The effect of active and passive virtual reality distractions on phlebotomy-related emotional behavior, pain, anxiety, and fear in children: A randomized controlled trial
Journal of Pediatric Nursing, vol.83, pp.190-198, 2025 (SCI-Expanded, SSCI, Scopus)
- Publication Type: Article / Article
- Volume: 83
- Publication Date: 2025
- Doi Number: 10.1016/j.pedn.2025.05.005
- Journal Name: Journal of Pediatric Nursing
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, ASSIA, CINAHL, MEDLINE, DIALNET
- Page Numbers: pp.190-198
- Keywords: Virtual reality, Immersive, Children, Phlebotomy, Pain, Fear, Anxiety
- Dokuz Eylül University Affiliated: Yes
Abstract
Background: School-age children can undergo phlebotomy using virtual reality (VR). Children experienced VR through a headset, and research using fully immersive VR is limited. Objectives: This study aimed to determine the impact of active (fully immersive) and passive (immersive) VR distractions during blood collection on phlebotomy-related emotional behavior, pain, anxiety, and fear in children aged 6–12. Methods: This parallel, randomized controlled trial used a three-arm design approach, with the CONSORT checklist serving as a guide. The study sample (n = 150) was divided into active VR, passive VR, and control groups using stratified randomization. The mean scores were obtained from the Emotional Appearance Scale for Children, Wong-Baker FACES Pain Rating Scale, Child Fear Scale, and Child Anxiety Scale-State. Evaluation of scale scores according to time*group interaction was evaluated by analysis of variance in repeated measurements. Results: The fear score of the active VR group was significantly lower than passive VR group and the control group (p < .001). The pain, anxiety, and emotional behavior scores of the active VR group and the passive VR group were significantly lower than the control group (p < .001). Conclusion: Both VR distractions were effective in reducing pain, anxiety, and negative behavior during phlebotomy (Clinical trials: NCT06336811). Application to practice: Children can be supported with pain, fear, anxiety, and emotional behavior management during phlebotomy by using fully immersive and immersive VR distractions.