Virtual reality for relaxation in a pediatric hospital setting: an interventional study with a mixed-methods design

Accumulating evidence supports virtual reality (VR) as a feasible and effective method to alleviate anxiety and pain in pediatric patients during specific medical procedures. However, adoption of VR in clinical practice is limited. To address implementation barriers, this intervention study with a mixed-methods design focuses on the feasibility, acceptability, tolerability, and preliminary effectiveness of Relaxation-VR, a VR application aimed to provide relaxation as it is used for anxiety, stress, and pain reduction for children in hospital. Primary outcomes include intervention completion, technical issues, the pediatric Simulator Sickness Questionnaire (tolerability), and visual analogue scales (VAS) addressing ease of use, likeability (feasibility), and future use (acceptability). Secondary outcomes include pre-to-post-changes in the Self-Assessment Manikin, VAS, and Faces Pain Rating Scale-Revised to measure happiness and stress, anxiety, and pain, respectively. We present preliminary data of 51 participants of this ongoing study. A minority of participants (10/51) quit the intervention prematurely for reasons including discomfort, disliking the application, technical issues, and willingness to see the medical procedure being performed. Only 5 out of 51 participants reported technical issues including start-up issues and low battery levels. Ease of use, likeability, and future use of the intervention were favorably scored. No adverse events and minimal VR sickness symptoms were reported. Compared to baseline, participants reported less anxiety, less pain, less tension, and more happiness while using Relaxation-VR. These preliminary findings indicate that Relaxation-VR is acceptable, feasible, and tolerable, and can reduce anxiety, tension and pain, and increase happiness in pediatric patients with various medical conditions.