To determine whether the virtual reality as a distracting intervention could reduce pain and fear in school-age children receiving intravenous injections at an emergency department.

Background

An intravenous injection is the most common invasive procedure that paediatric patients encounter in emergency department. School-age children seldom show their fear or discomfort during the procedure which may be ignored.

Design

A randomised controlled trial was conducted from December 2017–May 2018 and performed according to the CONSORT guidelines.

Methods

One hundred and thirty-six children aged 7–12 years were randomly allocated to receive either a routine intravenous injection procedure or one with an immersive virtual reality experience. Children were asked to rate their pain and fear along with their caregivers and nurses on the Wong–Baker FACES Pain Rating Scale and Children's Fear Scale, respectively. The time required for successful intravenous insertion was also assessed in the emergency department. Clinical trial registration was done (ClinicalTrials.gov.: NCT04081935).

Results

Pain and fear scores were significantly lower in the virtual reality group, as were the children's ratings as perceived by their caregivers and nurses. The children's ratings of pain and fear were positively correlated with the caregivers’ ratings and the nurses' ratings as well. The time required for successful intravenous insertion was significantly lower in the virtual reality group.

Conclusion

Visual reality intervention can effectively reduce the pain and fear during intravenous procedure in school-age children in emergency department.

Relevance to clinical practice

The results of this study indicate the feasible clinical value of virtual reality interventions during the administration of intravenous injections in school-age children in emergency departments.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest.

Supporting Information

REFERENCES

Ali, S., McGrath, T., & Drendel, A. L. (2016). An evidence-based approach to minimizing acute procedural pain in the emergency department and beyond. Pediatric Emergency Care, 32(1), 36–42. https://doi.org/10.1097/PEC.0000000000000669
10.1097/PEC.0000000000000669
PubMed Web of Science® Google Scholar
Aydin, D., & Sahiner, N. C. (2017). Effects of music therapy and distraction cards on pain relief during phlebotomy in children. Applied Nursing Research, 33, 164–168. https://doi.org/10.1016/j.apnr.2016.11.011
10.1016/j.apnr.2016.11.011
PubMed Web of Science® Google Scholar
Aydin, D., Şahiner, N. C., & Çiftçi, E. K. (2016). Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: Ball squeezing, balloon inflating and distraction cards. Journal of Clinical Nursing, 25(15–16), 2328–2335. https://doi.org/10.1111/jocn.13321
10.1111/jocn.13321
PubMed Web of Science® Google Scholar
Birnie, K. A., Noel, M., Chambers, C. T., Uman, L. S., & Parker, J. A. (2018). Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database of Systematic Reviews, 10, CD005179. https://doi.org/10.1002/14651858.CD005179
PubMed Web of Science® Google Scholar
Chang, L. Y., & Tsai, L. J. (2017). The reaction of children to hospitalization and its care. In Y. C. Chen (Ed.), Practical pediatric nursing ( 8th ed., pp. 177–241). Taipei City, Taiwan, ROC: Farseeing (Chinese).
Google Scholar
El-Gawad, S. M. E. K. A., & Elsayed, L. A. (2015). Effect of interactive distraction versus cutaneous stimulation for venipuncture pain relief in school age children. Journal of Nursing Education and Practice, 5(4), 32. https://doi.org/10.5430/jnep.v5n4p32
Google Scholar
Gershon, J., Zimand, E., Pickering, M., Rothbaum, B. O., & Hodges, L. (2004). A pilot and feasibility study of virtual reality as a distraction for children with cancer. Journal of the American Academy of Child & Adolescent Psychiatry, 43(10), 1243–1249. https://doi.org/10.1097/01.chi.0000135621.23145.05
10.1097/01.chi.0000135621.23145.05
PubMed Web of Science® Google Scholar
Gold, J. I., Kim, S. H., Kant, A. J., Joseph, M. H., & Rizzo, A. S. (2006). Effectiveness of virtual reality for pediatric pain distraction during IV placement. CyberPsychology & Behavior, 9(2), 207–212. https://doi.org/10.1089/cpb.2006.9.207
10.1089/cpb.2006.9.207
PubMed Web of Science® Google Scholar
Hoffman, H. G., Patterson, D. R., & Carrougher, G. J. (2000). Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: A controlled study. The Clinical Journal of Pain, 16(3), 244–250. https://doi.org/10.1097/00002508-200009000-00010
10.1097/00002508-200009000-00010
CAS PubMed Web of Science® Google Scholar
Koller, D., & Goldman, R. D. (2012). Distraction techniques for children undergoing procedures: A critical review of pediatric research. Journal of Pediatric Nursing, 27(6), 652–681. https://doi.org/10.1016/j.pedn.2011.08.001
10.1016/j.pedn.2011.08.001
PubMed Web of Science® Google Scholar
Li, M. Y., Yu, C. W., Yang, Y. C., & Chang, C. C. (2014). Reducing the pain of intravenous injections in preschool children. The Journal of Nursing, 61(2), 68–75 (Chinese). https://doi.org/10.6224/JN.61.2.68
Google Scholar
Lien, A. S. Y., Chuang, W. Y., Yang, J. Y., Chan, E. A., Chung, J. W. Y., & Wong, T. K. S. (2007). An exploration of virtual reality for the relief of pediatric burn pain. Chang Gung Nursing, 18(2), 294–306 (Chinese).
Google Scholar
Maghsoudi, S., Sajjadi, Z., Behnam Vashani, H., Nekah, A., Mohsen, S., & Manzari, Z. S. (2016). Comparison of the effects of play dough and bubble making distraction techniques on venepuncture pain intensity in children. Evidence Based Care Journal, 5(4), 25–32. https://doi.org/10.22038/ebcj.2015.6279
Google Scholar
Mahrer, N. E., & Gold, J. I. (2009). The use of virtual reality for pain control: A review. Current Pain and Headache Reports, 13(2), 100–109. https://doi.org/10.1007/s11916-009-0019-8
10.1007/s11916-009-0019-8
PubMed Web of Science® Google Scholar
McMurtry, C. M., Noel, M., Chambers, C. T., & McGrath, P. J. (2011). Children's fear during procedural pain: Preliminary investigation of the Children's Fear Scale. Health Psychology, 30(6), 780. https://doi.org/10.1037/a0024817
10.1037/a0024817
PubMed Web of Science® Google Scholar
Ming, J. L., & Hong, S. P. (2011). Assessment of acute pain and symptoms care. Yuan-Yuan Nursing, 5(1), 11–16 (Chinese). https://doi.org/10.6530/YYN.2011.5(1).02
Google Scholar
Moadad, N., Kozman, K., Shahine, R., Ohanian, S., & Badr, L. K. (2016). Distraction using the BUZZY for children during an IV insertion. Journal of Pediatric Nursing, 31(1), 64–72. https://doi.org/10.1016/j.pedn.2015.07.010
10.1016/j.pedn.2015.07.010
PubMed Web of Science® Google Scholar
Nilsson, S., Finnström, B., Kokinsky, E., & Enskär, K. (2009). The use of virtual reality for needle-related procedural pain and distress in children and adolescents in a paediatric oncology unit. European Journal of Oncology Nursing, 13(2), 102–109. https://doi.org/10.1016/j.ejon.2009.01.003
10.1016/j.ejon.2009.01.003
PubMed Web of Science® Google Scholar
Pillai Riddell, R. R., Racine, N. M., Turcotte, K., Uman, L. S., Horton, R. E., Din Osmun, L., … Gerwitz-Stern, A. (2011). Non-pharmacological management of infant and young child procedural pain. Cochrane Database Systematic Reviews, 10, CD006275. https://doi.org/10.1002/14651858
PubMed Web of Science® Google Scholar
Piskorz, J., & Czub, M. (2018). Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture. Journal for Specialists in Pediatric Nursing, 23(1), e12201. https://doi.org/10.1111/jspn.12201
10.1111/jspn.12201
Web of Science® Google Scholar
Rajasagaram, U., Taylor, D. M., Braitberg, G., Pearsell, J. P., & Capp, B. A. (2009). Paediatric pain assessment: Differences between triage nurse, child and parent. Journal of Paediatrics and Child Health, 45(4), 199–203. https://doi.org/10.1111/j.1440-1754.2008.01454.x
10.1111/j.1440-1754.2008.01454.x
CAS PubMed Web of Science® Google Scholar
Ryu, J. H., Oh, A. Y., Yoo, H. J., Kim, J. H., Park, J. W., & Han, S. H. (2019). The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: A randomized controlled trial. Pediatric Anesthesia, 29(1), 98–105. https://doi.org/10.1111/pan.13535
10.1111/pan.13535
PubMed Web of Science® Google Scholar
Ryu, J.-H., Park, S.-J., Park, J.-W., Kim, J.-W., Yoo, H.-J., Kim, T.-W., … Han, S.-H. (2017). Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia. British Journal of Surgery, 104(12), 1628–1633. https://doi.org/10.1002/bjs.10684
10.1002/bjs.10684
CAS PubMed Web of Science® Google Scholar
Sanchez-Vives, M. V., & Slater, M. (2005). From presence to consciousness through virtual reality. Nature Reviews Neuroscience, 6(4), 332–339. https://doi.org/10.1038/nrn1651
10.1038/nrn1651
CAS PubMed Web of Science® Google Scholar
Sander, W. S., Eshelman, D., Steele, J., & Guzzetta, C. E. (2002). Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. Oncology Nursing Forum, 29, E8–E15. https://doi.org/10.1188/02.ONF.E8-E15
10.1188/02.ONF.E8-E15
PubMed Google Scholar
Schmitt, Y. S., Hoffman, H. G., Blough, D. K., Patterson, D. R., Jensen, M. P., Soltani, M., … Sharar, S. R. (2011). A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns, 37(1), 61–68. https://doi.org/10.1016/j.burns.2010.07.007
10.1016/j.burns.2010.07.007
PubMed Web of Science® Google Scholar
Schneider, S. M., & Workman, M. (2000). Virtual reality as a distraction intervention for older children receiving chemotherapy. Pediatric Nursing, 26(6), 593.
CAS PubMed Google Scholar
Seers, T., Derry, S., Seers, K., & Moore, R. A. (2018). Professionals underestimate patients' pain: A comprehensive review. Pain, 159(5), 811–818. https://doi.org/10.1097/j.pain.0000000000001165
10.1097/j.pain.0000000000001165
PubMed Web of Science® Google Scholar
Spiegel, B. M. (2018). Virtual medicine: How virtual reality is easing pain, calming nerves and improving health. Medical Journal of Australia, 209(6), 245–247. https://doi.org/10.5694/mja17.00540
10.5694/mja17.00540
PubMed Web of Science® Google Scholar
Tomlinson, D., von Baeyer, C. L., Stinson, J. N., & Sung, L. (2010). A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics, 126(5), e1168–e1198. https://doi.org/10.1542/peds.2010-1609
10.1542/peds.2010-1609
PubMed Web of Science® Google Scholar
Wente, S. J. (2013). Nonpharmacologic pediatric pain management in emergency departments: A systematic review of the literature. Journal of Emergency Nursing, 39(2), 140–150. https://doi.org/10.1016/j.jen.2012.09.011
10.1016/j.jen.2012.09.011
PubMed Web of Science® Google Scholar
Wohlheiter, K. A., & Dahlquist, L. M. (2013). Interactive versus passive distraction for acute pain management in young children: The role of selective attention and development. Journal of Pediatric Psychology, 38(2), 202–212. https://doi.org/10.1093/jpepsy/jss108
10.1093/jpepsy/jss108
PubMed Web of Science® Google Scholar
Wolitzky, K., Fivush, R., Zimand, E., Hodges, L., & Rothbaum, B. O. (2005). Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients. Psychology and Health, 20(6), 817–824. https://doi.org/10.1080/14768320500143339
10.1080/14768320500143339
Web of Science® Google Scholar

Citing Literature

Volume29, Issue3-4

February 2020

Pages 503-510

Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial

Abstract

Aim and objectives

Background

Design

Methods

Results

Conclusion

Relevance to clinical practice

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Information

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Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial

Abstract

Aim and objectives

Background

Design

Methods

Results

Conclusion

Relevance to clinical practice

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Related

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