The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics: A Systematic Review and Meta-Analysis

Nordgård, Rikke Kathrine; Låg, Torstein

doi:10.3389/frvir.2021.699383

Cited by 23 publications

(23 citation statements)

References 167 publications

(201 reference statements)

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“…The rising applicability of iVR in medicine is consecutive to exponential technological growth and availability, and it is predicted to become as ubiquitous as smartphones are today [ 23 ]. Immersive virtual reality (iVR) interventions are reported to lower patients’ fear concerning a variety of medical procedures such as dental, magnetic resonance claustrophobia, or needle puncture [ 24 ], as well as decreasing acute procedural pain [ 25 ] and anxiety of both children and adults [ 26 , 27 , 28 ]. Nowadays, iVR equipment is a more affordable technological breakthrough, reflecting current consumer HMDs higher specifications and lower prices.…”

Section: Introductionmentioning

confidence: 99%

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Găină

Szalontay

Ştefănescu

et al. 2022

JCM

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Background: Colonoscopy related fear impairs the current gold standard screening of colorectal cancer. Compared to other minimally invasive procedures for cancer screening, colonoscopy-induced anxiety exceeds the procedure through bowel preparation. Immersive virtual reality’s (iVR) role in alleviating the complex stress–pain relationship encountered during medical procedures is directly proportional to the rising affordability of state-of-the-art Head-Mounted-Displays (HMDs). Objective: to assess the effect of iVR on patients’ colonoscopy-induced anxiety and pain. Materials and methods: A systematic search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and Scopus databases up to January 2022. Clinical trials evaluating anxiety as an outcome were included without language restriction. Results: Four clinical trials were included: three on the patients’ intraprocedural anxiety and one on patient education. Intraprocedural iVR interventions for colonoscopy-induced anxiety and pain revealed a similar effect as conventional sedation, while a statistically significant reduction was reported for non-sedated patients. iVR patient education improved the quality of bowel preparation and reduced patient anxiety before colonoscopy. Conclusions: The current research highlights the need to use high-end HMDs and appropriate interactive iVR software content for colonoscopy-induced anxiety. Methodological frameworks regarding the eligibility of participants, double-blinding and randomization of iVR studies can facilitate the development of iVR implementation for anxiety and pain management.

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Section: Introductionmentioning

confidence: 99%

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Găină

Szalontay

Ştefănescu

et al. 2022

JCM

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“…The available evidence for supporting the use of VR in managing distress in children undergoing painful procedures is still scarce [18,19] and the results from some studies report inconsistent effects on distress and anxiety in children during invasive procedures [20]. Although VR has been shown sometimes effective in the management of distress and anxiety in children, the available studies on this subject largely differ for their design, intervention, and outcome measures [21,22].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a VR Intervention to Decrease Anxiety in Children with Tumors Undergoing CVC Dressing

Russo

Tozzi

Mastronuzzi

et al. 2022

IJERPH

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Virtual reality (VR) represents a promising digital intervention for managing distress and anxiety in children with tumors undergoing painful medical procedures. In an experimental cross-over study, we administered a VR intervention consisting of relaxing games during central venous catheter (CVC) dressing. The VR sessions were compared with no-VR during CVC medication. We used the distress thermometer and RCMAS-2 scale to assess distress and anxiety levels. We also explored the satisfaction level in patients and families. We enrolled 22 children. The distress levels after medication were lower in the VR group than in those without VR (VR: median 2; IQR 0–2; no-VR: median 4; IQR: 3–5). No variation in anxiety levels was detected by VR intervention. Satisfaction for using VR was very high in children and their families although a total of 12% of children were disappointed by the effect of VR. Most healthcare workers felt that VR would be useful in routine clinical practice. A VR intervention is highly acceptable, may be efficacious in decreasing distress in children with cancer undergoing painful procedures, but it is less likely that it has a measurable impact on anxiety. Evidence from larger studies is needed to assess VR translation into the clinical workflow.

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“…When applied during an acutely stressful situation, VR has already been shown to lead to immediate and significant lowering of stress levels, marked by changes in heart rate variability and cortisol levels, as well as significant improvements in subjective measures of anxiety and affect (Liszio et al, 2018). The strongly absorbing nature of immersive VR environments that are designed to act as an immediate anxiety relief (Valtchanov, 2010;Yu et al, 2020), offer a competing stimulus (Wiederhold et al, 2014;Nordgård and Låg, 2021) and may act as a sobering tool during an overchallenging or otherwise psychologically detrimental psychedelic experience. Even when not utilized, the knowledge that VR is available as an immediate rescue tool may act as a safety net for the participant, aiding the sense of relaxation, trust and surrender into the experience.…”

Section: Rescuementioning

confidence: 99%

Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy

Sekula

Downey

Puspanathan³

2022

Front. Psychol.

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Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design that promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation.

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The Effects of Virtual Reality on Procedural Pain and Anxiety in Pediatrics: A Systematic Review and Meta-Analysis

Cited by 23 publications

References 167 publications

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

Feasibility of a VR Intervention to Decrease Anxiety in Children with Tumors Undergoing CVC Dressing

Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy

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