Having blood drawn is one of the more painful and distressing procedures children go through. Wong and Choi tested whether an immersive virtual reality (IVR) experience, which gave children both distraction and information about the procedure, could make it easier.
The randomised clinical trial took place in a public hospital in Hong Kong. It involved 149 patients aged 4 to 12 years who were having venipuncture. Children were randomly allocated to an age-appropriate IVR intervention (75 children) or to standard care only (74 children). The main outcome was child-reported pain.
Immediately after the intervention, the IVR group reported significantly less pain and significantly less anxiety than the control group. Health care professionals were also more satisfied with the procedure in the IVR group, with a mean score of 34.5 compared with 32.9 in the control group. The venipuncture itself was shorter in the IVR group, with a mean duration of 4.43 minutes compared with 6.56 minutes.
The authors conclude that combining procedural information and distraction in virtual reality significantly improved pain and anxiety in this group. This study looked at a medical procedure in a hospital, so it does not tell us how virtual reality works as a treatment for needle phobia. It does show that the technology can ease distress in the moment. That is useful.
If fear of medical procedures is affecting you or your child, a GP or psychologist can help you work out the next step.
What the study did
Venipuncture, the drawing of blood from a vein, is one of the most painful and distressing procedures that paediatric patients experience. Earlier evidence had suggested that immersive virtual reality (IVR) could reduce pain and anxiety in children having needle-related procedures by providing distraction and information about what is happening. Wong and Choi set out to examine the effects of IVR on pain, anxiety and stress in paediatric patients undergoing venipuncture.
This was a two-group randomised clinical trial. It recruited patients aged 4 to 12 years from a public hospital in Hong Kong between January 2019 and January 2020. Participants were randomly allocated to an intervention group, which received an age-appropriate IVR experience offering distraction and procedural information, or to a control group, which received standard care only.
The primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, the length of the procedure, and the satisfaction of health care professionals, rated on a 40 point scale. Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure.
What it found
A total of 149 paediatric patients were recruited, 86 of them female (57.7%), and 66 (44.3%) had been diagnosed with fever. There were 75 participants in the IVR group and 74 in the control group, and the mean age was 7.21 years in both.
Immediately after the intervention, the IVR group reported significantly less pain (β = -0.78; 95% CI -1.21 to -0.35; P < .001) and less anxiety (β = -0.41; 95% CI -0.76 to -0.05; P = .03) than the control group.
Health care professional satisfaction was significantly higher in the IVR group (mean 34.5, SD 4.5) than in the control group (mean 32.9, SD 4.0; P = .03). The venipuncture was also significantly shorter in the IVR group (mean 4.43 minutes, SD 3.47) than in the control group (mean 6.56 minutes, SD 7.39; P = .03).
How to read the result
The authors conclude that integrating procedural information and distraction in an IVR intervention significantly improved pain and anxiety in the IVR group compared with the control group. They also suggest the results point toward further clinical development of IVR for other painful and stressful medical procedures.
There are some points of context. The trial was conducted at a single public hospital, with children aged 4 to 12 years. The comparison was with standard care only, so the trial tests the whole package of distraction and information against usual practice. It cannot separate the effect of the distraction from the effect of the information. The abstract reports the pain and anxiety differences as measured immediately after the intervention, and it does not report on how the groups compared at the 30-minute assessment.
This study is also about coping with a medical procedure in the moment. It is not a trial of treatment for needle phobia, which is a separate clinical question, and the results should not be read as showing that virtual reality treats the phobia itself.
Why it matters
Fear and pain around blood tests can lead families to dread or avoid necessary care. A well-designed trial showing that an immersive experience reduced reported pain and anxiety, and shortened the procedure on average, is useful for hospitals that care for children, and it adds to the interest in virtual reality in health care.
If a fear of needles or medical procedures is affecting you or your child, a GP or a psychologist can talk through the options with you. Support is available, and getting help early can make a real difference.