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Prior experience with virtual reality (VR) in clinical care has demonstrated its potential to reduce patient anxiety and distress, particularly in pediatric settings. VR has been shown to effectively decrease preoperative anxiety in children undergoing various medical procedures, including IV catheter replacement, blood draws, and improve their compliance with anesthesia and overall procedural experiences. Limited evidence exists regarding the impact of VR on the broader care environment, including parental anxiety and nursing satisfaction in pediatric settings.
This retrospective study analyzes de-identified data from a nine-month quality improvement initiative to evaluate the impact of a custom VR intervention on pediatric preoperative anxiety, parental anxiety, and nurse satisfaction in a real clinical setting. The findings offer preliminary, practice-relevant evidence that VR can be a feasible, acceptable, and clinically meaningful non-pharmacologic tool in pediatric preoperative care, and they provide actionable insights to guide future implementation efforts and rigorous trials aimed at improving the hospital experience for children, families, and providers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pediatric Patients | Pediatric patients receiving VR interventions (6-15 years) |
| |
| Parent Caregivers | Parents of Pediatric patients receiving VR interventions (6-15 years) |
| |
| Nurses | The nursing staff are involved in the care process of the Pediatric patients receiving VR interventions (6-15 years) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual Reality | Other | Administered as part of a QI initiative aimed at reducing anxiety in pediatric patients during clinical care. The intervention involved using a VR system to provide a distraction and relaxation tool during routine procedures. This approach is consistent with recent research showing that VR can be an effective tool for reducing pain and anxiety in pediatric patients undergoing medical procedures. Retrospective data collection. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in patient anxiety levels, as measured by heart rate | Change in patient anxiety levels, as measured by heart rate, before and after VR intervention. Baseline heart rate will be compared to the heart rate after the intervention. | Before and after VR intervention, one visit only |
| Change in patient anxiety levels, as measured by blood pressure | Change in patient anxiety levels, as measured by blood pressure, before and after VR intervention. Baseline blood pressure will be compared to the blood pressure after the intervention. | Before and after VR intervention, one visit only |
| Change in patient anxiety levels, as measured by distress/fear scores | Change in patient anxiety levels, as measured by distress/fear scores before and after VR intervention Baseline distress/fear scores will be compared to the distress/fear scores after the intervention. Using the Children's Fear Scale (CFS) (0-4):
| Before and after VR intervention, one visit only |
| Measure | Description | Time Frame |
|---|---|---|
| Parental anxiety levels | Change in parental anxiety levels, measured by pre- and post-intervention State-Trait Anxiety Inventory (STAI) scores. The State-Trait Anxiety Inventory (STAI) scoring involves summing the scores from the 40 items, each rated on a 4-point Likert scale, to assess state and trait anxiety. The higher the score, the higher the level of anxiety.
|
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Pediatric Subjects
Inclusion Criteria:
Exclusion Criteria:
Caregivers/Parents
Inclusion Criteria:
- pediatric patients who were eligible and received VR during the QI initiative, aged 6-15 years
Exclusion Criteria:
- N/A
Nurses
Inclusion Criteria:
Exclusion Criteria:
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The study involved pediatric patients who received VR intervention as part of the original QI initiative. Data protection and de-identification procedures were rigorously applied throughout the study
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| Name | Affiliation | Role |
|---|---|---|
| Dayanjan Wijesinghe | Virginia Commonwealth University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Virginia Commonwealth University | Richmond | Virginia | 23298 | United States |
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D009726 | Nurses |
| ID | Term |
|---|---|
| D006282 | Health Personnel |
| D005159 | Health Care Facilities Workforce and Services |
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| Survey Responses/Parent Caregivers | Behavioral | Survey responses from parents regarding anxiety and satisfaction. |
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| Survey Responses/Nurses | Behavioral | Survey responses from nurses regarding anxiety and satisfaction. |
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| Before and after VR intervention, one visit only |
| Nurse satisfaction ratings | Nurse satisfaction ratings with the VR intervention, measured via survey responses. Nurse satisfaction with the VR intervention was measured using a brief, Likert-scale survey developed for this quality improvement project. Survey Format: A 5-point Likert scale was used for all items:
| Before and after VR intervention, one visit only |