Virtual reality deep breathing and guided relaxation training in stress relief during needle procedures in paediatric patients: A feasibility study

Abstract

Background: The incidence and disease burden of stress-related symptoms in children have increased in recent years. Relaxation techniques are beneficial when treating young people experiencing stress, anxiety and fear. Thus, new nonpharmacological treatment approaches, such as mindfulness-based methods for paediatric patients, must be introduced. Methods: This feasibility study compared virtual reality (VR)-based deep breathing and VR-guided relaxation exercises as stress relief options for paediatric patients. This study included 41 children aged 8–12 years who underwent a needle procedure in a hospital setting. Responses in the autonomic nervous system were monitored using heart rate variability (HRV) analysis. Results: VR-based deep breathing exercise lowered the respiratory rate more than the VR-guided relaxation exercise. HRV measurements taken 1 min before and after the exercises showed significant activation of the parasympathetic nervous system (PNS) during training, with the VR-guided relaxation exercise creating a slightly more intense response. In the 6-minute HRV analysis, no significant differences were seen between the exercises. These findings indicate that both exercises affect the parasympathetic nervous system, with no significant difference between the exercises. Conclusions: Both types of VR exercises seem to be equally well-received, feasible and promising nonpharmacological treatment options in paediatric clinical practice. VR-based deep breathing and VR-guided relaxation training showed great potential as stress relief techniques when dealing with paediatric patients undergoing needle procedures. Trial registration: ISRCTN12712970 was retrospectively registered on 23rd May 2025.