Anxiety, Pain, Post Operative
Conditions
Keywords
virtual reality, pediatric patients, orthopedic surgery
Brief summary
The goal of this randomized clinical trial is to learn whether immersive virtual reality can reduce anxiety and pain in children and adolescents undergoing postoperative orthopedic dressing changes. The main questions it aims to answer are: Does immersive virtual reality reduce anxiety during postoperative dressing changes compared with standard care? Does immersive virtual reality reduce pain and physiological signs of distress, such as changes in heart rate and respiratory rate? Researchers will compare participants who use an immersive virtual reality headset during the dressing change with participants who receive standard care without virtual reality. Participants will: Be randomly assigned to the virtual reality group or the standard care group Undergo a postoperative orthopedic dressing change with or without immersive virtual reality Report their anxiety and pain before and after the procedure Have their heart rate and respiratory rate measured before, during, and after the dressing change
Detailed description
Postoperative orthopedic dressing changes can cause anxiety, pain, and physiological distress in pediatric patients. Immersive virtual reality may provide a non-pharmacological form of distraction by directing the participant's attention away from the clinical procedure and toward an engaging virtual environment. This randomized clinical trial was conducted in a pediatric orthopedic unit to evaluate the use of immersive virtual reality during postoperative dressing changes. After enrollment and baseline assessment, participants were randomly assigned to receive either immersive virtual reality in addition to the usual dressing procedure or standard care alone. Participants assigned to the virtual reality group wore a head-mounted display and viewed an immersive virtual environment during the dressing change. Participants assigned to the standard care group underwent the same clinical procedure according to usual practice without virtual reality. The dressing change was performed by the clinical team in accordance with routine postoperative care. Anxiety, pain, heart rate, respiratory rate and peripheral oxygen saturation were assessed at predefined time points before, during, and after the procedure, as applicable. These measurements were used to examine whether immersive virtual reality was associated with reduced psychological and physiological distress during the dressing change. The study was designed to provide evidence on the potential usefulness of immersive virtual reality as a non-drug supportive intervention during postoperative procedures in pediatric orthopedic care.
Interventions
DEVICEImmersive Virtual Reality Distraction
Participants used an immersive virtual reality headset during the first postoperative orthopedic dressing procedure. The headset presented an immersive virtual environment intended to divert attention from the clinical procedure and reduce anxiety, pain, and physiological stress. The virtual reality intervention was provided in addition to the routine postoperative dressing care delivered by the clinical team. The headset was worn during the dressing procedure and removed after its completion.
OTHERStandard Postoperative Dressing Care
Participants underwent the first postoperative orthopedic dressing procedure according to routine clinical practice without the use of immersive virtual reality. Standard nursing care and clinical monitoring were provided throughout the procedure.
Sponsors
Gianluca Catania
Istituto Giannina Gaslini
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 6-18 years. * Undergoing corrective orthopedic surgery for congenital or acquired limb deformities, with or without external fixation devices, or spinal arthrodesis for scoliosis or spondylolisthesis. * Undergoing the first postoperative wound dressing procedure. * Written informed consent obtained from a parent or legal guardian. * Assent obtained from the participant, when appropriate.
Exclusion criteria
* Neurological disorders. * History of epilepsy. * Prematurity. * Sensory impairments preventing the use of the virtual reality headset. * Cognitive impairments preventing the use of the virtual reality headset. * Motor limitations preventing the use of the virtual reality headset.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Anxiety Assessed Using the Visual Analogue Scale for Anxiety | Immediately before and immediately after the first postoperative orthopedic dressing procedure | Anxiety was assessed using the Visual Analogue Scale for Anxiety (VAS-A), a 100 mm horizontal scale ranging from 0, indicating no anxiety, to 100, indicating maximum anxiety. Higher scores indicate greater anxiety. Change in anxiety was calculated as the score immediately after the procedure minus the score immediately before the procedure. A negative change score indicates a reduction in anxiety. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain Intensity Assessed Using the Faces Pain Scale | Immediately before and immediately after the first postoperative orthopedic dressing procedure | Pain intensity in participants aged 6 to 10 years was assessed immediately before and immediately after the first postoperative orthopedic dressing procedure using the Faces Pain Scale. Higher scores indicate greater pain intensity. Change in pain was calculated as the post-procedure score minus the pre-procedure score. |
| Change in Pain Intensity Assessed Using the Numeric Rating Scale | Immediately before and immediately after the first postoperative orthopedic dressing procedure. | Pain intensity in participants older than 10 years was assessed immediately before and immediately after the first postoperative orthopedic dressing procedure using the Numeric Rating Scale (0-10). Higher scores indicate greater pain intensity. Change in pain was calculated as the post-procedure score minus the pre-procedure score. |
Countries
Italy
Outcome results
None listed