The impact of virtual reality exposure on anxiety and pain levels in pediatric patients: A systematic review and meta-analysis

Problem: Virtual reality (VR) is used as a novel intervention technique to alleviate uncomfortable experiences such as anxiety and pain in children. Recently, VR distraction has gained prominence in pediatric medical procedures. However, no studies have yet conducted a further quantitative analysis of the intervention effects of virtual reality exposure (VRE). This systematic review aims to analyse the effect of VRE on anxiety and pain levels in paediatric patients undergoing medical procedures. Eligibility criteria: Relevant studies were searched from four databases, including PubMed, Cochrane Library, Embase, and Web of Science. This systematic review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Results: The meta-analysis incorporated a total of 11 articles, encompassing 1,099 pediatric patients. The results showed that VRE relieved children's anxiety [SMD = -0.61, 95% CI (-0.93, -0.28), p < 0.001], but there was no significant difference in alleviating pain in children [SMD = -1.48, 95% CI (-3.40, 0.44), p = 0.131]. Conclusions: The results suggest that VRE is effective in reducing children's anxiety during medical procedures. However, 7 of the 11 original studies included in this review were from the same research project, which may increase the risk of reporting bias. Also, more high-quality studies are needed in the future to verify its effectiveness for pain levels. Implications: VRE can help children become familiar with the medical environment, overcome anxiety and fear, and learn about medical procedures in advance. This can enhance their cooperation during medical process, leading to a more positive medical experience.