{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:21:15Z","timestamp":1790356875836,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Recent research has explored the effectiveness of interactive virtual experiences in managing pain and anxiety in children during routine medical procedures, compared to conventional care methods. However, the influence of the specific technology used as an interface, 3-dimensions (D) immersive virtual reality (VR) vs. 2D touch screens, during pediatric venipuncture, remains unexamined. This study aimed to determine if immersive VR is more effective than a tablet in reducing pain and anxiety during short procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An interactive game was designed by clinicians and psychologists, expert in pain theory, hypnosis, and procedural pain and anxiety relief, and was tailored for both VR and tablet use. Fifty patients were randomly assigned to either the Tablet or VR group. The primary outcome measures were pain and anxiety levels during the procedure. Secondary outcome measures included the need for physical restraint, duration of the procedure, enjoyment levels, and satisfaction ratings from both parents and nurses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants, in both groups, had low levels of pain and anxiety. Physical restraint was infrequently used, procedures were brief, and high satisfaction levels were reported by patients, parents, and nurses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study suggests that the type of technology used as a support for the game has a minimal effect on the child's experience, with both groups reporting low pain and anxiety levels, minimal physical restraint, and high enjoyment. Despite immersive VR's technological advancements, this study underscores the value of traditional tablets with well-designed interactive games in enhancing children's wellbeing during medical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>[<jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>], identifier [NCT05065307].<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1378459","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T04:46:42Z","timestamp":1715575602000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Virtual reality vs. tablet for procedural comfort using an identical game in children undergoing venipuncture: a randomized clinical trial"],"prefix":"10.3389","volume":"12","author":[{"given":"Christina","family":"Zavlanou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Savary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Mermet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Corradi-Dell\u2019Acqua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rudrauf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvain","family":"Tisserand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Sahyoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/j.1532-2149.2012.00169.x","article-title":"Pain tolerance in children and adolescents","volume":"17","author":"Schmitz","year":"2013","journal-title":"Eur J Pain"},{"key":"B2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1111\/jan.13818","article-title":"The fear of needles: a systematic review and meta-analysis","volume":"75","author":"McLenon","year":"2019","journal-title":"J Adv Nurs"},{"key":"B3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s00431-021-04169-x","article-title":"Adolescents\u2019 pain and distress during peripheral intravenous cannulation in a paediatric emergency setting","volume":"181","author":"Cozzi","year":"2022","journal-title":"Eur J Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/0005-7967(89)90088-0","article-title":"Blood\/injury fear, fainting and avoidance of medically-related situations: a family correspondence study","volume":"27","author":"Kleinknecht","year":"1989","journal-title":"Behav Res Ther"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4807","DOI":"10.1016\/j.vaccine.2012.05.011","article-title":"Survey of the prevalence of immunization non-compliance due to needle fears in children and adults","volume":"30","author":"Taddio","year":"2012","journal-title":"Vaccine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1542\/peds.77.1.11","article-title":"Status of pediatric pain control: a comparison of hospital analgesic usage in children and adults","volume":"77","author":"Schechter","year":"1986","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/s0031-3955(05)70227-3","article-title":"Complementary therapies for acute pediatric pain management","volume":"47","author":"Rusy","year":"2000","journal-title":"Pediatr Clin North Am"},{"key":"B8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.pmn.2014.04.004","article-title":"Can presence of a dog reduce pain and distress in children during venipuncture?","volume":"16","author":"Vagnoli","year":"2015","journal-title":"Pain Manag Nurs"},{"key":"B9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.anr.2013.12.001","article-title":"Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children","volume":"8","author":"Canbulat","year":"2014","journal-title":"Asian Nurs Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/j.pedn.2011.08.001","article-title":"Distraction techniques for children undergoing procedures: a critical review of pediatric research","volume":"27","author":"Koller","year":"2012","journal-title":"J Pediatr Nurs"},{"key":"B11","first-page":"725","author":"Sonne","year":"2017"},{"key":"B12","doi-asserted-by":"publisher","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":"Ger\u00e7eker","year":"2020","journal-title":"J Clin Nurs"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2508","DOI":"10.3389\/fpsyg.2018.02508","article-title":"Virtual reality analgesia during venipuncture in pediatric patients with onco-hematological diseases","volume":"9","author":"Atzori","year":"2018","journal-title":"Front Psychol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3389\/fnhum.2019.00262","article-title":"Immersive virtual reality as an adjunctive non-opioid analgesic for Pre-dominantly Latin American children with large severe burn wounds during burn wound cleaning in the intensive care unit: a pilot study","volume":"13","author":"Hoffman","year":"2019","journal-title":"Front Hum Neurosci"},{"key":"B15","doi-asserted-by":"publisher","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":"B16","doi-asserted-by":"publisher","first-page":"102427","DOI":"10.1016\/j.ijhcs.2020.102427","article-title":"Computer games as distraction from PAIN: effects of hardware and difficulty on pain tolerance and subjective IMMERSION","volume":"139","author":"Fairclough","year":"2020","journal-title":"Int J Hum-Comput Stud"},{"key":"B17","doi-asserted-by":"publisher","first-page":"7086","DOI":"10.1038\/s41467-022-34616-8","article-title":"A population-based serological study of post-COVID syndrome prevalence and risk factors in children and adolescents","volume":"13","author":"Dumont","year":"2022","journal-title":"Nat Commun"},{"key":"B18","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1745-6215-11-32","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"11","author":"Schulz","year":"2010","journal-title":"Trials"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e333","DOI":"10.3109\/0142159x.2011.575903","article-title":"Using a Delphi process to establish consensus on emergency medicine clerkship competencies","volume":"33","author":"Penciner","year":"2011","journal-title":"Med Teach"},{"key":"B20","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1080\/00207147308409308","article-title":"Age differences in susceptibility to hypnosis","volume":"21","author":"Morgan","year":"1973","journal-title":"Int J Clin Exp Hypn"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1097\/j.pain.0000000000000666","article-title":"Young children\u2019s ability to report on past, future, and hypothetical pain states","volume":"157","author":"Jaaniste","year":"2016","journal-title":"Pain"},{"key":"B22","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1213\/ane.0000000000000350","article-title":"Development of a short version of the modified Yale preoperative anxiety scale","volume":"119","author":"Jenkins","year":"2014","journal-title":"Anesthesia Analg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s10880-020-09716-6","article-title":"Predicting intense levels of child anxiety during anesthesia induction at hospital arrival","volume":"28","author":"Eijlers","year":"2021","journal-title":"J Clin Psychol M\u00e9d Settings"},{"key":"B24","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1097\/pec.0b013e3181666f32","article-title":"Derivation of the DIVA score","volume":"24","author":"Yen","year":"2008","journal-title":"Pediatr Emerg Care"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e1168","DOI":"10.1542\/peds.2010-1609","article-title":"A systematic review of faces scales for the self-report of pain intensity in children","volume":"126","author":"Tomlinson","year":"2010","journal-title":"Pediatrics"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e387","DOI":"10.3928\/19382359-20170921-03","article-title":"Pain assessment in newborns, infants, and children","volume":"46","author":"Beltramini","year":"2017","journal-title":"Pediatr Ann"},{"key":"B27","first-page":"335","article-title":"The creation, validation, and continuing development of the oucher: a measure of pain intensity in children","volume":"7","author":"Beyer","year":"1992","journal-title":"J Pediatr Nurs"},{"key":"B28","first-page":"9","article-title":"Pain in children: comparison of assessment scales","volume":"14","author":"Wong","year":"1988","journal-title":"Pediatr Nurs"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e2023174","DOI":"10.23750\/abm.v94i4.14289","article-title":"Pain management in pediatric age. An update","volume":"94","author":"Sarno","year":"2023","journal-title":"Acta Biomed"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.3389\/fpsyg.2018.02265","article-title":"Virtual reality analgesia for pediatric dental patients","volume":"9","author":"Atzori","year":"2018","journal-title":"Front Psychol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1089\/cyber.2014.0058","article-title":"Feasibility of articulated arm mounted Oculus rift virtual reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients","volume":"17","author":"Hoffman","year":"2014","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"B32","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1542\/hpeds.2018-0249","article-title":"Immersive virtual reality for pediatric procedural pain: a randomized clinical trial","volume":"9","author":"Walther-Larsen","year":"2019","journal-title":"Hosp Pediatr"},{"key":"B33","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.jpain.2011.12.010","article-title":"Validation of the numerical rating scale for pain intensity and unpleasantness in pediatric acute postoperative pain: sensitivity to change over time","volume":"13","author":"Pag\u00e9","year":"2012","journal-title":"J Pain"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e971","DOI":"10.1542\/peds.2013-1509","article-title":"Validation of self-report pain scales in children","volume":"132","author":"Tsze","year":"2013","journal-title":"Pediatrics"},{"key":"B35","article-title":"International Association for the Study of Pain","year":""},{"key":"B36","unstructured":"2022"},{"key":"B37","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/j.ijnurstu.2011.02.010","article-title":"Blinding during the analysis of research data","volume":"48","author":"Polit","year":"2011","journal-title":"Int J Nurs Stud"},{"key":"B38","doi-asserted-by":"publisher","first-page":"699383","DOI":"10.3389\/frvir.2021.699383","article-title":"The effects of virtual reality on procedural pain and anxiety in pediatrics: a systematic review and meta-analysis","volume":"2","author":"Nordg\u00e5rd","year":"2021","journal-title":"Front Virtual Real"},{"key":"B39","doi-asserted-by":"publisher","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":"B40","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1089\/g4h.2018.0111","article-title":"A randomized controlled trial on the use of virtual reality for needle-related procedures in children and adolescents in the emergency department","volume":"8","author":"Dumoulin","year":"2019","journal-title":"Games Health J"},{"key":"B41","doi-asserted-by":"publisher","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":"B42","doi-asserted-by":"publisher","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":"B43","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.3390\/jcm10112486","article-title":"Virtual reality vs. tablet video as an experiential education platform for pediatric patients undergoing chest radiography: a randomized clinical trial","volume":"10","author":"Ryu","year":"2021","journal-title":"J Clin Med"},{"key":"B44","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1097\/pec.0000000000001559","article-title":"Certified child life specialists lessen emotional distress of children undergoing laceration repair in the emergency department","volume":"34","author":"Hall","year":"2018","journal-title":"Pediatr Emerg Care"},{"key":"B45","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1093\/labmed\/lmv006","article-title":"Phlebotomy cycle time related to phlebotomist experience and\/or hospital location","volume":"47","author":"Jones","year":"2016","journal-title":"Lab Med"},{"key":"B46","doi-asserted-by":"publisher","first-page":"854673","DOI":"10.3389\/fpubh.2022.854673","article-title":"Non-pharmacologic approaches in preoperative anxiety, a comprehensive review","volume":"10","author":"Wang","year":"2022","journal-title":"Front Public Heal"},{"key":"B47","doi-asserted-by":"publisher","first-page":"A459","DOI":"10.1136\/archdischild-2012-302724.1621","article-title":"1621 heart rates and respiratory rates are associated with Manchester pain scores in children presented at the emergency department","volume":"97","author":"Seiger","year":"2012","journal-title":"Arch Dis Child"},{"key":"B48","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.jpsychores.2009.02.007","article-title":"Autonomic activity and somatic symptoms in response to success vs. Failure on a cognitive task: a comparison of chronic abdominal pain patients and well children","volume":"67","author":"Puzanovova","year":"2009","journal-title":"J Psychosom Res"},{"key":"B49","author":"Donovan","year":"2022"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1378459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T04:46:50Z","timestamp":1715575610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1378459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,13]]},"references-count":49,"alternative-id":["10.3389\/fped.2024.1378459"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1378459","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,13]]},"article-number":"1378459"}}