Effect of Immersive Virtual Reality Education Before  Chest Radiography on Anxiety and Distress Among Pediatric Patients

Han, Sung Hee; Park, Jin Woo; Choi, Sang Il; Kim, Ji Young; Lee, Hyunju; Yoo, Hee Jeong; Ryu, Jung Hee

doi:10.1001/jamapediatrics.2019.3000

Cited by 34 publications

(67 citation statements)

References 12 publications

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“…This supports previous findings in the literature. Our previous study investigating pediatric patients who received VR prior to undergoing chest radiography showed that VR decreased the number of distressed patients from 48% to 22.4% [ 32 ]. Ganry et al [ 33 ] measured the salivary cortisol concentration, which is a biological marker of anxiety, in 20 patients scheduled for surgery.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Koo

Park

Ryu

et al. 2020

JCM

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Virtual reality (VR), a technology that provides a stimulated sensory experience, has recently been implemented in various fields of medicine. Several studies have investigated the efficacy of VR on preoperative anxiety. The purpose of this meta-analysis was to validate whether VR could relieve preoperative anxiety in patients undergoing surgery. Electronic databases were searched to identify all randomized controlled trials (RCTs) investigating the effect of VR on preoperative anxiety. The primary outcome was defined as the preoperative anxiety scores. We estimated the effect size using the standard mean difference (SMD) with a 95% confidence interval (CI) using a random effect model. Ultimately, 10 RCTs, with a total of 813 patients, were included in the final analysis. Preoperative anxiety was significantly lower in the VR group than in the control group (SMD −0.64, 95% CI −1.08 to −0.20, p = 0.004). In a subgroup analysis, the preoperative anxiety scores were lower in the VR group than in the control group in pediatric patients (SMD −0.71, 95% CI −1.14 to −0.27, p = 0.002), whereas a significant difference was not observed between the two groups in adult patients (p = 0.226). The results of this meta-analysis indicated that VR could decrease preoperative anxiety, especially in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Koo

Park

Ryu

et al. 2020

JCM

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“…Children in the tablet group experienced the process of chest radiography indirectly with a 3 min video using a tablet PC ( Figure 1 A). Children in the VR group, on the other hand, experienced the same content and information as the control group, but using a head-mounted VR display ( Figure 1 B), offering a 360°, 3-dimensional virtual environment that introduced and explained the process of chest radiography, which was described by Han et al [ 5 ]. In this VR content, the participant, along with Chatan and Ace, who are famous animation characters in the animated film Hello Carbot (Choi- Rock Contents Factory, Seoul, Republic of Korea), experienced the chest radiography together in the radiography room ( Figure 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…Pediatric patients usually suffer from anxiety and distress ahead of a procedure or surgery; the primary challenge of hospital staff is to reduce such anxiety and distress. Besides various interventions, such as premedication, parental presence and behavioral intervention [ 3 , 4 ], exposure therapy using video or VR is shown to be effective in controlling anxiety and distress among children before a procedure or surgery [ 5 , 6 , 7 , 8 ]. Exposure using video or VR allows the pediatric patients to confront the fearful or unknown situation by providing visual expectations ahead of the procedure, allowing the children to become familiar with the room and the overall process [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Virtual Reality vs. Tablet Video as an Experiential Education Platform for Pediatric Patients Undergoing Chest Radiography: A Randomized Clinical Trial

Ryu

Park

Choi

et al. 2021

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Virtual reality (VR), which offers an immersive experience, has been implemented into the education of pediatric patients to reduce peri-procedural anxiety. This randomized clinical trial evaluated the effect of VR, compared with standard video, on reducing anxiety and distress in pediatric patients undergoing chest radiography. A total of 120 children aged 4 to 8 years with scheduled chest radiography appointments were randomized into either the tablet or the VR group. Children in the tablet group experienced chest radiography indirectly with a 3 min tablet video, whereas those in the VR group received the same content via a VR experience. The distress of children was measured using the Observational Scale of Behavioral Distress (OSBD) scale. Parental presence and procedural outcomes were also recorded. The number of less distressed children (OSBD score < 5) was significantly higher in the VR group than in the tablet group (49 [81.7%]) vs. 32 [53.3%]) (p = 0.001). The OSBD scores, the need for parental presence, the procedure time, and the number of repeated procedures were all lower in the VR group. The immersive VR experience appears to decrease the degree of anxiety in children and increase the efficiency of the procedures compared with the tablet video with the same content.

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“…Physicians, nurses, and families (including the patients) require relevant and trusted information delivered in an engaging, and developmentally and professionally appropriate way to support the rapid acquisition in knowledge [44,45]. Recent advances in medical education for patients and clinicians have focused on using immersive virtual and augmented reality (AR/VR), app-based interactive training, virtual assistants to answer questions in real-time, 3D modeling, and online real-time education [8,46,47]. In particular, virtual assistants or chatbots have been identified as a technology suitable for supporting patient groups with focused information available in real time [48][49][50].…”

Section: Principal Findingsmentioning

confidence: 99%

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Dimitri¹,

Fernández-Luque²,

Banerjee³

et al. 2021

J Med Internet Res

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Background The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Objective Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. Methods A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. Results A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. Conclusions The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

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Effect of Immersive Virtual Reality Education Before Chest Radiography on Anxiety and Distress Among Pediatric Patients

Cited by 34 publications

References 12 publications

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

Virtual Reality vs. Tablet Video as an Experiential Education Platform for Pediatric Patients Undergoing Chest Radiography: A Randomized Clinical Trial

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

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