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Cited by 48Pediatric Pain Management TechniquesVirtual Reality Applications and ImpactsMusic Therapy and Health

Development of a Virtual Reality Exposure Tool as Psychological Preparation for Elective Pediatric Day Care Surgery: Methodological Approach for a Randomized Controlled Trial

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Eijlers, Robin, Legerstee, Jeroen S, Dierckx, Bram, Staals, Lonneke M, Berghmans, Johan, van der Schroeff, Marc P, Wijnen, Rene MH, Utens, Elisabeth MWJ·2017·JMIR Research Protocols
DOI 10.2196/resprot.7617PMC PMC5613189
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Abstract

BACKGROUND: Preoperative anxiety in children is highly prevalent and is associated with adverse outcomes. Existing psychosocial interventions to reduce preoperative anxiety are often aimed at distraction and are of limited efficacy. Gradual exposure is a far more effective way to reduce anxiety. Virtual reality (VR) provides a unique opportunity to gradually expose children to all aspects of the operating theater. OBJECTIVE: The aims of our study are (1) to develop a virtual reality exposure (VRE) tool to prepare children psychologically for surgery; and (2) to examine the efficacy of the VRE tool in a randomized controlled trial (RCT), in which VRE will be compared to care as usual (CAU). METHODS: The VRE tool is highly realistic and resembles the operating room environment accurately. With this tool, children will not only be able to explore the operating room environment, but also get accustomed to general anesthesia procedures. The PREoperative Virtual reality Intervention to Enhance Wellbeing (PREVIEW) study will be conducted. In this single-blinded RCT, 200 consecutive patients (aged 4 to 12 years) undergoing elective day care surgery for dental, oral, or ear-nose-throat problems, will be randomly allocated to the preoperative VRE intervention or CAU. The primary outcome is change in child state anxiety level between baseline and induction of anesthesia. Secondary outcome measures include child's postoperative anxiety, emergence delirium, postoperative pain, use of analgesics, health care use, and pre- and postoperative parental anxiety. RESULTS: The VRE tool has been developed. Participant recruitment began March 2017 and is expected to be completed by September 2018. CONCLUSIONS: To our knowledge, this is the first RCT evaluating the effect of a VRE tool to prepare children for surgery. The VRE intervention is expected to significantly diminish preoperative anxiety, postoperative pain, and the use of postoperative analgesics in pediatric patients. The tool could create a less stressful experience for both children and their parents, in line with the modern emphasis on patient- and family-centered care. TRIAL REGISTRATION: Netherlands Trial Registry: NTR6116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6116 (Archived by WebCite at http://www.webcitation.org/6ryke7aep).

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  • mHealth can play an important role in accurate recognition of symptoms and timely treatment.

    “Mobile health (mHealth) can play an important role in accurate recognition of symptoms and timely treatment [9-11].”

    From A Smartphone Serious Game for Adolescents (Grow It! App): Development, Feasibility, and Acceptance Study (2022) · cites this paper as [9]

    The Introduction and Discussion discuss virtual-reality preparation for pediatric surgery and reducing preoperative anxiety. Searches for symptom recognition, timely treatment, and mHealth found no passage in our copy addressing the attributed claim; the paper is not marked as truncated. No page numbers are available in the copy. (LLM, conf=0.76)

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Authors
Eijlers, R., Legerstee, J. S., Dierckx, B., Staals, L. M., Berghmans, J., van der Schroeff, M. P., Wijnen, R. M., & Utens, E. M.
Affiliations
Erasmus MC (NL)
Corresponding author
Utens, Elisabeth MWJ
ORCID
Venue
JMIR Research Protocols
Publisher
JMIR Publications Inc.
Published
2017-09-11
Volume
6
Issue
9
Pages
e174
ISSN
1929-0748 (ISSN-L)
DOI
10.2196/resprot.7617
PMC
PMC5613189
OpenAlex
W2753997489
Cited by
48
References
34
Citations by year
2026: 2 · 2025: 7 · 2024: 9 · 2023: 7 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 3 · 2018: 1
FWCI
2.99
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Research Protocols (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UvA-DARE (University of Amsterdam) (publishedVersion, cc-by)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Social Sciences › Psychology › Social Psychology › Music Therapy and Health
Keywords
virtual reality exposure, preoperative anxiety, gradual exposure, general anesthesia, postoperative pain, postoperative analgesic use, emergence delirium, parental anxiety, family-centered care

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