Virtual distraction found effective in pain-linked anxiety

HONG KONG: The use of virtual reality (VR) headsets to distract the children undergoing any needle-based procedure to significantly lessen their anxiety, as well as nervousness of their parents, has been suggested by researchers involved in a recent study.    

Individuals of all ages can be anxious about needles, although this fear is particularly prevalent among children. Distraction tools, such as toys, can help reduce feelings of anxiety and pain among infants undergoing needle-based procedures.

A new research finds that virtual reality (VR) devices may be an even more effective distraction aid, leading to greater positive outcomes.

Led by The Chinese University of Hong Kong and published in JAMA Network, the study builds on prior explorations into the benefits of distraction during venipuncture (a common needle-based procedure).

“Previous [studies] were just distractions with cartoons or games,” Cho Lee Wong, Associate Professor in The Nethersole School of Nursing at The Chinese University of Hong Kong and co-author of the study, explains.

The research involved a total of 149 children aged 4-12, undergoing venipuncture, where a needle punctures the skin, divided into control and intervention groups.

The control group received ‘standard’ care during the procedure, involving comforting words and an explanation by a medical professional of what was happening.

Meanwhile, those in the intervention group received standard care but were also provided with a VR headset to wear during the procedure.

For children aged 4-7, the VR involved watching a cartoon character undergo venipuncture and explain why it was necessary. For children aged 8-12, the character explained the process in more detail — and they also played an interactive game where they took on the role of ‘doctor’.

“Our VR integrates distraction and procedural information,” notes Wong. “We think it’s important to prepare and let patients know what is going on and what should be expected, [as] it also helps ease their anxiety about the procedure.”

Furthermore, Wong shares, “We found that children had no difficulty understanding the content. The procedure was not difficult to understand, and we also told them in simple, age-appropriate language.”

The children self-reported their feelings of anxiety using a visual scale, while the researchers used the self-reported Faces Pain Scale to gauge their pain levels.

Compared to the control group, those in the VR group reported significantly lower amounts of pain and greatly reduced anxiety.

The average venipuncture procedure time was also much faster in the VR group; just under 4:30 minutes, compared to the control group for which it was just over 6:30 minutes.

In addition, the researchers monitored the children’s heart rates and cortisol levels to obtain further insights into their physiological reactions to anxiety and pain.

However, while the VR group showed a smaller increase in heart rate and a greater decrease in cortisol (the stress hormone), the amounts were not statistically significant.

Interestingly, the researchers noted that providing an additional game-play element in the 8-12-year-old VR group did not lower stress levels further.

“Our results found that the additional element of game play made no difference — despite other studies having found interactive games to have greater effect than passive viewing of VR content,” reveals Wong.

“This may be because children aged 8-12 did not have as high levels of anxiety as younger children, so the effects were less pronounced,” Wong shares. “This aspect may require further research.”