Effects of Virtual Reality on the Management of Anxiety and Pain in Pediatric Cancer Patients: A Pilot Study

Pediatric hospitalization often induces significant anxiety, fear, and pain, particularly during invasive medical procedures. Traditionally addressed through pharmacological interventions, pain management has increasingly embraced a multimodal approach in recent years, integrating both pharmacological and nonpharmacological strategies to enhance effectiveness. Among these, immersive virtual reality (VR) has emerged as a promising tool for alleviating the pain and stress associated with medical procedures. Background/Objectives: This study investigates the effectiveness of VR as a distraction and relaxation tool in pediatric patients aged 8-20 years, including those with oncohematological conditions and others undergoing sedation procedures. The research explores the impact of VR in these patients, examining their relationship with medical, sociodemographic (eg, number of procedures, diagnosis, age, sex), and parental psychological factors. Methods: Following informed consent, 29 patients in average aged 12.19 years (SD = 3.16; range: 8.01-20.08), 72.4% of males who underwent on average 8.82 procedures (SD = 6.83; range: 1-28) and their main caregiver, primarily mothers (89.7%), mainly married (79.8%) and with a medium to high economic condition (96.6%) were evaluated in Pediatric Hematology-Oncology. Participants used VR headsets as a distraction tool before and during induction of anesthesia for medical procedures. The SAFA anxiety scale and PPCI were adopted before the procedure (T0) together with the Wong-Baker Faces Pain and the Children’s Fear Scales assessed also upon awakening (T1). Caregivers were monitored by adoption of GAD7 and ASA27 in T0 and T1. Results: Patients self-reported limited anxiety indexes (normal in 86.2%) while caregivers attested more at clinical levels (27.6% separation anxiety and 24.1% general anxiety) at T0. Caregivers’ separation (rho = 0.42, p = 0.02) and general anxiety (rho = 0.51, p = 0.005) were significantly associated with patients’ anxiety at T0. Wilcoxon test (Z = -2.74; p = 0.006) showed a significative change between patient’s fear perceptions before (Mean T1 = 0.81; SD T1 = 1.27) and after the procedure (Mean T2 = 0.30; SD T2 = 0.61) and another Wilcoxon test (Z = -2.74; p = 0.006) showed the same trend in pain perception before (Mean T1 = 1.48; SD T1 = 2.19) and after the procedure (Mean T1 = 0.52; SD T2 = 1.05). Conclusions: Important clinical considerations could be developed based on these results.