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Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety
Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791566/ https://www.ncbi.nlm.nih.gov/pubmed/31136330 http://dx.doi.org/10.1213/ANE.0000000000004165 |
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author | Eijlers, Robin Utens, Elisabeth M. W. J. Staals, Lonneke M. de Nijs, Pieter F. A. Berghmans, Johan M. Wijnen, René M. H. Hillegers, Manon H. J. Dierckx, Bram Legerstee, Jeroen S. |
author_facet | Eijlers, Robin Utens, Elisabeth M. W. J. Staals, Lonneke M. de Nijs, Pieter F. A. Berghmans, Johan M. Wijnen, René M. H. Hillegers, Manon H. J. Dierckx, Bram Legerstee, Jeroen S. |
author_sort | Eijlers, Robin |
collection | PubMed |
description | Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures. METHODS: On April 25, 2018, we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of Science, and PsycINFO with the keywords “VR,” “children,” and “adolescents.” Studies that applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions. RESULTS: We identified 2889 citations, of which 17 met our inclusion criteria. VR was applied as distraction (n = 16) during venous access, dental, burn, or oncological care or as exposure (n = 1) before elective surgery under general anesthesia. The effect of VR was mostly studied in patients receiving burn care (n = 6). The overall weighted standardized mean difference (SMD) for VR was 1.30 (95% CI, 0.68–1.91) on patient-reported pain (based on 14 studies) and 1.32 (95% CI, 0.21–2.44) on patient-reported anxiety (based on 7 studies). The effect of VR on pediatric pain was also significant when observed by caregivers (SMD = 2.08; 95% CI, 0.55–3.61) or professionals (SMD = 3.02; 95% CI, 0.79–2.25). For anxiety, limited observer data were available. CONCLUSIONS: VR research in pediatrics has mainly focused on distraction. Large effect sizes indicate that VR is an effective distraction intervention to reduce pain and anxiety in pediatric patients undergoing a wide variety of medical procedures. However, further research on the effect of VR exposure as a preparation tool for medical procedures is needed because of the paucity of research into this field. |
format | Online Article Text |
id | pubmed-6791566 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-67915662019-11-26 Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety Eijlers, Robin Utens, Elisabeth M. W. J. Staals, Lonneke M. de Nijs, Pieter F. A. Berghmans, Johan M. Wijnen, René M. H. Hillegers, Manon H. J. Dierckx, Bram Legerstee, Jeroen S. Anesth Analg Pediatric Anesthesiology Medical procedures often evoke pain and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide distraction during, or to prepare patients for, medical procedures. This meta-analysis is the first to collate evidence on the effectiveness of VR on reducing pain and anxiety in pediatric patients undergoing medical procedures. METHODS: On April 25, 2018, we searched EMBASE, MEDLINE, CENTRAL, PubMed, Web of Science, and PsycINFO with the keywords “VR,” “children,” and “adolescents.” Studies that applied VR in a somatic setting with participants ≤21 years of age were included. VR was defined as a fully immersive 3-dimensional environment displayed in surround stereoscopic vision on a head-mounted display (HMD). We evaluated pain and anxiety outcomes during medical procedures in VR and standard care conditions. RESULTS: We identified 2889 citations, of which 17 met our inclusion criteria. VR was applied as distraction (n = 16) during venous access, dental, burn, or oncological care or as exposure (n = 1) before elective surgery under general anesthesia. The effect of VR was mostly studied in patients receiving burn care (n = 6). The overall weighted standardized mean difference (SMD) for VR was 1.30 (95% CI, 0.68–1.91) on patient-reported pain (based on 14 studies) and 1.32 (95% CI, 0.21–2.44) on patient-reported anxiety (based on 7 studies). The effect of VR on pediatric pain was also significant when observed by caregivers (SMD = 2.08; 95% CI, 0.55–3.61) or professionals (SMD = 3.02; 95% CI, 0.79–2.25). For anxiety, limited observer data were available. CONCLUSIONS: VR research in pediatrics has mainly focused on distraction. Large effect sizes indicate that VR is an effective distraction intervention to reduce pain and anxiety in pediatric patients undergoing a wide variety of medical procedures. However, further research on the effect of VR exposure as a preparation tool for medical procedures is needed because of the paucity of research into this field. Lippincott Williams & Wilkins 2019-11 2019-05-23 /pmc/articles/PMC6791566/ /pubmed/31136330 http://dx.doi.org/10.1213/ANE.0000000000004165 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Pediatric Anesthesiology Eijlers, Robin Utens, Elisabeth M. W. J. Staals, Lonneke M. de Nijs, Pieter F. A. Berghmans, Johan M. Wijnen, René M. H. Hillegers, Manon H. J. Dierckx, Bram Legerstee, Jeroen S. Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title | Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title_full | Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title_fullStr | Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title_full_unstemmed | Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title_short | Systematic Review and Meta-analysis of Virtual Reality in Pediatrics: Effects on Pain and Anxiety |
title_sort | systematic review and meta-analysis of virtual reality in pediatrics: effects on pain and anxiety |
topic | Pediatric Anesthesiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791566/ https://www.ncbi.nlm.nih.gov/pubmed/31136330 http://dx.doi.org/10.1213/ANE.0000000000004165 |
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