Effect of Immersive Virtual Reality during Arteriovenous Fistula Puncture on Pain Intensity among Children Undergoing Hemodialysis in El Beheira Governorate

Abstract

Background: Pain is an inherently human experience with the Arteriovenous Fistula Puncture, especially among children. Thus, it becomes of utmost importance to devote modern technologies to lessen this annoying sensation aside from the suffering from the disease itself. Thereof, this study aimed to evaluate the effect of immersive virtual reality intervention during arteriovenous fistula puncture on pain intensity among children undergoing hemodialysis in El Beheira Governorate, Egypt. Methods: A non-randomized controlled trial was executed in eight governmental hemodialysis units (that were assigned to receive pediatric cases), representing eight administrative districts. All the available children who fulfilled the inclusion criteria were incorporated in the study (36 children). Five tools were used: Socio-demographic and Medical History Structured Interview Schedule, Physiological Pain Indicators, Numerical Pain Rating Scale, Procedural Behavior Rating Scale and the Gold-Rizzo Immersion and Presence Inventory. Results: The Analysis of Covariance test (ANCOVA) proved a large effect size of virtual reality intervention on all pain measures (η2≥0.06). A statistically significant improvements in the mean scores of all the physiological pain measures was found after virtual reality intervention as compared to baseline (P0=<0.05) and standard care (P2<0.05). Most of the studied children reported either mild (58.3%) or moderate (27.8%) pain with no severe pain after virtual reality intervention with a statistically significant mean difference compared to the baseline (p0<0.001) and standard care (p2<0.001). A significant difference was proved between the virtual reality intervention and standard care concerning the observed pain behaviors during the procedure (p2<0.001). A high level of immersion with the virtual reality intervention was revealed among the studied children with a mean percent score of 90.97 ± 7.23. Conclusion & recommendations: Virtual Reality intervention proved to be efficient in lessening pain intensity among children undergoing hemodialysis. Thereof, it is recommended to be incorporated in the routine care of pediatric hemodialysis units.