. The proportion of VR patients who reported resuming daily activities on the day of the procedure was significantly higher than in the control group. The VR group patients spent significantly less time in the hospital compared to the control group. VR technology can provide adequate substitution for sedation for most patients undergoing colonoscopy and offers comparable patient satisfaction and faster return to daily activities.

Evaluation of Virtual Reality in the Reduction of Pain During Dressing Changes in Patients With Burn Wounds: A Pilot Study.

Burn injuries are among the most common life-threatening injuries for which medical attention is sought, and are accompanied by intense, severe pain, particularly during treatment. Burn therapy pain management with opioid and nonopioid analgesics is often insufficient when administered alone. Virtual reality (VR) interfaces provide an immersive experience that has demonstrable therapeutic benefits, including distraction from, and reduction of, pain. In this interventional pilot study, we assessed the correlation between VR and passive distraction and pain tolerance during burn wound treatment. This pilot study assessed patients undergoing burn wound dressing changes while receiving both pharmacological and VR intervention. Questionnaires and evaluation forms were subjectively completed by both patients and medical staff before and after treatment, and clinical metrics were recorded throughout the treatment. Forty-one patients ≥18 years old and 76.9% male that had primarily undergone ≥4 dressing changes before the study were included. Correlations were found between VR engagement during treatment and a decrease in subjective levels of nausea, anxiety, and pain sensation. Furthermore, high levels of VR engagement were correlated with high levels of VR enjoyment. These results suggest that highly engaging and enjoyable VR interfaces may reduce sensations of anxiety and pain in burn patients during dressing changes. Furthermore, these data suggest that VR technology may be applied as an adjunct therapy to pharmacological treatment in the standardization of burn wound care management. Further studies with control groups and larger sample populations are needed for better quantification of these benefits.

Effectiveness of Two Types of Distraction Techniques in the Management of Pain and Anxiety during Dental Treatment in 6-9-year-old Children.

To determine the effectiveness of distraction with virtual reality (VR) distraction devices in comparison with mobile phone video games in the management of pain and anxiety during dental treatment in 6-9-year-old children. It was a comparative observational study. A total of 33 children aged 6-9 years who reported to the department for their first dental visit were selected and the subjects were divided into three groups. Group I patients were in a normal clinical environment without any distractions. Group II patients were given mobile phone video games. Group III patients were given a VR distraction device as a means of distraction.The anxiety levels of patients before treatment, after using a distraction device preoperatively, during local anesthesia injection, and after dental treatment were assessed. Pain after local anesthesia injection in each group was assessed. The easability of handling the patient and carrying out the procedure was assessed using a questionnaire. All data were collected and analyzed. The results showed when compared to the children in groups I and II, children in group III obtained significantly lower anxiety scores after treatment, and they also reported significantly decreased pain perception during dental treatment (p < 0.001). The pain while administering local anesthesia was greater for the control group and lowest for the VR group. It was observed that VR group patients were easier to handle and easier to carry out procedures than those in the mobile phone group. Virtual reality distraction is an effective distraction technique for reducing pain and anxiety in children during various treatment procedures. Virtual reality distraction can be used effectively in clinics.It is a patient-friendly technique and is more comfortable for both patients and dentists during treatment.It does not require any previous education and training and has a positive impact on memories of the treatment, leading to behavior modification. Chandran LS, Issac JS, Girija P, et al. Effectiveness of Two Types of Distraction Techniques in the Management of Pain and Anxiety during Dental Treatment in 6-9-year-old Children. Int J Clin Pediatr Dent 2024;17(3):291-296.

Virtual reality use in pediatric patients for orthopedic clinical procedures: A randomized prospective trial of efficacy.

Distraction therapy use such as virtual reality is novel in the pediatric orthopedic field. In this study, we use subjective and objective metrics to evaluate virtual reality efficacy to reduce anxiety and pain in a pediatric orthopedic cohort. A prospective randomized controlled trial included patients between age 5 and 17 years, presenting to a tertiary care pediatric orthopedic clinic. Parallel groups underwent orthopedic procedures in clinic, utilizing immersive and interactive virtual reality distraction therapies versus standard of care. Procedures included cast application, cast removal, bone pin removal, and fracture reduction. All preprocedure parameters were similar between the groups. Primary outcome was the difference between maximum procedural heart rate and baseline. Secondary outcomes included Wong Baker FACES Rating Scale (Wong & Baker, 1988, Oklahoma, USA) for pain and Visual Analog Scale scores for anxiety. Ninety-five patients (66 M, 29 F) underwent 59 cast removals, 26 cast applications, 7 percutaneous pin removals, and 3 fracture reductions. Average patient age in the virtual reality and control cohorts was 10.1 (5-17) and 10.6 (5-17), respectively. Average change in maximum heart rate in the virtual reality and control groups was 10.6 ± 10.1 versus 18.4 ± 11.0 (p = 0.00048). The virtual reality group demonstrated trends toward lower perceived anxiety (1.7 ± 2.8 versus 2.9 ± 3.6, p = 0.0666) when compared to controls. This level 1 study is the first to utilize objective biometric measurements to evaluate use of interactive virtual reality during multiple types of pediatric orthopedic procedures in the clinical setting. The findings suggest that an interactive and immersive virtual reality experience can be effective in reducing pain and anxiety. Level 1, Randomized Controlled Trial.

Impact of Virtual Reality Distraction on Pain and Anxiety for Bedside Abdominal VAC Dressing Change (VIRPA) – A Randomized Controlled Clinical Trial

Abstract Background Virtual reality (VR) distraction techniques are promising adjuncts to reduce pain and anxiety. Aims This study assessed the impact of VR distraction during bedside change of vacuum assisted closure (VAC) dressings. Methods In this non-blinded randomized superiority trial, patients scheduled for bedside change of a subcutaneous VAC dressing were allocated to receive distraction through VR masks in addition to a standardized pain protocol (intervention) or pain protocol alone (control). Primary endpoints were pain scores assessed by a visual analogue scale (VAS:0-10), secondary outcomes were anxiety (State Trait Anxiety Inventory (STAI-Y:20-80), VAS:0-10), hemodynamic parameters and satisfaction (VAS:0-10). Results Nineteen and twenty-one patients were randomized to receive intervention and control, respectively. Baseline characteristics were well balanced including age (61±11 vs. 62±17), sex (female: 9 vs. 13), American Society of Anesthesiologists (ASA) scores (≥3: 18 vs. 18, all non-significant). Pre- and postoperative pain levels were 2.2±2.2 vs. 2.0±2.1 (p=0.38) for the intervention group compared with 2.6±2.1 vs. 2.2±1.6 (p=0.26), with no significant difference between the groups (p=0.38). Similar findings for blood pressure and heart rates. Anxiety was reduced in both groups post VAC change in the intervention and control group: STAI 40±12 pre-VAC vs. 30±8 post VAC and 45±14 pre-VAC vs. 32±9 post VAC (both p&amp;lt;0.01), ΔVAS -2 (interquartile range IQR 0, -3) vs. -2 (IQR 0, -5), both p&amp;lt;0.01. Postinterventional satisfaction was 8.3±1.9 (intervention) vs. 7.5±2.4 (p=0.11). Conclusion In this study, pain and anxiety were well managed with a standardized pain protocol with or without adjunct VR distraction. Further studies will focus on patients with insufficient control of pain and anxiety with a standard protocol.

Virtual Reality Distraction for Needle-Related Pain and Distress in Children: A Multicenter Randomized Controlled Trial.

This international multicenter randomized controlled trial aimed to compare the effectiveness of virtual reality (VR) distraction with an identical non-VR game in reducing needle-related pain and anxiety in children undergoing venous blood draw. The study involved 304 children aged 5-9 years undergoing a blood draw procedure, randomly allocated to one of three groups: VR distraction, non-VR distraction, and control group (usual care). The distraction task was based on the Multiple Object Tracking (MOT) paradigm, and the game was identical in design and gameplay for both VR and non-VR distraction groups. The primary outcome was self-reported pain intensity using the Faces Pain Scale-Revised (FPS-R). Secondary outcomes included child distress, attention/distraction to the blood draw, and parent and medical staff satisfaction with procedure. Analyses were conducted using analysis of variance and multivariable linear regression models. The results showed that VR distraction and non-VR distraction performed similarly, showing large effect sizes compared with standard care. There was no significant difference between the two types of distraction. The study's findings suggest that VR and non-VR distraction are similarly effective in reducing needle-related pain and anxiety in children undergoing venous blood draw. This is the first well-powered study comparing modern VR distraction with an identical task displayed on a smartphone or monitor screen. The study's results have important implications for using VR in clinical settings and suggest that investing in expensive VR equipment for acute pain management may not be necessary. The study protocol was pre-registered on Open Science Framework at https://osf.io/frsyc.

Virtual reality for pain management in hospitalized patients with cancer: A randomized controlled trial.

Hospitalized patients with cancer often experience acute and/or chronic pain. Although virtual reality (VR) has been extensively studied across a wide range of clinical settings, no studies have yet evaluated potential impact on pain management in this patient population. Prospective randomized controlled trial at an urban academic hospital comparing VR against an active control to mitigate moderate-severe cancer disease and treatment-related pain. A total of 128 adult hospitalized patients with cancer (any tumor type) were randomized to 10 minutes of immersive VR distraction therapy or 10 minutes of two-dimensional guided imagery distraction therapy delivered by handheld tablet. Participants in the two arms were similar in age, sex, race, presence of metastatic disease, concurrent pain specialist consultation, and baseline opioid use. Although both groups experienced improved self-reported pain scores (primary outcome), those randomized to VR experienced significantly greater reduction in pain immediately after intervention compared with active control (p=.03). This difference was sustained for 24 hours as well (p=.004). Within-group analysis showed significant improvement in VR arm of pain bothersomeness (p=.05) and general distress (p=.03) as well. Among hospitalized adult patients with moderate-severe pain related to cancer and cancer therapies, VR provided more nonpharmacologic pain relief than active control and this benefit sustained long after conclusion of the intervention. Virtual reality (VR), a developing technology that immerses the user in new environments, has been shown to improve pain in different patient populations. To test the role of VR in improving pain in hospitalized patients with cancer who report moderate-severe pain, we compared the impact of a 10-minute immersive VR intervention to that of a 10-minute two-dimensional guided imagery experience to improve self-reported pain scores. We found that, although both interventions improved pain, VR did so significantly more. Moreover, participants assigned to VR had sustained improvement in pain 24 hours later.

The effect of virtual reality glasses on dental anxiety during scaling and root planing in patients with periodontitis: A randomized controlled clinical trial.

This study aimed to evaluate the effect of virtual reality distraction (VRD) on dental anxiety during scaling and root planing (SRP) in periodontitis patients. This randomized controlled split-mouth study included 60 patients who scored 9 or above on the dental anxiety scale (DAS) and required SRP in at least two quadrants with at least five teeth and two sites with a probing depth of ≥4 mm. Randomly chosen quadrants were treated using virtual reality glasses, and other quadrants were treated without glasses at the same visit. During VRD, a video of nature scenes was projected onto the screen in front of the patient's eyes. DAS and a visual analogue scale about patient feelings were applied at the end of the procedure. With VRD, the scale value of pain and discomfort level (VASP) was significantly reduced (p = 0.01, d = 0.57). Starting treatment without glasses significantly decreased VASP in both control and test sides (p = 0.00, d = 0.85; p = 0.00, d = 0.80, respectively) and increased the sensation of immersion and realism (p = 0.03, d = 0.45; p = 0.02, d = 0.46, respectively). Intraoperative and postoperative DAS values were significantly lower in patients who started treatment without VRD (p = 0.04, d = 0.34; p = 0.02, d = 0.44, respectively). Of the patients, 63.3% preferred VRD in the subsequent treatment. While patient preference did not correlate with sex, it correlated with age (r = -0.48, p = 0.01). The VRD and initiating SRP procedure with VRD affected the pain and discomfort level in anxious periodontitis patients. In addition, the anxiety level was also affected by starting the procedure with glasses.

Virtual Reality is Beneficial in Decreasing Pain in Laboring Women: A Preliminary Study

(Aust N Z J Obstet Gynaecol. 2023; 63: 193–197) Labor pain is a highly variable experience, with a wide range of both pharmacological and nonpharmacologic methods available to help relieve pain during labor. Virtual reality (VR) distraction therapy is one of many nonpharmacologic modalities shown to assist patients in managing their acute pain in clinical settings. This has been tested in patients undergoing chemotherapy, physical therapy, treatment for dental work, and burn wounds, among other procedures. Those who use VR technology wear a headset to experience a 3D multisensory virtual world. Four published quantitative studies to date have used VR to determine the influence of VR on laboring women’s pain scores. This preliminary study is an open-label, randomized, controlled cross-over trial to examine how effective VR is in decreasing pain in laboring women.

Effectiveness of Virtual Reality Environment for Post-Operative Pain Management

Objectives The imperative need of post-operative period is effective pain management. Virtual reality (VR) causes psychological distraction from pain stimuli, and thus may cause pain alleviation. The study was undertaken to determine the effectiveness of VR distraction on post-operative pain and experience of VR sessions among the patients. Material and Methods A hospital-based interventional study was conducted for a period of two months with the objectives to estimate changes in post-operative pain intensity after VR session as well as to analyze experience related to VR interventions. It comprised patients of either gender undergoing surgery and with 1–3 days of hospitalization, who were randomized into two groups (age and gender matched). The control group was kept on standard post-operative pain management. The interventional group was subjected to VR exposure in addition to standard care therapy. The Numerical Rating Scale (NRS) scores were obtained twice post-operatively in subsequent days. I-group presence questionnaire (IPQ) responses were obtained after the VR session. Results Both control and interventional groups had 25 participants each for analysis. In both the groups, majority were given bupivacaine for anesthesia and combination of paracetamol and diclofenac for post-operative analgesia. The NRS scores of both groups obtained post-operatively on standard therapy without VR intervention did not show any significant difference. However, the post-VR-sessions’ NRS scores showed significant reduction as compared to pre-session scores among the participants of the interventional group. The responses obtained via IPQ revealed acceptance for the features of realism, engagement, and presence during VR intervention. Majority confirmed their willingness to undergo VR sessions in future. Conclusion VR session helped in significant reduction of pain perception as VR simulation diverted considerable attention away from the pain. Majority expressed positive inclination for utilization of VR in comprehensive patient care.

Effects of virtual reality on pain induced by arteriovenous fistula needle insertion in patients undergoing hemodialysis: A randomized clinical trial.

Chronic kidney disease (CKD) is characterized by irreversible damage to renal function. For patients undergoing replacement therapies like hemodialysis (HD), the pain caused by arteriovenous fistula (AVF) cannulation becomes a significant aspect of their daily lives. This study aimed to examine the impact of virtual reality (VR) distraction techniques on the pain experienced during AVF needle insertion in patients undergoing HD. This randomized clinical trial (RCT) recruited a total of 60 patients undergoing HD from the 9 Dey Hospital in Torbat Heydariyeh, Iran, between March and August 2022. These patients were then divided into two groups: the intervention group and the control group. The intervention group received distraction techniques using the Shinecon 4th Gen Virtual Reality Headset, while the control group received routine care services. To assess the level of pain experienced during AVF cannulation, the Visual Analog Scale (VAS) was utilized. The collected data were analyzed using SPSS20. Various statistical tests, including the Chi-square test, Mann-Whitney U test, Multiple linear regression, and independent-samples t-test, were employed for data analysis. Additionally, Cohen's d was used to determine the effect size of the intervention. The analysis of the data revealed a statistically significant difference in the mean (SD) pain scores between the control group (7.6 ± 0.8) and the intervention group (5.1 ± 0.9) (p < 0.002 after Bonferroni correction). Furthermore, it was observed that a majority of patients in the intervention group reported experiencing moderate pain, whereas the control group experienced more severe pain. The study findings demonstrated that the use of virtual reality (VR) was effective in reducing the intensity of pain experienced during AVF needle insertion in patients undergoing HD. Based on these results, it is recommended to incorporate VR as a routine practice in the HD department of the hospital. This study, with the code no. IRCT20180429039463N3, was registered on the Iranian Registry of Clinical Trials on 28/03/2022.

Virtual Reality Distraction: A Novel Behaviour Management Technique

ABSTRACT Virtual reality distraction (VRD) is developing technologies for behavior management that can assist a child in adjusting to the dental setting and provide high-quality dental care. The purpose of this literature is to shed light on VRD and its application to the treatment of pediatric dental patients.

Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review.

Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods. To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary. The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0. In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect. The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.