{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:11:53Z","timestamp":1774483913513,"version":"3.50.1"},"reference-count":117,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["10051972"],"award-info":[{"award-number":["10051972"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Extended reality (XR) applications are gaining support as a method of reducing anxieties about medical treatments and conditions; however, their impacts on health service inequalities remain underresearched. We therefore undertook a synthesis of evidence relating to the equity implications of these types of interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Searches of MEDLINE, Embase, APA PsycINFO, and Epistemonikos were conducted in May 2023 to identify reviews of patient-directed XR interventions for health and procedural anxiety. Equity-relevant data were extracted from records (n\u2009=\u200956) that met these criteria, and from individual trials (n\u2009=\u200963) evaluated within 5 priority reviews. Analyses deductively categorized data into salient situation- and technology-related mechanisms, which were then developed into a novel implementation-focused framework.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Analyses highlighted various mechanisms that impact on the availability, accessibility, and\/or acceptability of services aiming to reduce patient health and procedural anxieties. On one hand, results showed that XR solutions offer unique opportunities for addressing health inequities, especially those concerning transport, cost, or mobility barriers. At the same time, however, these interventions can accelerate areas of inequity or even engender additional disparities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our \u201cdouble jeopardy, common impact\u201d framework outlines unique pathways through which XR could help address health disparities, but also accelerate or even generate inequity across different systems, communities, and individuals. This framework can be used to guide prospective interventions and assessments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Despite growing positive assertions about XR\u2019s capabilities for managing patient anxieties, we emphasize the need for taking a cautious, inclusive approach to implementation in future programs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocaf047","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T17:53:00Z","timestamp":1742665980000},"page":"945-957","source":"Crossref","is-referenced-by-count":3,"title":["Equity implications of extended reality technologies for health and procedural anxiety: a systematic review and implementation-focused framework"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1018-3627","authenticated-orcid":false,"given":"Tom","family":"Arthur","sequence":"first","affiliation":[{"name":"Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter , Exeter EX1 2LU,","place":["United Kingdom"]}]},{"given":"Sophie","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter , Exeter EX1 2LU,","place":["United Kingdom"]}]},{"given":"Samuel","family":"Vine","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter , Exeter EX1 2LU,","place":["United Kingdom"]}]},{"given":"Lauren","family":"Asare","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter , Exeter EX1 2LU,","place":["United Kingdom"]}]},{"given":"G J","family":"Melendez-Torres","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter , Exeter EX1 2LU,","place":["United Kingdom"]}]}],"member":"286","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"2025042203524375900_ocaf047-B1","author":"Arthur"},{"key":"2025042203524375900_ocaf047-B2","author":"World Health Organization","year":"2018"},{"key":"2025042203524375900_ocaf047-B3","doi-asserted-by":"crossref","first-page":"e58086","DOI":"10.2196\/58086","article-title":"Extended reality interventions for health and procedural anxiety: panoramic meta-analysis based on overviews of reviews","volume":"27","author":"Arthur","year":"2025","journal-title":"J Med Internet Res"},{"key":"2025042203524375900_ocaf047-B4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s40140-021-00472-3","article-title":"State of the art: immersive technologies for perioperative anxiety, acute, and chronic pain management in pediatric patients","volume":"11","author":"Alqudimat","year":"2021","journal-title":"Curr Anesthesiol Rep"},{"key":"2025042203524375900_ocaf047-B5","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s12553-021-00561-7","article-title":"Effectiveness of immersive virtual reality-supported interventions for patients with disorders or impairments: a systematic review and meta-analysis","volume":"11","author":"Chen","year":"2021","journal-title":"Health Technol"},{"key":"2025042203524375900_ocaf047-B6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1038\/s41746-022-00663-0","article-title":"A framework for digital health equity","volume":"5","author":"Richardson","year":"2022","journal-title":"NPJ Digit Med"},{"key":"2025042203524375900_ocaf047-B7","doi-asserted-by":"crossref","first-page":"1241020","DOI":"10.3389\/fresc.2023.1241020","article-title":"A framework for equitable virtual rehabilitation in the metaverse era: challenges and opportunities","volume":"4","author":"Veras","year":"2023","journal-title":"Front Rehabil Sci"},{"key":"2025042203524375900_ocaf047-B8","doi-asserted-by":"crossref","first-page":"e0000509","DOI":"10.1371\/journal.pdig.0000509","article-title":"Construction of the digital health equity-focused implementation research conceptual model-bridging the divide between equity-focused digital health and implementation research","volume":"3","author":"Groom","year":"2024","journal-title":"PLOS Digit Health"},{"key":"2025042203524375900_ocaf047-B9","first-page":"295","article-title":"Health service coverage and its evaluation","volume":"56","author":"Tanahashi","year":"1978","journal-title":"Bull World Health Organ"},{"key":"2025042203524375900_ocaf047-B10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11920-018-0912-0","article-title":"Recent advances in the understanding and treatment of health anxiety","volume":"20","author":"Tyrer","year":"2018","journal-title":"Curr Psychiatry Rep"},{"key":"2025042203524375900_ocaf047-B11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1136\/thoraxjnl-2015-207488","article-title":"International committee on mental health in cystic fibrosis: cystic fibrosis foundation and European Cystic Fibrosis Society consensus statements for screening and treating depression and anxiety","volume":"71","author":"Quittner","year":"2016","journal-title":"Thorax"},{"key":"2025042203524375900_ocaf047-B12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13012-023-01304-0","article-title":"A scoping review of equity-focused implementation theories, models and frameworks in healthcare and their application in addressing ethnicity-related health inequities","volume":"18","author":"Gustafson","year":"2023","journal-title":"Implement Sci"},{"key":"2025042203524375900_ocaf047-B13","first-page":"55","volume-title":"ESRC Research Methods Programme","author":"Pawson","year":"2004"},{"key":"2025042203524375900_ocaf047-B14","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jclinepi.2013.08.005","article-title":"Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health","volume":"67","author":"O\u2019Neill","year":"2014","journal-title":"J Clin Epidemiol"},{"key":"2025042203524375900_ocaf047-B15","article-title":"How effects on health equity are assessed in systematic reviews of interventions","volume":"1","author":"Welch","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"2025042203524375900_ocaf047-B16","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4324\/9781003457077-4","article-title":"Nothing as practical as an analytical strategy in realist evaluation: findings and recommendations from a comprehensive review","author":"Nielsen","year":"2024","journal-title":"Realist Evaluation"},{"key":"2025042203524375900_ocaf047-B17","doi-asserted-by":"crossref","first-page":"3032","DOI":"10.1111\/jocn.16217","article-title":"Use of virtual reality in managing paediatric procedural pain and anxiety: an integrative literature review","volume":"31","author":"Addab","year":"2022","journal-title":"J Clin Nurs"},{"key":"2025042203524375900_ocaf047-B18","doi-asserted-by":"crossref","first-page":"3151","DOI":"10.3390\/jcm9103151","article-title":"The effect of virtual reality on preoperative anxiety: a meta-analysis of randomized controlled trials","volume":"9","author":"Koo","year":"2020","journal-title":"J Clin Med"},{"key":"2025042203524375900_ocaf047-B19","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1093\/abm\/kaab016","article-title":"Using virtual technology for fear of medical procedures: a systematic review of the effectiveness of virtual reality-based interventions","volume":"55","author":"K\u0131l\u0131\u00e7","year":"2021","journal-title":"Ann Behav Med"},{"key":"2025042203524375900_ocaf047-B20","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.pmn.2020.04.002","article-title":"Virtual reality technology for pain and anxiety management among patients with cancer: a systematic review","volume":"21","author":"Ahmad","year":"2020","journal-title":"Pain Manag Nurs"},{"key":"2025042203524375900_ocaf047-B21","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/jan.15065","article-title":"Virtual reality interventions and the outcome measures of adult patients in acute care settings undergoing surgical procedures: an integrative review","volume":"78","author":"Wang","year":"2022","journal-title":"J Adv Nurs"},{"key":"2025042203524375900_ocaf047-B22","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.3390\/jcm11061670","article-title":"State-of-the-art review on immersive virtual reality interventions for colonoscopy-induced anxiety and pain","volume":"11","author":"G\u0103in\u0103","year":"2022","journal-title":"J Clin Med"},{"key":"2025042203524375900_ocaf047-B23","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.burns.2008.08.017","article-title":"Predicting the effectiveness of virtual reality relaxation on pain and anxiety when added to PCA morphine in patients having burns dressings changes","volume":"35","author":"Konstantatos","year":"2009","journal-title":"Burns"},{"key":"2025042203524375900_ocaf047-B24","doi-asserted-by":"crossref","first-page":"100203","DOI":"10.1016\/j.tipsro.2023.100203","article-title":"Using virtual reality to prepare patients for radiotherapy: a systematic review of interventional studies with educational sessions","volume":"25","author":"Grilo","year":"2023","journal-title":"Tech Innov Patient Support Radiat Oncol"},{"key":"2025042203524375900_ocaf047-B25","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.joms.2022.11.011","article-title":"The use of virtual reality to reduce pain and anxiety in surgical procedures of the oral cavity: a scoping review","volume":"81","author":"Martinez-Bernal","year":"2023","journal-title":"J Oral Maxillofac Surg"},{"key":"2025042203524375900_ocaf047-B26","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.burns.2017.11.002","article-title":"Virtual reality in the treatment of burn patients: a systematic review","volume":"44","author":"Scapin","year":"2018","journal-title":"Burns"},{"key":"2025042203524375900_ocaf047-B27","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1097\/BCR.0000000000000019","article-title":"Effect of virtual reality on adolescent pain during burn wound care","volume":"35","author":"Jeffs","year":"2014","journal-title":"J Burn Care Res"},{"key":"2025042203524375900_ocaf047-B28","doi-asserted-by":"crossref","first-page":"751735","DOI":"10.3389\/frvir.2021.751735","article-title":"Impact of virtual reality technology on pain and anxiety in pediatric burn patients: a systematic review and meta-analysis","volume":"2","author":"Smith","year":"2022","journal-title":"Front Virtual Real"},{"key":"2025042203524375900_ocaf047-B29","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/jnu.12885","article-title":"Effectiveness of virtual reality interventions on physiological and psychological outcomes of adults with cardiovascular disease: a systematic review and meta-analysis","volume":"55","author":"Turan Kavradim","year":"2023","journal-title":"J Nurs Scholarsh"},{"key":"2025042203524375900_ocaf047-B30","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/PRS.0000000000005831","article-title":"Virtual reality improves the patient experience during wide-awake local anesthesia no tourniquet hand surgery: a single-blind, randomized, prospective study","volume":"144","author":"Hoxhallari","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2025042203524375900_ocaf047-B31","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1016\/j.arthro.2019.02.037","article-title":"Effects of preoperative virtual reality magnetic resonance imaging on preoperative anxiety in patients undergoing arthroscopic knee surgery: a randomized controlled study","volume":"35","author":"Yang","year":"2019","journal-title":"Arthroscopy"},{"key":"2025042203524375900_ocaf047-B32","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1111\/jocn.16394","article-title":"Effects of virtual reality on preoperative anxiety in children: a systematic review and meta-analysis of randomised controlled trials","volume":"32","author":"Chen","year":"2023","journal-title":"J Clin Nurs"},{"key":"2025042203524375900_ocaf047-B33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13741-019-0116-0","article-title":"The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial","volume":"8","author":"Dehghan","year":"2019","journal-title":"Perioper Med"},{"key":"2025042203524375900_ocaf047-B34","doi-asserted-by":"crossref","first-page":"e35008","DOI":"10.2196\/35008","article-title":"Effect of virtual reality on pediatric pain and fear during procedures involving needles: systematic review and meta-analysis","volume":"10","author":"Lluesma-Vidal","year":"2022","journal-title":"JMIR Serious Games"},{"key":"2025042203524375900_ocaf047-B35","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1093\/jpepsy\/jsx129","article-title":"Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management","volume":"43","author":"Gold","year":"2018","journal-title":"J Pediatr Psychol"},{"key":"2025042203524375900_ocaf047-B36","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/NCC.0000000000000844","article-title":"Virtual reality intervention targeting pain and anxiety among pediatric cancer patients undergoing peripheral intravenous cannulation: a randomized controlled trial","volume":"44","author":"Wong","year":"2021","journal-title":"Cancer Nurs"},{"key":"2025042203524375900_ocaf047-B37","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1186\/s12903-021-01602-3","article-title":"A systematic review of the use of virtual reality or dental smartphone applications as interventions for management of paediatric dental anxiety","volume":"21","author":"Cunningham","year":"2021","journal-title":"BMC Oral Health"},{"key":"2025042203524375900_ocaf047-B38","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/j.1365-2702.2006.01719.x","article-title":"Application of a virtual reality prototype for pain relief of pediatric burn in Taiwan","volume":"16","author":"Chan","year":"2007","journal-title":"J Clin Nurs"},{"key":"2025042203524375900_ocaf047-B39","doi-asserted-by":"crossref","first-page":"e10902","DOI":"10.2196\/10902","article-title":"A novel clinician-orchestrated virtual reality platform for distraction during pediatric intravenous procedures in children with hemophilia: randomized controlled trial","volume":"7","author":"Dunn","year":"2019","journal-title":"JMIR Serious Games"},{"key":"2025042203524375900_ocaf047-B40","doi-asserted-by":"crossref","first-page":"343","DOI":"10.2147\/JPR.S151084","article-title":"Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study","volume":"11","author":"Khadra","year":"2018","journal-title":"J Pain Res"},{"key":"2025042203524375900_ocaf047-B41","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1188\/04.ONF.81-88","article-title":"Virtual reality as a distraction intervention for women receiving chemotherapy","volume":"31","author":"Schneider","year":"2004","journal-title":"Oncol Nurs Forum"},{"key":"2025042203524375900_ocaf047-B42","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.3390\/jpm11111167","article-title":"Virtual reality-based therapy reduces the disabling impact of fibromyalgia syndrome in women: systematic review with meta-analysis of randomized controlled trials","volume":"11","author":"Cort\u00e9s-P\u00e9rez","year":"2021","journal-title":"J Pers Med"},{"key":"2025042203524375900_ocaf047-B43","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jopan.2019.11.002","article-title":"The effects of intraoperative progressive muscle relaxation and virtual reality application on anxiety, vital signs, and satisfaction: a randomized controlled trial","volume":"35","author":"Sahin","year":"2020","journal-title":"J Perianesth Nurs"},{"key":"2025042203524375900_ocaf047-B44","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1089\/109493103322011605","article-title":"Virtual reality intervention for older women with breast cancer","volume":"6","author":"Schneider","year":"2003","journal-title":"Cyberpsychol Behav"},{"key":"2025042203524375900_ocaf047-B45","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/pan.14546","article-title":"Virtual reality in pediatrics, effects on pain and anxiety: a systematic review and meta-analysis update","volume":"32","author":"Tas","year":"2022","journal-title":"Pediatr Anesth"},{"key":"2025042203524375900_ocaf047-B46","first-page":"117","article-title":"The impact of virtual reality distraction on pain and anxiety during dental treatment in 4-6 year-old children: a randomized controlled clinical trial","volume":"6","author":"Aminabadi","year":"2012","journal-title":"J Dent Res Dent Clin Dent Prospects"},{"key":"2025042203524375900_ocaf047-B47","doi-asserted-by":"crossref","first-page":"364","DOI":"10.4103\/JISPPD.JISPPD_1158_17","article-title":"Effects of distraction using virtual reality technology on pain perception and anxiety levels in children during pulp therapy of primary molars","volume":"36","author":"Niharika","year":"2018","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"2025042203524375900_ocaf047-B48","doi-asserted-by":"crossref","first-page":"e15872","DOI":"10.2196\/15872","article-title":"A virtual reality video to improve information provision and reduce anxiety before cesarean delivery: randomized controlled trial","volume":"6","author":"Noben","year":"2019","journal-title":"JMIR Ment Health"},{"key":"2025042203524375900_ocaf047-B49","doi-asserted-by":"crossref","first-page":"e2122569","DOI":"10.1001\/jamanetworkopen.2021.22569","article-title":"Effect of an immersive virtual reality intervention on pain and anxiety associated with peripheral intravenous catheter placement in the pediatric setting: a randomized clinical trial","volume":"4","author":"Gold","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025042203524375900_ocaf047-B50","doi-asserted-by":"crossref","first-page":"e31395","DOI":"10.2196\/31395","article-title":"The effectiveness of virtual reality-based interventions in rehabilitation management of breast cancer survivors: systematic review and meta-analysis","volume":"10","author":"Bu","year":"2022","journal-title":"JMIR Serious Games"},{"key":"2025042203524375900_ocaf047-B51","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1016\/j.pec.2021.12.015","article-title":"The use of virtual reality in patient education related to medical somatic treatment: a scoping review","volume":"105","author":"van der Linde-van den Bor","year":"2022","journal-title":"Patient Educ Couns"},{"key":"2025042203524375900_ocaf047-B52","doi-asserted-by":"crossref","first-page":"e467","DOI":"10.1016\/j.jpainsymman.2023.01.023","article-title":"Effectiveness of virtual reality in symptom management of cancer patients: a systematic review and meta-analysis","volume":"65","author":"Wu","year":"2023","journal-title":"J Pain Symptom Manage"},{"key":"2025042203524375900_ocaf047-B53","doi-asserted-by":"crossref","first-page":"100720","DOI":"10.1016\/j.srhc.2022.100720","article-title":"The impact of virtual reality on pain management during normal labor: a systematic review and meta-analysis of randomized controlled trials","volume":"32","author":"Baradwan","year":"2022","journal-title":"Sex Reprod Healthc"},{"key":"2025042203524375900_ocaf047-B54","doi-asserted-by":"crossref","first-page":"104323","DOI":"10.1016\/j.ijnurstu.2022.104323","article-title":"Effectiveness of virtual reality in cardiac rehabilitation: a systematic review and meta-analysis of randomized controlled trials","volume":"133","author":"Chen","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"2025042203524375900_ocaf047-B55","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/s12884-021-03725-5","article-title":"Virtual reality applications to assist pregnant women: a scoping review","volume":"21","author":"Hajesmaeel-Gohari","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025042203524375900_ocaf047-B56","doi-asserted-by":"crossref","first-page":"277","DOI":"10.17245\/jdapm.2019.19.5.277","article-title":"Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children","volume":"19","author":"Nunna","year":"2019","journal-title":"J Dent Anesth Pain Med"},{"key":"2025042203524375900_ocaf047-B57","first-page":"1","author":"Robertson","year":"2017"},{"key":"2025042203524375900_ocaf047-B58","doi-asserted-by":"crossref","first-page":"e91276","DOI":"10.1371\/journal.pone.0091276","article-title":"Improving dental experiences by using virtual reality distraction: a simulation study","volume":"9","author":"Tanja-Dijkstra","year":"2014","journal-title":"PLoS One"},{"key":"2025042203524375900_ocaf047-B59","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1186\/s13063-021-05540-x","article-title":"Application of virtual reality on non-drug behavioral management of short-term dental procedure in children","volume":"22","author":"Ran","year":"2021","journal-title":"Trials"},{"key":"2025042203524375900_ocaf047-B60","doi-asserted-by":"crossref","first-page":"985","DOI":"10.3390\/cancers15030985","article-title":"Immersive and non-immersive virtual reality for pain and anxiety management in pediatric patients with hematological or solid cancer: a systematic review","volume":"15","author":"Comparcini","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2025042203524375900_ocaf047-B61","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/jan.15473","article-title":"Effectiveness of virtual reality intervention on reducing the pain, anxiety and fear of needle-related procedures in paediatric patients: a systematic review and meta-analysis","volume":"79","author":"Gao","year":"2023","journal-title":"J Adv Nurs"},{"key":"2025042203524375900_ocaf047-B62","doi-asserted-by":"crossref","first-page":"102356","DOI":"10.1016\/j.ctim.2020.102356","article-title":"Feasibility of implementing a virtual reality program as an adjuvant tool for peri-operative pain control; results of a randomized controlled trial in minimally invasive foregut surgery","volume":"49","author":"Haisley","year":"2020","journal-title":"Complement Ther Med"},{"key":"2025042203524375900_ocaf047-B63","first-page":"93","article-title":"Effectiveness of virtual reality glasses as a distraction for children during dental care","volume":"42","author":"Cust\u00f3dio","year":"2020","journal-title":"Pediatr Dent"},{"key":"2025042203524375900_ocaf047-B64","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.apmr.2022.08.005","article-title":"Use of virtual reality in burn rehabilitation: a systematic review and meta-analysis","volume":"104","author":"Lan","year":"2023","journal-title":"Arch Phys Med Rehabil"},{"key":"2025042203524375900_ocaf047-B65","doi-asserted-by":"crossref","first-page":"e26040","DOI":"10.2196\/26040","article-title":"Pediatric coping during venipuncture with virtual reality: pilot randomized controlled trial","volume":"4","author":"Canares","year":"2021","journal-title":"JMIR Pediatr Parent"},{"key":"2025042203524375900_ocaf047-B66","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1097\/01.chi.0000135621.23145.05","article-title":"A pilot and feasibility study of virtual reality as a distraction for children with cancer","volume":"43","author":"Gershon","year":"2004","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2025042203524375900_ocaf047-B67","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1213\/XAA.0000000000001114","article-title":"Use of virtual reality as a surrogate for parental presence during anesthetic induction: a case report","volume":"13","author":"Gupta","year":"2019","journal-title":"A Pract"},{"key":"2025042203524375900_ocaf047-B68","doi-asserted-by":"crossref","first-page":"101628","DOI":"10.1016\/j.cpcardiol.2023.101628","article-title":"The impact of virtual reality on anxiety and functional capacity in cardiac rehabilitation: a systematic review and meta-analysis","volume":"48","author":"Bashir","year":"2023","journal-title":"Curr Probl Cardiol"},{"key":"2025042203524375900_ocaf047-B69","doi-asserted-by":"crossref","first-page":"e2112082","DOI":"10.1001\/jamanetworkopen.2021.12082","article-title":"Efficacy of smartphone active and passive virtual reality distraction vs standard care on burn pain among pediatric patients: a randomized clinical trial","volume":"4","author":"Xiang","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025042203524375900_ocaf047-B70","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.jad.2020.07.076","article-title":"A randomised wait-list controlled pilot trial of one-session virtual reality exposure therapy for blood-injection-injury phobias","volume":"276","author":"Jiang","year":"2020","journal-title":"J Affect Disord"},{"key":"2025042203524375900_ocaf047-B71","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jormas.2017.12.010","article-title":"Using virtual reality to control preoperative anxiety in ambulatory surgery patients: a pilot study in maxillofacial and plastic surgery","volume":"119","author":"Ganry","year":"2018","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"2025042203524375900_ocaf047-B72","first-page":"477","article-title":"Use of virtual reality for symptom management in solid-tumor patients with implications for primary brain tumor research: a systematic review","volume":"7","author":"Leggiero","year":"2020","journal-title":"Neurooncol Pract"},{"key":"2025042203524375900_ocaf047-B73","doi-asserted-by":"crossref","first-page":"e0256489","DOI":"10.1371\/journal.pone.0256489","article-title":"Virtual reality environment using a dome screen for procedural pain in young children during intravenous placement: a pilot randomized controlled trial","volume":"16","author":"Lee","year":"2021","journal-title":"PLoS One"},{"key":"2025042203524375900_ocaf047-B74","doi-asserted-by":"crossref","first-page":"e5801","DOI":"10.2196\/mental.5801","article-title":"Feasibility of an immersive virtual reality intervention for hospitalized patients: an observational cohort study","volume":"3","author":"Mosadeghi","year":"2016","journal-title":"JMIR Ment Health"},{"key":"2025042203524375900_ocaf047-B75","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/1471-0528.16377","article-title":"Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial","volume":"128","author":"Deo","year":"2021","journal-title":"BJOG"},{"key":"2025042203524375900_ocaf047-B76","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1213\/ANE.0000000000004165","article-title":"Systematic review and meta-analysis of virtual reality in pediatrics: effects on pain and anxiety","volume":"129","author":"Eijlers","year":"2019","journal-title":"Anesth Analg"},{"key":"2025042203524375900_ocaf047-B77","doi-asserted-by":"crossref","first-page":"104455","DOI":"10.1016\/j.jdent.2023.104455","article-title":"Effectiveness of virtual reality distraction interventions to reduce dental anxiety in paediatric patients: a systematic review and meta-analysis","volume":"132","author":"Yan","year":"2023","journal-title":"J Dent"},{"key":"2025042203524375900_ocaf047-B78","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ajem.2020.04.009","article-title":"Virtual reality distraction during pediatric intravenous line placement in the emergency department: a prospective randomized comparison study","volume":"44","author":"Schlechter","year":"2021","journal-title":"Am J Emerg Med"},{"key":"2025042203524375900_ocaf047-B79","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/PRS.0000000000008196","article-title":"A randomized controlled trial of virtual reality in awake minor pediatric plastic surgery procedures","volume":"148","author":"Clerc","year":"2021","journal-title":"Plast Reconstr Surg"},{"key":"2025042203524375900_ocaf047-B80","doi-asserted-by":"crossref","first-page":"e1714","DOI":"10.1002\/lary.29148","article-title":"Virtual reality as distraction analgesia and anxiolysis for pediatric otolaryngology procedures","volume":"131","author":"Liu","year":"2021","journal-title":"Laryngoscope"},{"key":"2025042203524375900_ocaf047-B81","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/s00520-022-07568-4","article-title":"Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis","volume":"31","author":"Hao","year":"2023","journal-title":"Support Care Cancer"},{"key":"2025042203524375900_ocaf047-B82","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.3390\/jcm9041025","article-title":"Use of virtual reality for the management of anxiety and pain in dental treatments: systematic review and meta-analysis","volume":"9","author":"L\u00f3pez-Valverde","year":"2020","journal-title":"J Clin Med"},{"key":"2025042203524375900_ocaf047-B83","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1213\/ANE.0000000000005004","article-title":"Pediatric distraction on induction of anesthesia with virtual reality and perioperative anxiolysis: a randomized controlled trial","volume":"132","author":"Jung","year":"2021","journal-title":"Anesth Analg"},{"key":"2025042203524375900_ocaf047-B84","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1097\/BCR.0B013E318148C96F","article-title":"Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes","volume":"28","author":"van Twillert","year":"2007","journal-title":"J Burn Care Res"},{"key":"2025042203524375900_ocaf047-B85","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2431-5-1","article-title":"The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial [ISRCTN87413556]","volume":"5","author":"Das","year":"2005","journal-title":"BMC Pediatr"},{"key":"2025042203524375900_ocaf047-B86","doi-asserted-by":"crossref","first-page":"4133","DOI":"10.3390\/cancers14174133","article-title":"Digital and interactive health interventions minimize the physical and psychological impact of breast cancer, increasing women\u2019s quality of life: a systematic review and meta-analysis","volume":"14","author":"Obrero-Gait\u00e1n","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2025042203524375900_ocaf047-B87","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1089\/cpb.2006.9.207","article-title":"Effectiveness of virtual reality for pediatric pain distraction during iv placement","volume":"9","author":"Gold","year":"2006","journal-title":"Cyberpsychol Behav"},{"key":"2025042203524375900_ocaf047-B88","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.janxdis.2018.12.001","article-title":"Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: a randomized controlled trial","volume":"62","author":"Gujjar","year":"2019","journal-title":"J Anxiety Disord"},{"key":"2025042203524375900_ocaf047-B89","doi-asserted-by":"crossref","first-page":"104115","DOI":"10.1016\/j.ijnurstu.2021.104115","article-title":"Effectiveness of virtual reality in the management of paediatric anxiety during the peri\u2011operative period: a systematic review and meta-analysis","volume":"125","author":"Simonetti","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"2025042203524375900_ocaf047-B90","doi-asserted-by":"crossref","first-page":"e17980","DOI":"10.2196\/17980","article-title":"The effectiveness of virtual reality in managing acute pain and anxiety for medical inpatients: systematic review","volume":"22","author":"Smith","year":"2020","journal-title":"J Med Internet Res"},{"key":"2025042203524375900_ocaf047-B91","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5005\/jp-journals-10005-1640","article-title":"Effectiveness of virtual reality eyeglasses as a distraction aid to reduce anxiety among 6\u201310-year-old children undergoing dental extraction procedure","volume":"12","author":"Koticha","year":"2019","journal-title":"Int J Clin Pediatr Dent"},{"key":"2025042203524375900_ocaf047-B92","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1023\/A:1005591626518","article-title":"Using the bedside wellness system during chemotherapy decreases fatigue and emesis in cancer patients","volume":"24","author":"Oyama","year":"2000","journal-title":"J Med Syst"},{"key":"2025042203524375900_ocaf047-B93","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.jopan.2022.11.013","article-title":"Impact of virtual operating room tours on relieving perioperative anxiety in adult patients: a systematic review","volume":"38","author":"Yu","year":"2023","journal-title":"J Perianesth Nurs"},{"key":"2025042203524375900_ocaf047-B94","doi-asserted-by":"crossref","first-page":"e051808","DOI":"10.1136\/bmjopen-2021-051808","article-title":"Efficacy of virtual reality-based interventions for patients with breast cancer symptom and rehabilitation management: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2022","journal-title":"BMJ Open"},{"key":"2025042203524375900_ocaf047-B95","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1089\/cpb.1999.2.125","article-title":"Effects of virtual reality on symptom distress in children receiving chemotherapy","volume":"2","author":"Schneider","year":"1999","journal-title":"Cyberpsychol Behav"},{"key":"2025042203524375900_ocaf047-B96","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1111\/jocn.15173","article-title":"Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5\u201312 years old: a randomised controlled study","volume":"29","author":"\u00d6zalp Ger\u00e7eker","year":"2020","journal-title":"J Clin Nurs"},{"key":"2025042203524375900_ocaf047-B97","first-page":"312","article-title":"Virtual reality relaxation to decrease dental anxiety: immediate effect randomized clinical trial","volume":"5","author":"Lahti","year":"2020","journal-title":"JDR Clin Trans Res"},{"key":"2025042203524375900_ocaf047-B98","doi-asserted-by":"crossref","first-page":"e36695","DOI":"10.2196\/36695","article-title":"The effects of virtual reality in maternal delivery: systematic review and meta-analysis","volume":"10","author":"Xu","year":"2022","journal-title":"JMIR Serious Games"},{"key":"2025042203524375900_ocaf047-B99","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1017\/S1478951518000639","article-title":"Virtual reality as a distraction technique for pain and anxiety among patients with breast cancer: a randomized control trial","volume":"17","author":"Mohammad","year":"2019","journal-title":"Palliat Support Care"},{"key":"2025042203524375900_ocaf047-B100","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jpeds.2019.02.034","article-title":"Virtual reality for pediatric needle procedural pain: two randomized clinical trials","volume":"209","author":"Chan","year":"2019","journal-title":"J Pediatr"},{"key":"2025042203524375900_ocaf047-B101","doi-asserted-by":"crossref","first-page":"97","DOI":"10.17796\/1053-4625-43.2.5","article-title":"Effect of virtual reality distraction on pain and anxiety during dental treatment in 5 to 8 year old children","volume":"43","author":"Shetty","year":"2019","journal-title":"J Clin Pediatr Dent"},{"key":"2025042203524375900_ocaf047-B102","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/ams.ams_263_18","article-title":"Role of virtual reality in pain perception of patients following the administration of local anesthesia","volume":"9","author":"Sweta","year":"2019","journal-title":"Ann Maxillofac Surg"},{"key":"2025042203524375900_ocaf047-B103","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s10877-021-00725-w","article-title":"The use of virtual reality in children undergoing vascular access procedures: a systematic review and meta-analysis","volume":"36","author":"Saliba","year":"2022","journal-title":"J Clin Monit Comput"},{"key":"2025042203524375900_ocaf047-B104","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s40653-021-00350-4","article-title":"Pilot randomized controlled trial of virtual reality vs standard-of-care during pediatric laceration repair","volume":"14","author":"Goldman","year":"2021","journal-title":"J Child Adolesc Trauma"},{"key":"2025042203524375900_ocaf047-B105","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1002\/bjs.10684","article-title":"Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia","volume":"104","author":"Ryu","year":"2017","journal-title":"Br J Surg"},{"key":"2025042203524375900_ocaf047-B106","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3390\/jcm7090284","article-title":"The effect of gamification through a virtual reality on preoperative anxiety in pediatric patients undergoing general anesthesia: a prospective, randomized, and controlled trial","volume":"7","author":"Ryu","year":"2018","journal-title":"J Clin Med"},{"key":"2025042203524375900_ocaf047-B107","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/pan.13535","article-title":"The effect of an immersive virtual reality tour of the operating theater on emergence delirium in children undergoing general anesthesia: a randomized controlled trial","volume":"29","author":"Ryu","year":"2019","journal-title":"Paediatr Anaesth"},{"key":"2025042203524375900_ocaf047-B108","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1188\/07.ONF.39-46","article-title":"Virtual reality: a distraction intervention for chemotherapy","volume":"34","author":"Schneider","year":"2007","journal-title":"Oncol Nurs Forum"},{"key":"2025042203524375900_ocaf047-B109","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1186\/s12871-020-01177-6","article-title":"The use of pre-operative virtual reality to reduce anxiety in women undergoing gynecological surgeries: a prospective cohort study","volume":"20","author":"Chan","year":"2020","journal-title":"BMC Anesthesiol"},{"key":"2025042203524375900_ocaf047-B110","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S0304-3959(99)00275-4","article-title":"Virtual reality as an adjunctive pain control during burn wound care in adolescent patients","volume":"85","author":"Hoffman","year":"2000","journal-title":"Pain"},{"key":"2025042203524375900_ocaf047-B111","doi-asserted-by":"crossref","first-page":"102341","DOI":"10.1016\/j.ctim.2020.102341","article-title":"Non-pharmacological interventions for anxiety in burn patients: a systematic review and meta-analysis of randomized controlled trials","volume":"49","author":"Fardin","year":"2020","journal-title":"Complement Ther Med"},{"key":"2025042203524375900_ocaf047-B112","doi-asserted-by":"crossref","first-page":"1534735419871108","DOI":"10.1177\/1534735419871108","article-title":"Meta-analysis of the efficacy of virtual reality-based interventions in cancer-related symptom management","volume":"18","author":"Zeng","year":"2019","journal-title":"Integr Cancer Ther"},{"key":"2025042203524375900_ocaf047-B113","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13012-015-0345-7","article-title":"The concept of mechanism from a realist approach: a scoping review to facilitate its operationalization in public health program evaluation","volume":"10","author":"Lacouture","year":"2015","journal-title":"Implementation Sci"},{"key":"2025042203524375900_ocaf047-B114","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implementation Sci"},{"key":"2025042203524375900_ocaf047-B115","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/qshc.7.3.149","article-title":"Enabling the implementation of evidence based practice: a conceptual framework","volume":"7","author":"Kitson","year":"1998","journal-title":"Qual Health Care"},{"key":"2025042203524375900_ocaf047-B116","doi-asserted-by":"crossref","first-page":"e0000279","DOI":"10.1371\/journal.pdig.0000279","article-title":"Digital literacy as a new determinant of health: a scoping review","volume":"2","author":"Arias L\u00f3pez","year":"2023","journal-title":"PLOS Digit Health"},{"key":"2025042203524375900_ocaf047-B117","doi-asserted-by":"crossref","first-page":"e15025","DOI":"10.2196\/15025","article-title":"Immersive virtual reality in health care: systematic review of technology and disease states","volume":"4","author":"Snoswell","year":"2019","journal-title":"JMIR Biomed Eng"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/32\/5\/945\/62494773\/ocaf047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/32\/5\/945\/62494773\/ocaf047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T07:53:08Z","timestamp":1745308388000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/32\/5\/945\/8088352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":117,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3,20]]},"published-print":{"date-parts":[[2025,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocaf047","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,3,20]]}}}