@article{guingo_efficacy_2025,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004216228&doi=10.1111%2fjan.16991&partnerID=40&md5=4862f57a6a524f825f04fb1a70bb5a21},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {Journal of Advanced Nursing},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

note = {Publisher: John Wiley and Sons Inc},

keywords = {Anxiety, Children, Pain Management, procedural pain, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{le_may_immersive_2021,

title = {Immersive virtual reality vs. non-immersive distraction for pain management of children during bone pins and sutures removal: A randomized clinical trial protocol [沉浸式虚拟现实与非沉浸式分心治疗儿童骨钉和缝合线疼痛的比较:随机临床试验方案]},

author = {S. Le May and A. Tsimicalis and M. Noel and P. Rainville and C. Khadra and A. Ballard and E. Guingo and C. Cotes-Turpin and S. Addab and K. Chougui and M. Francoeur and N. Hung and M. Bernstein and S. Bouchard and S. Parent and M. Hupin Debeurme},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85093928841&doi=10.1111%2fjan.14607&partnerID=40&md5=57256b68253aa1c6288a603f795aceb4},

doi = {10.1111/jan.14607},

issn = {03092402},

year  = {2021},

date = {2021-01-01},

journal = {Journal of Advanced Nursing},

volume = {77},

number = {1},

pages = {439–447},

abstract = {Aims: To examine the efficacy of an immersive virtual reality distraction compared with an active non-immersive distraction, such as video games on a tablet, for pain and anxiety management and memory of pain and anxiety in children requiring percutaneous bone pins and/or suture removal procedures. Design: Three-centre randomized clinical trial using a parallel design with two groups: experimental and control. Methods: Study to take place in the orthopaedic department of three children hospital of the Montreal region starting in 2019. Children, from 7–17 years old, requiring bone pins and/or suture removal procedures will be recruited. The intervention group (N = 94) will receive a virtual reality game (Dreamland), whereas the control group (N = 94) will receive a tablet with video games. The primary outcomes will be both the mean self-reported pain score measured by the Numerical Rating Scale and mean anxiety score, measured by the Child Fear Scale. Recalls of pain and anxiety will be measured 1 week after the procedure using the same scales. We aim to recruit 188 children to achieve a power of 80% with a significance level (alpha) of 5%. Discussion: While multiple pharmacological methods have previously been tested for children, no studies have evaluated the impact of immersive virtual reality distraction for pain and anxiety management in the orthopaedic setting. Impact: Improved pain management can be achieved using virtual reality during medical procedures for children. This method is innovative, non-pharmacological, adapted to the hospital setting, and user-friendly. Trial Registration: NCT03680625, registered on clinicaltrials.gov. © 2020 John Wiley & Sons Ltd},

note = {Publisher: Blackwell Publishing Ltd},

keywords = {Adolescent, analgesia, bone nail, Bone Nails, Child, human, Humans, Pain, Pain Management, randomized controlled trial (topic), Randomized Controlled Trials as Topic, suture, Sutures, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{dumoulin_randomized_2019,

title = {A Randomized Controlled Trial on the Use of Virtual Reality for Needle-Related Procedures in Children and Adolescents in the Emergency Department},

author = {S. Dumoulin and S. Bouchard and J. Ellis and K. L. Lavoie and M. -P. Vézina and P. Charbonneau and J. Tardif and A. Hajjar},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070371865&doi=10.1089%2fg4h.2018.0111&partnerID=40&md5=7e08321a27d48f8221f1aa092a77dbda},

doi = {10.1089/g4h.2018.0111},

issn = {2161783X (ISSN)},

year  = {2019},

date = {2019-01-01},

journal = {Games for Health Journal},

volume = {8},

number = {4},

pages = {285–293},

abstract = {Objective: A large number of children report fear and distress when undergoing blood work and intravenous placement. In pediatric departments, Child Life interventions are considered to be the gold standard in nonmedical pain management techniques. Virtual reality (VR) has also been identified as an effective tool for pain distraction in children undergoing painful medical procedures. The aim of this study was to document the efficacy of VR as a mode of distraction during a medical procedure compared with two comparison conditions: watching television (TV, minimal control condition) and distraction provided by the Child Life (CL, gold standard control condition) program. Materials and Methods: A total of 59 children aged 8-17 years (35% female) were recruited through the emergency department (ED) of the Children's Hospital of Eastern Ontario and randomly assigned to one of the three conditions. The key outcome measures were visual analog scale ratings of pain intensity and fear of pain, administrated before and right after the procedure. Patient satisfaction was also measured after the intervention. Results: A significant reduction in fear of pain and pain intensity was reported in all three conditions. A larger and statistically significant reduction in fear of pain was observed among children who used VR distraction compared with the CL and TV conditions, but this effect was not observed for pain intensity. The children's satisfaction with the VR procedure was significantly higher than for TV and comparable to CL. Discussion: The advantages of using VR in the ED to manage pain in children are discussed. © 2019, Mary Ann Liebert, Inc.},

note = {Publisher: Mary Ann Liebert Inc.},

keywords = {Adolescent, analgesia, analysis of variance, Child, Child Life, Children, controlled study, Distraction, Emergency Service, Fear, female, Hospital, hospital emergency service, human, Humans, male, Ontario, organization and management, Pain analgesia, Pain Management, Phlebotomy, procedures, psychology, randomized controlled trial, virtual reality},

pubstate = {published},

tppubtype = {article}

}