Evaluating The Effect of the Use of Virtual Reality Headset in School Vaccinations on Children’s Fear and Anxiety Levels: A Randomized Controlled Trial

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Evaluating The Effect of the Use of Virtual Reality Headset in School Vaccinations on Children’s Fear and Anxiety Levels: A Randomized Controlled Trial

1Zila Özlem Kırbaş, 2İlknur Kahriman
1Faculty of Health Sciences, Department of Nursing, Bayburt University, Bayburt, Türkiye
2Faculty of Health Sciences, Department of Pediatric Nursing, Karadeniz Technical University, Trabzon, Türkiye


ABSTRACT:

Aim: The study aims to evaluate the use of virtual reality during school vaccination and its impact on children’s fears and anxiety.
Methods: The study was carried out as a randomized controlled study in primary schools located in a city centre. The study was completed with 169 (experimental group=84, control group=85) students. Child and Parent Information Form, Children’s Fear Scale and Children’s Anxiety Scale-State Scale were used to collect the data. Data were analysed using SPSS version (SPSS 25.0 SPSS, Chicago, IL). Independent samples t-test was used to compare independent data with normal distribution, and dependent samples t-test was used to compare dependent data. Data with normal distribution were presented as mean ± standard deviation. Chi-square test was used to compare categorical data, which were presented as frequency (percentage).
Results: While the mean score of Children’s Fear Scale post-vaccination was 0.64 in the experimental group, it was 2.16 in the control group. Post-vaccination mean score of Children’s Anxiety Scale-State was 2.14 in the experimental group; however, it was 6.06 in the control group. The Children’s Fear Scale and Children’s Anxiety Scale-State scores were higher in the control group compared to the experimental group.
Conclusion: This study is the first study of virtual reality to reduce fear and anxiety during vaccine administration. Study results have demonstrated its effectiveness and will fill a knowledge gap in the literature.


KEYWORDS:

Anxiety, Child, Fear, Nursing, Vaccine, Virtual reality

 

REFERENCES :

1) Gerçeker GÖ, Binay Ş, Bilsin E, Kahraman A, Yılmaz HB. Effects of Virtual Reality and External Cold and Vibration on Pain in 7- to 12-Year-Old Children During Phlebotomy: A Randomized Controlled Trial. J Perianesth Nurs 2018;33(6):981-989.
2) Hedén L, von Essen L, Ljungman G. The relationship between fear and pain levels during needle procedures in children from the parents’ perspective. Eur J Pain 2016;20(2):223-230.
3) Taddio A, Ipp M, Thivakaran S, et al. Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine 2012;30(32):4807-4812.
4) WHO, UNICEF, World Bank. State of the World’s Vaccines and Immunization, Third edition. World Health Organization. 2009. Geneva. https://apps.who.int/iris/bitstream/handle/10665/44169/9789241563864_eng.pdf.
5) Public Health Agency of Canada. Vaccine coverage in Canadian children: highlights from the 2013 Childhood National Immunization Coverage Survey (cNICS) (online). Retrieved January 19, 2020 from:
https://healthycanadians.gc.ca/publications/healthy-living-vie-saine/immunization-coverage-children-2013-couverture-vaccinale-enfants/alt/icc-2013-cve-eng.pdf.
6) Bucci LM, MacDonald NE, Sondagar C, Taddio A. Taking the sting out of school-based immunizations. Paediatr Child Health 2017;22(1):41-42.
7) Taddio A, Ilersich AF, Ilersich AN, Wells J. From the mouth of babes: Getting vaccinated doesn’t have to hurt. Can J Infect Dis Med Microbiol 2014;25(4):196-200.
8) McMurtry CM, Pillai Riddell R, Taddio A, et al. Far From “Just a Poke”: Common Painful Needle Procedures and the Development of Needle Fear. Clin J Pain 2015;31(10 Suppl):S3-S11.
9) McMurtry CM, Noel M, Chambers CT, McGrath PJ. Children’s fear during procedural pain: preliminary investigation of the Children’s Fear Scale. Health Psychol 2011;30(6):780-788.
10) Taddio A, Appleton M, Bortolussi R, et al. Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline. CMAJ 2010;182(18):E843-E855.
11) Uman LS, Birnie KA, Noel M, et al. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev 2013;(10):CD005179. Published 2013 Oct 10.
12) İnal S, Canbulat N. Using of distraction methods on procedural pain management of pediatric patients. Journal of Current Pediatrics 2015;13(2):116-121.
13) Moadad N, Kozman K, Shahine R, Ohanian S, Badr LK. Distraction Using the BUZZY for Children During an IV Insertion. J Pediatr Nurs 2016;31(1):64-72.
14) Sadeghi T, Mohammadi N, Shamshiri M, Bagherzadeh R, Hossinkhani N. Effect of distraction on children’s pain during intravenous catheter insertion. J Spec Pediatr Nurs 2013;18(2):109-114.
15) Hsieh YC, Cheng SF, Tsay PK, Su WJ, Cho YH, Chen CW. Effectiveness of Cognitive-behavioral Program on Pain and Fear in School-aged Children Undergoing Intravenous Placement. Asian Nurs Res (Korean Soc Nurs Sci) 2017;11(4):261-267.
16) Gupta A, Scott K, Dukewich M. Innovative Technology Using Virtual Reality in the Treatment of Pain: Does It Reduce Pain via Distraction, or Is There More to It?. Pain Med 2018;19(1):151-159.
17) Tüfekci FG, Celebioğlu A, Küçükoğlu S. Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture. J Clin Nurs 2009;18(15):2180-2186.
18) Chen YJ, Cheng SF, Lee PC, Lai CH, Hou IC, Chen CW. Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial. J Clin Nurs 2020;29(3-4):503-510.
19) Gerçeker GÖ, Ayar D, Özdemir EZ, Bektaş M. Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5-12 years old: A randomised controlled study. J Clin Nurs 2020;29(7-8):1151-1161.
20) Lee VY, Caillaud C, Fong J, Edwards KM. Improving vaccine-related pain, distress or fear in healthy children and adolescents-a systematic search of patient-focused interventions. Hum Vaccin Immunother 2018;14(11):2737-2747.
21) Luthy KE, Beckstrand RL, Asay W, Hewett C. Vaccinating parents experience vaccine anxiety too. J Am Assoc Nurse Pract 2013;25(12):667-673. 
22) Birnie KA, Noel M, Parker JA, et al. Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents. J Pediatr Psychol 2014;39(8):783-808.
23) Harrison D, Elia S, Royle J, Manias E. Pain management strategies used during early childhood immunisation in Victoria. J Paediatr Child Health 2013;49(4):313-318.
24) G*Power. https://stats.idre.ucla.edu/ (online). Retrieved March 06, 2020. from:
25) http://www.psychologie.hhu.de/arbeitsgruppen/allgemeine-psychologie-und-arbeitspsychologie/ gpower.html.
26) McKinley S, Coote K, Stein-Parbury J. Development and testing of a Faces Scale for the assessment of anxiety in critically ill patients. J Adv Nurs 2003;41(1):73-79.
27) Gerçeker GÖ, Ayar D, Özdemir Z, Bektaş M. Turkish adaptation of Child State Anxiety Scale and Child Fear Scale. Dokuz Eylül University Faculty of Nursing Electronic Journal 2018;11(1):9-13.
28) Kleiber C, McCarthy AM. Evaluating instruments for a study on children’s responses to a painful procedure when parents are distraction coaches. J Pediatr Nurs 2006;21(2):99-107.
29) Ersig AL, Kleiber C, McCarthy AM, Hanrahan K. Validation of a clinically useful measure of children’s state anxiety before medical procedures. J Spec Pediatr Nurs 2013;18(4):311-319.
30) Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 2010;1(2):100-107.
31) Eijlers R, Utens EMWJ, Staals LM, et al. Systematic review and meta-analysis of virtual reality in pediatrics: effects on pain and anxiety. Anesth Analg 2019;129(5):1344-1353.
32) Althumairi A, Sahwan M, Alsaleh S, Alabduljobar Z, Aljabri D. Virtual Reality: Is It Helping Children Cope with Fear and Pain During Vaccination?, Journal of Multidisciplinary Healthcare 2021;2625-2632.
33) Dumoulin S, Bouchard S, Ellis J, et al. A randomized controlled trial on the use of virtual reality for needle-related procedures in children and adolescents in the emergency department. Games Health J 2019;8(4):285-293.
34) Piskorz J, Czub M. Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture. J Spec Pediatr Nurs 2018;23(1):10.1111/jspn.12201.
35) Walther-Larsen S, Petersen T, Friis SM, Aagaard G, Drivenes B, Opstrup P. Immersive Virtual Reality for Pediatric Procedural Pain: A Randomized Clinical Trial. Hosp Pediatr 2019;9(7):501-507.
36) Wong CL, Lui MMW, Choi KC. Effects of immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a study protocol for a randomized controlled trial. Trials. 2019;20(1):369.
37) Chad R, Emaan S, Jillian O. Effect of virtual reality headset for pediatric fear and pain distraction during immunization. Pain Manag 2018;8(3):175-179.
38) Trottier ED, Osmanlliu E, Bailey B, Lagacé M, Certain M, Khadra C, et al. LO52: distraction in the ED using virtual reality for intravenous needs in children to improve comfort-DEVINCI-a pilot RCT. Canadian Journal of Emergency Medicine 2020;22(S1):S26-S26.

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