Effectiveness of virtual reality in the management of paediatric anxiety during the peri-operative period: A systematic review and meta-analysis.

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Publisher: Elsevier B.V.
Document Type: Report
Length: 539 words

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Keywords Anxiety; Child; Surgery; Virtual reality; Systematic review; Meta-analyses Abstract Background Children undergoing surgery generally experience anxiety during the perioperative period, which could impact the surgical outcome, cause long-term psychological consequences and result in later healthcare avoidance. Preoperative anxiety in children is managed using both pharmacological and non-pharmacological therapies. The latter include distraction, a tour of the operating room and parental presence until the induction of anaesthesia. A novel and effective non-pharmacological therapies is the use of virtual reality to reduce anxiety and pain in children scheduled for medical procedures. However, the effectiveness of virtual reality in paediatric surgery has yet to be evaluated in a systematic review. Objective To evaluate the effectiveness of virtual reality in the management of anxiety in paediatric patients during the perioperative period. Design Both a systematic review and a meta-analysis of randomised controlled trials were performed according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and in accordance with the Cochrane Effective Practice and Organisation of Care. The results are reported as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources A systematic search of randomised controlled trials was conducted using Medline, SCOPUS, Web of Science, Ovid MEDLINE and CINAHL. Review methods Two researchers screened potentially eligible articles and then assessed the quality of the reported studies using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and according to Cochrane Effective Practice and Organisation of Care. The data were synthesised using the random-effects models to incorporate the estimated heterogeneity in the weighting. Heterogeneity was tested using the Q and I.sup.2 statistics. The [tau].sup.2 statistic, an estimate of the amount of variation between the included studies, was also determined. Studies whose heterogeneity with respect to primary outcome measurements hindered pooling of the results for meta-analysis were summarised narratively. Results Seven studies were eligible for inclusion in this systematic review. An effect size for anxiety could be determined in six. The results support the effectiveness of virtual reality in reducing anxiety in paediatric patients undergoing elective surgery. The overall effect was supported by a confidence interval Conclusions Paediatric patients undergoing elective surgery may benefit from virtual reality as a distraction method that can reduce anxiety. PROSPERO register, number: (blinded for Referee). Author Affiliation: (a) Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy (b) Department Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom (c) Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland (d) Azienda Ospedaliera Universitaria "Ospedali Riuniti" di Ancona, di Ancona, via Conca 71 -- 60100, Ancona, Italy (e) Politecnica delle Marche University, Ascoli Piceno, Italy * Corresponding author. Article History: Received 21 May 2021; Revised 6 October 2021; Accepted 18 October 2021 (footnote)1 These authors contributed equally to this work. Byline: Valentina Simonetti [v.simonetti@staff.univpm.it] (a,1), Marco Tomietto [marco.tomietto@northumbria.ac.uk] (b,c,1), Dania Comparcini [da.comparcini@gmail.com] (*,d), Nadezhda Vankova [nadia.vankova@gmail.com] (e), Stefano Marcelli [s.marcelli@staff.univpm.it] (e), Giancarlo Cicolini [giancarlo.cicolini@uniba.it] (a)

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Gale Document Number: GALE|A686459885