Virtual Reality System for Reducing Anxiety in Pediatric Patients during Vaccination: A Quasi-Experimental Study

Abstract

Introduction: Positive vaccination experiences may improve children’s attitudes, compliance, and engagement with healthcare. Virtual reality (VR) interventions have been shown to reduce anxiety and pain during needle-related procedures. We developed a VR-Shot system to improve the vaccination experience and conducted a pilot study to evaluate its effectiveness. Materials and methods: This mixed-methods pilot study included 122 children aged 4–12 years undergoing vaccination between March and December 2021. A total of 60 and 62 participants were assigned to the usual care and VR groups, respectively. Procedural anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS). Procedural time and number of nurses involved were recorded. Between-group comparisons were performed using the independent samples t-test or Wilcoxon rank-sum test, as appropriate. Univariable and multivariable linear regression analyses with bootstrapping were conducted to examine associations between the VR intervention and outcomes. Exploratory analyses using Spearman’s rank correlation were performed within the VR group. Satisfaction was assessed using questionnaires and interviews. Results: The modified Yale Preoperative Scale (mYPAS) score and nurse count were significantly lower in the VR group compared with the usual care group (P < 0.001 and P < 0.0001, respectively). Procedural time was not different in the VR compared with usual care group (P = 0.34). Seventy-five percent (n = 46) of stakeholders were highly satisfied or satisfied with VR-Shot. Conclusion: VR-Shot may improve the vaccination experience by reducing procedural anxiety and enhancing cooperation, resulting in decreased staff involvement without a significant difference in procedural time. Trial registration: Thai Clinical Trials Registry identifier: TCTR20230407006.