{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:37:12Z","timestamp":1790815032423,"version":"4.1.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"health and medical research fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Anxiety, nausea and vomiting are common side effects suffered by paediatric patients receiving chemotherapy. Emerging evidence supports the efficacy of immersive virtual reality (IVR) on improving anxiety and distress symptoms including nausea and vomiting among this vulnerable group. This trial aims to assess the feasibility and acceptability of IVR for preventing and managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method and analysis<\/jats:title>\n<jats:p>An exploratory trial supplemented by qualitative methods will be conducted. We will recruit 20 paediatric patients who are aged between 6 and 12 years, chemotherapy na\u00efve, scheduled to receive their first intravenous chemotherapy and able to understand Chinese. Participants will be randomly allocated to intervention or control groups. The intervention group will receive the IVR intervention for three sessions as follows: 4 hours before chemotherapy, 5 minutes before and during their first course chemotherapy and 5 minutes before and during their second course chemotherapy. The control group will receive standard care only. Main outcome measures included (1) key parameters for the design of a definitive trial (i.e. screening, eligibility, consent and withdrawal rates); (2) anxiety, anticipatory and acute chemotherapy-induced nausea and vomiting for collection of preliminary data; (3) feasibility and acceptability of the intervention. Semi-structured interviews will be conducted with patients, parents and oncology nurses. Generalized estimating equations model will be used to compare each of the outcome measures across the time points between the two groups. Qualitative data will be analysed by conventional content analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Expected results<\/jats:title>\n<jats:p>The results of this exploratory trial will inform the design and conduct of future definitive trial.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration number<\/jats:title>\n<jats:p> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/com\/25\/showproj.aspx?proj=21694\" xlink:type=\"simple\">ChiCTR1900021694<\/jats:ext-link>; Pre-results.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0258514","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T18:19:27Z","timestamp":1634235567000},"page":"e0258514","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effects of immersive virtual reality for preventing and managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: A study protocol for an exploratory trial"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-1323","authenticated-orcid":true,"given":"Cho Lee","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Chow","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winnie Kwok Wei","family":"So","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7444-6935","authenticated-orcid":true,"given":"Jojo Yan Yan","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin Ting","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Wing Han","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"pone.0258514.ref001","article-title":"Chemotherapy-induced nausea and vomiting (CINV) in patients with advanced lung cancer during the first-line treatment: assessment by physicians, nurses, and patients from an Italian multicentre survey","author":"S Carnio","year":"2017","journal-title":"Support Care Cancer"},{"issue":"2","key":"pone.0258514.ref002","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":"SM Schneider","year":"1999","journal-title":"Cyberpsycho Behav"},{"issue":"1","key":"pone.0258514.ref003","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00520-014-2375-0","article-title":"Incidence and predictors of anticipatory nausea and vomiting in Asia Pacific clinical practice-a longitudinal analysis","volume":"23","author":"A Chan","year":"2015","journal-title":"Supportive Care Cancer"},{"issue":"6","key":"pone.0258514.ref004","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.jpainsymman.2015.12.317","article-title":"Anticipatory nausea, risk factors, and its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry Study","volume":"51","author":"A Molassiotis","year":"2016","journal-title":"J Pain Symptom Manage"},{"issue":"1","key":"pone.0258514.ref005","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00520-016-3384-y","article-title":"2016 updated MASCC\/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children","volume":"25","author":"LL Dupuis","year":"2017","journal-title":"Support Care Cancer"},{"key":"pone.0258514.ref006","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s005200050161","article-title":"Anticipatory nausea and vomiting in the era of 5-HT3 antiemetics","volume":"6","author":"GR Morrow","year":"1998","journal-title":"Support Care Cancer"},{"issue":"3","key":"pone.0258514.ref007","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1007\/s00520-015-2924-1","article-title":"Poor chemotherapy-induced nausea and vomiting control in children receiving intermediate or high dose methotrexate","volume":"2","author":"H Vol","year":"2016","journal-title":"Support Care Cancer"},{"issue":"8","key":"pone.0258514.ref008","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1002\/pbc.25063","article-title":"Pediatric Oncology Group of Ontario. 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