Reducing Periprocedural Pain and Anxiety of Child Patients with Guided Relaxation Exercises in a Virtual Natural Environment: A Clinical Research Study

Abstract

Fear of needles is common among child patients. It causes stress and can lead to difficulty in procedures and future treatment avoidance. Virtual reality (VR) has emerged as a promising tool to reduce pain and anxiety non-pharmacologically. However, a research gap exists regarding what VR content is most effective in decreasing periprocedural stress. This article reports a VR feasibility study conducted with 83 child patients aged 8–12 years during a cannulation procedure. It has a between-subjects design with four groups, comparing deep breathing and mindfulness-based relaxation in a virtual nature environment (VNE) to passive VNE and standard care. The results from both relaxation exercise groups have been previously reported. This follow-up article adds findings from passive VNE and control groups, comparing all four for effectiveness and patient experience. The key findings highlight that deep breathing was highly effective according to heart rate variability (HRV) data, but less enjoyable than the mindfulness-based relaxation, which achieved higher patient satisfaction but was less effective according to HRV. Passive VNEs were pleasant but did not cause measurable stress reduction. All VR interventions improved patient experience over standard care. Relaxation exercises in a VNE reduce periprocedural stress more efficiently than passive VNEs or standard care in pediatrics.