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

Abstract

BackgroundVirtual 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.ObjectiveThis study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures.MethodsWe 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.ResultsOverall, 1386 articles were identified. In total, 18 articles were included in the review. Articles were published in English between 2013 and 2018. Our review determined that VR technology was being administered in a range of situations to modulate acute and chronic pain or anxiety, needle phobia, and procedural care in children and adolescents. We identified 9 articles that designed the bespoke VR apps. 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.ConclusionsVR has been demonstrated to be effective for managing pain and anxiety in a variety of populations. However, 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 active participants in managing their own care. To achieve this, design must be part of the development.