JMIR Publications

ABSTRACT

Background:

Children with acute and chronic illness undergo frequent, painful, and distressing procedures.

Objective:

This randomized control trial was used to evaluate the effectiveness of guided imagery (GI) vs virtual reality (VR) on the procedural pain and state anxiety of children and young adults undergoing unsedated procedures. We explored the role of trait anxiety and pain catastrophizing in intervention response.

Methods:

Children and young adults were recruited from the hematology, oncology, and blood and marrow transplant clinics at a children’s hospital. Each study participant completed the GI and VR intervention during separate but consecutive unsedated procedures. Self-report measures of pain and anxiety were completed before and after the procedures.

Results:

Fifty participants (median age = 13 years) completed both interventions. GI and VR performed similarly in the management of procedural pain. Those with high pain catastrophizing reported experiencing less intense pain during procedures that utilized VR than those using GI. State anxiety declined pre- to post-procedure in both interventions; however, the decrease was more pronounced during the VR intervention, particularly in participants who started with higher state anxiety. Those with high trait anxiety had less pain during GI.

Conclusions:

VR works as well as GI to manage the pain and distress associated with common procedures experienced by children with an acute or chronic illness. Children who are primed for pain based on beliefs about pain or because of their history of chronic pain have a better response to VR. GI is a better intervention for those with high trait anxiety. Clinical Trial: Distracting Through Procedural Pain and Distress NCT04892160