The effect of virtual reality on pain, fear and emotional appearance during blood draw in pediatric patients at the hematology-oncology outpatient clinic: A randomized controlled study

Kanad N., ÖZALP GERÇEKER G., Eker İ., Şen Susam H.

European Journal of Oncology Nursing, vol.68, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 68
  • Publication Date: 2024
  • Doi Number: 10.1016/j.ejon.2023.102495
  • Journal Name: European Journal of Oncology Nursing
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, ASSIA, CINAHL, EMBASE, MEDLINE, Psycinfo
  • Keywords: Blood draw, Emotional appearance, Fear, Pain, Pediatric hematology, Pediatric oncology, Virtual reality
  • Dokuz Eylül University Affiliated: Yes


Objective: Invasive attempts can be very painful and stressful for pediatric patients. Virtual Reality (VR) can be used to distract patients undergoing such procedures in pediatric hematology oncology patients. Methods: A parallel trial design approach was adopted for this randomized controlled trial, guided by the CONSORT checklist. The study sample (n = 69) was divided into a VR group (n = 34) and a control group (n = 35) using stratified randomization. For the blood draw attempt, no distraction method was applied to the control group, while the children in the VR group were distracted from the procedure with the Epic Roller Coasters VR application. The primary variable assessed was pain, while secondary variables were fear and emotional appearance. The scores of emotional appearance, fear, and pain were compared with a Mann-Whitney U Test. Results: The pre-procedure emotional appearance score was 11.3 ± 4.3 in the VR group and 11.0 ± 5.0 in the control group, and the post-procedure score was 6.5 ± 3.3 in the VR group and 11.8 ± 5.3 in the control group, indicating a difference in emotional appearance after the procedure. VR group had lower negative emotional appearance, lower pain, and lower fear scores after procedure compared to the control group. Conclusion: VR can be considered an effective approach to reducing the negative emotional appearance and for relieving pain and fear in children aged 4–12 years undergoing blood draw procedures in pediatric hematology and oncology outpatient unit ( NCT05675358).