Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 31;8(1):e14565.
doi: 10.2196/14565.

Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review

Naseem Ahmadpour  1 , Melanie Keep  2 , Anna Janssen  3 , Anika Saiyara Rouf  4 , Michael Marthick  3
Affiliations

Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review

Naseem Ahmadpour et al. JMIR Serious Games. .

Abstract

Background: Virtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps.

Objective: This study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. Specifically, we wanted to gain an understanding of the techniques and goals used in selecting or designing VR apps in this context.

Methods: We performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria.

Results: Overall, 1386 articles published between 2013 and 2018 were identified. In total 18 articles were included in the review, with 7 reporting significant reduction in pediatric pain or anxiety, 3 testing but finding no significant impact of the VR apps employed, and the rest not conducting any test of significance. We identified 9 articles that were based on VR apps specifically designed and tailored for pediatric patients. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps.

Conclusions: VR has been demonstrated to be a viable choice for managing pain and anxiety in a range of medical treatments. However, commercial products lack diversity and meaningful design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be an active participant in managing their own care. To achieve this, design must be part of the development.

Keywords: adolescents; anxiety; children; design; distraction; pain; virtual reality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of the literature screening and selection process. ACM: Association for Computing Machinery.
Figure 2
Figure 2
VR interventions for pain and anxiety on a continuum; characterized in terms of patient experience and role (passive to active), VR design (feedback to user from none to interactive feedback) and intervention goal (distraction to skill-building).
Figure 3
Figure 3
A holistic model to support design of VR interventions for managing pain and anxiety.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chirico A, Lucidi F, de Laurentiis M, Milanese C, Napoli A, Giordano A. Virtual reality in health system: beyond entertainment. A mini-review on the efficacy of VR during cancer treatment. J Cell Physiol. 2016 Feb;231(2):275–87. doi: 10.1002/jcp.25117. - DOI - PubMed
    1. Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. 2000 Mar;85(1-2):305–9. doi: 10.1016/s0304-3959(99)00275-4. - DOI - PubMed
    1. Hoffman HG, Patterson DR, Carrougher GJ. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain. 2000 Sep;16(3):244–50. doi: 10.1097/00002508-200009000-00010. - DOI - PubMed
    1. Li A, Montaño Z, Chen VJ, Gold JI. Virtual reality and pain management: current trends and future directions. Pain Manag. 2011 Mar;1(2):147–57. doi: 10.2217/pmt.10.15. http://europepmc.org/abstract/MED/21779307 - DOI - PMC - PubMed
    1. Chirico A, D'Aiuto M, Pinto M, Milanese C, Napoli A, Avino F. The elapsed time during a virtual reality treatment for stressful procedures. A pool analysis on breast cancer patients during chemotherapy. In: Pietro G, Gallo L, Howlett R, Jain L, editors. Intelligent Interactive Multimedia Systems and Services 2016. Cham: Springer; 2016. pp. 731–8.

Publication types