Virtual reality for pain and anxiety of pediatric oncology patients: A systematic review and meta-analysis

Objective: The aim of this paper is to systematically evaluate the effects of virtual reality (VR) on pain, anxiety, and fear symptoms of pediatric patients with cancer. Methods: PubMed, Web of Science, Embase, Cochrane Library, Scopus, CINAHL, and four Chinese medical databases were searched from January 1, 1975, to February 22, 2022. Randomized controlled trials on the effects of VR technology on pediatric cancer patients were searched. Two researchers independently screened literatures, extracted data, and evaluated literature quality according to inclusion and exclusion criteria, and meta-analysis was performed by RevMan 5.3. Results: A total of 379 children with cancer were included in six randomized controlled trials. Overall, there were significant differences in favor of VR in pain (MD = -4.82, 95% CI [-7.74, -1.89], P<0.01; I2= 95%, P<0.01), anxiety (SMD = -1.47, 95% CI [-2.46, -0.48], P<0.01; I2 = 92%, P<0.01), and fear (MD = -1.25, 95% CI [-1.78,0.72], P<0.01; I2 = 0%, P = 0.69). Conclusions: VR is beneficial to improve the pain, anxiety, and fear mood of pediatric cancer patients. Larger sample sizes and more rigorous studies are needed.