Child and Parent Perspectives on the Acceptability of Virtual Reality to Mitigate Medical Trauma in an Infusion Center

• Published in: Maternal and child health journal Vol. 24; no. 8; pp. 986 - 997
• Main Authors: Easterlin, Molly C., Berdahl, Carl T., Rabizadeh, Shervin, Spiegel, Brennan, Agoratus, Lauren, Hoover, Clarissa, Dudovitz, Rebecca
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2020; Springer Nature B.V
• Subjects: Adolescent; Anxiety; Anxiety - prevention & control; Anxiety - psychology; Anxiety - therapy; Child; Children & youth; Childrens health; Female; Gynecology; Humans; Inflammatory Bowel Diseases - psychology; Inflammatory Bowel Diseases - therapy; Interviews as Topic - methods; Male; Maternal & child health; Maternal and Child Health; Medicine; Medicine & Public Health; Pain; Pain management; Pain Management - methods; Parents & parenting; Parents - psychology; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patients - psychology; Patients - statistics & numerical data; Pediatrics; Population Economics; Psychological Distress; Public Health; Qualitative Research; Sociology; Stress; Trauma; Virtual Reality; Children and youth with special heath care needs; Inflammatory bowel disease; Qualitative; Virtual reality; Medical trauma
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-020-02955-x

Introduction Children may experience medical trauma when undergoing medical procedures even when procedures are minor. While virtual reality (VR) is effective for managing procedural pain and anxiety, few studies address how families feel about using VR. We explore pediatric patient and guardian views regarding the acceptability of using VR during procedures to mitigate medical trauma. Methods Semi-structured qualitative interviews with 18 patient-guardian dyads at a tertiary outpatient infusion center for inflammatory bowel disease (IBD) treatment. Interviews explored how VR may change the infusion experience, including benefits, risks, and recommendations for clinical integration. Interviews were recorded, transcribed, and analyzed in ATLAS.ti. Two coders used a 3-step coding approach to: (1) identify themes; (2) develop a codebook and code transcripts using the constant comparative method; and (3) describe themes/patterns. Results Potential benefits of VR were distraction from infusion-related anxiety and pain and generating excitement for the appointment. Potential challenges were VR-side effects (dizziness, nausea), limited mobility during the procedure, disorientation/immersion leading to shock upon IV-placement, and a lost opportunity to build coping skills. Families queried when VR should first be introduced and when during the appointment use would be optimal. Parents expressed concerns about pushing VR when their child was already under stress. A limited number of families doubted the utility of VR. Conclusions Patients and parents found VR to be an acceptable option for helping to manage medical trauma during infusions but highlighted that the VR experience must be carefully crafted to avoid unintended consequences, including lost opportunities to build resilience.