Beyond Needles: Pioneering Pediatric Care with Virtual Reality (VR) for TIVAD Access in Oncology

Simple Summary Chronic use of totally implantable venous access devices (TIVADs) in pediatric oncology patients can be challenging in terms of pain and anxiety. Our aim is to evaluate the usefulness of virtual reality (VR) goggles to reduce anxiety and pain in children and to facilitate the work of the nursing team. We conducted a clinical trial with two groups randomized to use the goggles or not, and for the intervention group we used a relaxation video in the Raja Ampat environment (Ecosphere app by Phoria (R)) for Oculus Quest 2 goggles (Meta Platforms (R), Menlo Park, CA, USA). Our results highlighted that the use of VR goggles could be a simple addition to clinical practice to reduce anxiety and pain in oncology children using TIVADs, and could also facilitate the work of the nursing team, helping to achieve a more efficient use of time.Abstract Introduction: Pediatric oncology patients use totally implantable venous access devices (TIVADs) to enable central venous access. Anxiety, pain and/or discomfort are common despite anesthesia. Virtual reality (VR) is a non-pharmacological approach that may reduce pain and anxiety in these patients. We aimed to assess the use of VR for reducing anxiety/pain in patients with TIVADs while facilitating the task of healthcare providers when accessing a TIVAD. Methods: patients 4-18 years old with a TIVAD were prospectively randomized to an intervention group (IG) or a control group (CG). In the IG, VR goggles (Oculus Quest 2, Meta Platforms (R), Menlo Park, CA, USA) were used displaying a relaxing video in the Raja Ampat environment (Ecosphere app from Phoria (R)) while the TIVAD was accessed. The CG was managed as per standard of care. Satisfaction and pain were measured by FPS-R and STAIC scales, respectively. Results: this is the report of a prospective, randomized (60 per group)-unblinded-, single institution study of 120 pediatric oncology patients enrolled from January to April 2022. Median ages for IG and CG were 9.22 and 10.52 years, respectively. Satisfaction was higher in the IG (4.80) compared to the CG (3.92), p <= 0.0001. Regarding pain, mean FPS-R scores were 1.79 for the CG and 0.83 for the IG. Significantly different scores were found in the 12 to 18 years group, p <= 0.05. The healthcare professionals index of satisfaction was high (4.50 mean Likert score) for the IG compared to accessing the TIVAD without VR (3.73 mean Likert score). Conclusion: The use of VR helped reduce pain and/or discomfort in pediatric oncology patients, mainly in the older age group as they can better interact with VR. Healthcare providers were satisfied with the help of VR for TIVAD management.