Virtual reality intervention reduces pain, anxiety in kids during blood draws

A virtual reality intervention designed to distract children undergoing a blood draw significantly improved pain and anxiety, highlighting the possibility for virtual reality interventions for other procedures, according to researchers.

Cho Lee Wong, RN, PhD, a professor at the Chinese University of Hong Kong, and Kai Chow Choi, PhD, a senior research fellow of the Nethersole School of Nursing at the Chinese University of Hong Kong, wrote in JAMA Network Open that, for pediatric patients, venipuncture is “one of the most distressing and painful” procedures they experience. But new evidence indicates that offering information about the procedure and using immersive virtual reality (IVR) as a distraction might improve their experience.

“Poorly managed procedural pain and anxiety can have short- and long-term consequences to patients, increase the time and resources to perform the procedure, and decrease the health care professionals’ satisfaction with the procedures,” the researchers wrote. “Therefore, clinical guidelines emphasize the importance of managing procedural pain and anxiety in pediatric patients.”

According to the researchers, a distraction intervention “is the most frequently used nonpharmacological intervention in clinical settings to manage procedural pain and anxiety in pediatric patients undergoing needle-related procedures.” So, they conducted a randomized clinical trial to assess how IVR might affect pediatric patients undergoing a blood draw.

They recruited 149 pediatric patients aged 4 to 12 years — 57.7% of whom were girls — who had their blood drawn at a public hospital in Hong Kong between January 2019 and January 2020. The participants were randomly assigned to standard care (control group) or an age-appropriate IVR intervention: 74 were enrolled in the control group and 75 were enrolled in the IVR group.

Wong and Choi found that those in the IVR group reported significantly less pain (β = 0.78; 95% CI, 1.21 to 0.35) and anxiety (β = 0.41; 95% CI, 0.76 to 0.05) after the intervention. These patients did not report adverse effects like dizziness, headache or nausea during and after the procedure.

“Given that venipuncture is one of the most frequently performed and distressing procedures in hospitalized pediatric patients, the results generated in this study may contribute tangible improvements to patient care and outcomes,” the researchers wrote.

Additionally, the time it took to complete the procedure was significantly shorter in the IVR group than the control — 4.43 minutes compared with 6.56 minutes. Health care professional satisfaction scores were also significantly higher in the intervention group compared with the control group: 34.5 vs. 32.9 out of 40 points.

“Our encouraging results imply that an IVR intervention can be adopted as a high-quality clinical intervention for simultaneously offering distraction and procedural information to mitigate pain and anxiety in children undergoing venipuncture,” the researchers wrote. “In contrast to previously used approaches (eg, playing with toys and soothing by adults) that are time and resource intensive, IVR can be used virtually by numerous patients simultaneously at any time and place.”

Wong and Choi concluded that their findings “shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures.”

“The principles of this intervention can be generalized and extended to other needle-related or pain- and anxiety-inducing medical procedures beyond venipuncture,” the researchers wrote. “As IVR devices are becoming increasingly affordable, health care professionals may benefit from integrating IVR interventions into routine practices.”