TY - JOUR
T1 - Effectiveness of virtual reality in the management of paediatric anxiety during the peri‑operative period
T2 - A systematic review and meta-analysis
AU - Simonetti, Valentina
AU - Tomietto, Marco
AU - Comparcini, Dania
AU - Vankova, Nadezhda
AU - Marcelli, Stefano
AU - Cicolini, Giancarlo
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: Children undergoing surgery generally experience anxiety during the perioperative period, which could impact the surgical outcome, cause long-term psychological consequences and result in later healthcare avoidance. Preoperative anxiety in children is managed using both pharmacological and non-pharmacological therapies. The latter include distraction, a tour of the operating room and parental presence until the induction of anaesthesia. A novel and effective non-pharmacological therapies is the use of virtual reality to reduce anxiety and pain in children scheduled for medical procedures. However, the effectiveness of virtual reality in paediatric surgery has yet to be evaluated in a systematic review. Objective: To evaluate the effectiveness of virtual reality in the management of anxiety in paediatric patients during the perioperative period. Design: Both a systematic review and a meta-analysis of randomised controlled trials were performed according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and in accordance with the Cochrane Effective Practice and Organisation of Care. The results are reported as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources: A systematic search of randomised controlled trials was conducted using Medline, SCOPUS, Web of Science, Ovid MEDLINE and CINAHL. Review methods: Two researchers screened potentially eligible articles and then assessed the quality of the reported studies using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and according to Cochrane Effective Practice and Organisation of Care. The data were synthesised using the random-effects models to incorporate the estimated heterogeneity in the weighting. Heterogeneity was tested using the Q and I 2 statistics. The τ 2 statistic, an estimate of the amount of variation between the included studies, was also determined. Studies whose heterogeneity with respect to primary outcome measurements hindered pooling of the results for meta-analysis were summarised narratively. Results: Seven studies were eligible for inclusion in this systematic review. An effect size for anxiety could be determined in six. The results support the effectiveness of virtual reality in reducing anxiety in paediatric patients undergoing elective surgery. The overall effect was supported by a confidence interval < 0 (PL = −0.341, 95% confidence interval: −0.620 to −0.107) and by heterogenity indexes that were non significant (Q = 9.49, p = 0.091) or not important (I 2 = 38.64%). Conclusions: Paediatric patients undergoing elective surgery may benefit from virtual reality as a distraction method that can reduce anxiety. PROSPERO register, number: (blinded for Referee).
AB - Background: Children undergoing surgery generally experience anxiety during the perioperative period, which could impact the surgical outcome, cause long-term psychological consequences and result in later healthcare avoidance. Preoperative anxiety in children is managed using both pharmacological and non-pharmacological therapies. The latter include distraction, a tour of the operating room and parental presence until the induction of anaesthesia. A novel and effective non-pharmacological therapies is the use of virtual reality to reduce anxiety and pain in children scheduled for medical procedures. However, the effectiveness of virtual reality in paediatric surgery has yet to be evaluated in a systematic review. Objective: To evaluate the effectiveness of virtual reality in the management of anxiety in paediatric patients during the perioperative period. Design: Both a systematic review and a meta-analysis of randomised controlled trials were performed according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and in accordance with the Cochrane Effective Practice and Organisation of Care. The results are reported as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources: A systematic search of randomised controlled trials was conducted using Medline, SCOPUS, Web of Science, Ovid MEDLINE and CINAHL. Review methods: Two researchers screened potentially eligible articles and then assessed the quality of the reported studies using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and according to Cochrane Effective Practice and Organisation of Care. The data were synthesised using the random-effects models to incorporate the estimated heterogeneity in the weighting. Heterogeneity was tested using the Q and I 2 statistics. The τ 2 statistic, an estimate of the amount of variation between the included studies, was also determined. Studies whose heterogeneity with respect to primary outcome measurements hindered pooling of the results for meta-analysis were summarised narratively. Results: Seven studies were eligible for inclusion in this systematic review. An effect size for anxiety could be determined in six. The results support the effectiveness of virtual reality in reducing anxiety in paediatric patients undergoing elective surgery. The overall effect was supported by a confidence interval < 0 (PL = −0.341, 95% confidence interval: −0.620 to −0.107) and by heterogenity indexes that were non significant (Q = 9.49, p = 0.091) or not important (I 2 = 38.64%). Conclusions: Paediatric patients undergoing elective surgery may benefit from virtual reality as a distraction method that can reduce anxiety. PROSPERO register, number: (blinded for Referee).
KW - Anxiety
KW - Child
KW - Meta-analyses
KW - Surgery
KW - Systematic review
KW - Virtual reality
UR - http://www.scopus.com/inward/record.url?scp=85118985244&partnerID=8YFLogxK
U2 - 10.1016/j.ijnurstu.2021.104115
DO - 10.1016/j.ijnurstu.2021.104115
M3 - Review article
SN - 0020-7489
VL - 125
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
M1 - 104115
ER -