Virtual Reality Distraction for Needle-Related Pain and Distress in Children: A Multicenter Randomized Controlled Trial.

This international multicenter randomized controlled trial aimed to compare the effectiveness of virtual reality (VR) distraction with an identical non-VR game in reducing needle-related pain and anxiety in children undergoing venous blood draw. The study involved 304 children aged 5-9 years undergoing a blood draw procedure, randomly allocated to one of three groups: VR distraction, non-VR distraction, and control group (usual care). The distraction task was based on the Multiple Object Tracking (MOT) paradigm, and the game was identical in design and gameplay for both VR and non-VR distraction groups. The primary outcome was self-reported pain intensity using the Faces Pain Scale-Revised (FPS-R). Secondary outcomes included child distress, attention/distraction to the blood draw, and parent and medical staff satisfaction with procedure. Analyses were conducted using analysis of variance and multivariable linear regression models. The results showed that VR distraction and non-VR distraction performed similarly, showing large effect sizes compared with standard care. There was no significant difference between the two types of distraction. The study's findings suggest that VR and non-VR distraction are similarly effective in reducing needle-related pain and anxiety in children undergoing venous blood draw. This is the first well-powered study comparing modern VR distraction with an identical task displayed on a smartphone or monitor screen. The study's results have important implications for using VR in clinical settings and suggest that investing in expensive VR equipment for acute pain management may not be necessary. The study protocol was pre-registered on Open Science Framework at https://osf.io/frsyc.

Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture.

PURPOSE: Virtual reality (VR) technology is an effective tool in treatment of acute pain. Numerous studies show the effectiveness of this method both in a clinical context and in the laboratory. However, research results on the effectiveness of VR in pediatric venipuncture pain is not conclusive-not all studies report the analgesic effect of VR. In addition to testing effectiveness of VR, we also assess the usability of a novel hands-free interface. DESIGN AND METHODS: Patients of paediatric nephrology clinic (N = 38; mean age 11 years, range 7-17) participated in a posttest only between group quasi-experimental study. Participants in the treatment group received the venipuncture procedure with VR distraction. They were wearing a head-mounted Oculus DK2 HMD, and playing a game designed by the authors of the study. The game was based on Multiple Object Tracking (MOT) task, where players have to remember and simultaneously track several moving targets. MOT has been used in many studies on attention and working memory. Participants rated their pain and stress intensity on visual analogue scales (VAS) on a scale of 0 to 100 and answered a short questionnaire. RESULTS: The VR group reported significantly lower pain intensity than the controls (mean = 15.16 ± 20.51 vs. 37.05 ± 30.66; t = 2.59, df = 36, p < .02, d = 0.863). Similar results were obtained for stress level (11.16 ±18.58 vs 41.89 ± 40.89; t = 2.98, df = 36, p < .01, d = 0.993). There were no correlations with age. PRACTICE IMPLICATIONS: VR can be as an effective tool to minimize pediatric pain and stress due to venipuncture. The MOT-based VR game was suitable for children at the studied age range. This solution can be easily applied by nurses in their clinical practice.