Virtual Reality for Anxiety Reduction in Women Undergoing Colposcopy: A Randomized Controlled Trial

Abstract

ObjectiveTo test whether headset-delivered virtual reality (VR) content affects satisfaction and/or anxiety in women with cervical squamous intraepithelial lesions undergoing colposcopy and colposcopically guided cervical biopsy.MethodsIn this single-center, randomized trial, the authors measured overall satisfaction (100-mm visual analog scale) and situation-specific anxiety (STAI-S) in 247 women with suspected cervical squamous intraepithelial lesions wearing either no VR headset (arm 1, control) or a VR headset before (arm 2) or before and during colposcopy (arm 3). Secondary endpoints were pain, discomfort, and anxiety during colposcopy, heart rate, and 72-hour follow-up parameters: overall satisfaction, bleeding severity, bleeding duration, pain, and use of analgesics. Analysis was by intention to treat.ResultsMedian values for overall satisfaction were 100 (interquartile range, 90–100) in controls (n = 83), 100 (95–100) in arm 2 (n = 82), and 100 (95–100) in arm 3 (n = 82), respectively (p = .92). The median Δ of situational anxiety (baseline vs after colposcopy) was −8 (−13 to −3), −8 (−16.5 to −4), and −10 (−20.5 to −4.5), respectively (p = .09). The secondary endpoints pain during colposcopy (20 [10–50] vs 20 [10–40] vs 30 [10–50]; p = .65), discomfort during colposcopy (30 [10–50] vs 30 [10–50] vs 20 [10–50]; p = .46), and anxiety during colposcopy (20 [0–50] vs 10 [0–40] vs 10 [0–30]; p = .44), were not different between arms. Follow-up data showed no improvement in the 2 VR arms compared with controls (overall satisfaction, p = .37; bleeding severity, p = .09; pain level, p = .89; duration of pain; p = .23; and use of analgesics; p = .39). Per-protocol analysis did not change the results.ConclusionsA VR headset showing a 360-degree surround vision film has no effect on satisfaction or anxiety in women undergoing colposcopy.

A Preparatory Virtual Reality Experience Reduces Anxiety before Surgery in Gynecologic Oncology Patients: A Randomized Controlled Trial

“…In line with this, it is not surprising that some studies examining the use of VR for reducing pain during surgical interventions, such as biopsies, did not find VR to be beneficial [24]. In such a setting, the factors described above are not at play, and VR's mode of action can merely be distraction, which may or may not work and might even be counterproductive, although varying results have been described [25][26][27].…”