{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:08:24Z","timestamp":1788865704543,"version":"build-2803163510"},"reference-count":101,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Immersive virtual reality (VR) is increasingly used during pediatric procedures, but intervention effects vary across children, procedures, devices, comparators, and outcomes. This review synthesized recent evidence and developed a proposed developmentally informed child-procedure-intervention framework for clinical matching. Methods: A structured narrative review synthesized 96 publications identified through PubMed, Scopus, Web of Science Core Collection, the Cochrane Library, and CINAHL through 31 July 2026. Explicit searching, eligibility criteria, screening, and structured evidence characterization were used to improve transparency; however, this was not a systematic review, and no formal risk-of-bias or certainty-of-evidence assessment was performed. Evidence was interpreted according to publication type and organized by clinical context, developmental modifiers, intervention characteristics, implementation, biofeedback, and future AI-supported decision support. Results: The most recurrent favorable findings concerned venipuncture, intravenous access, vaccination, and related needle procedures, particularly against usual care, whereas comparisons with active distraction and evidence from oncology, burns, dentistry, orthopedics, surgery, and emergency care were more mixed. The narrative synthesis identified developmental readiness, baseline anxiety, previous procedural experience, sensory tolerance, content, interactivity, immersion, timing, comparator, concurrent analgesia, and patient preference as plausible moderators, although their predictive value remains insufficiently validated. The author-generated framework links nursing assessment, purpose-based VR selection, monitoring, stopping criteria, and clinically approved adjustment. Conclusions: Pediatric procedural VR should not be treated as a uniform intervention. The proposed framework is evidence-informed and hypothesis-generating, not a validated clinical decision model. Biofeedback is supported by preliminary pediatric evidence, whereas AI-supported adaptation remains a future research and translational opportunity requiring prospective validation, governance, and continuous clinical oversight.<\/jats:p>","DOI":"10.3390\/nursrep16090316","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:17:37Z","timestamp":1788862657000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immersive Virtual Reality for Pediatric Procedural Pain and Anxiety: A Structured Narrative Review and Developmentally Informed Framework for Clinical Matching and AI-Supported Personalization"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8068-0942","authenticated-orcid":false,"given":"Domonkos","family":"Tinka","sequence":"first","affiliation":[{"name":"Doctoral School of Economic and Regional Sciences, Sz\u00e9chenyi Istv\u00e1n University, 9026 Gy\u0151r, Hungary"},{"name":"Department of Paediatrics, Petz Alad\u00e1r University Teaching Hospital of Gy\u0151r-Moson-Sopron County, 9024 Gy\u0151r, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4403-6480","authenticated-orcid":false,"given":"Mohammad Milad","family":"Shafaie","sequence":"additional","affiliation":[{"name":"Multidisciplinary Doctoral School of Engineering Sciences, Sz\u00e9chenyi Istv\u00e1n University, 9026 Gy\u0151r, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","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":"Peyro","year":"2022","journal-title":"JMIR Serious Games"},{"key":"ref_2","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":"ref_3","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.3390\/nursrep14030182","article-title":"Effectiveness of Virtual Reality for Managing Pain, Fear, and Anxiety in Children and Adolescents Undergoing Needle-Related Procedures: Systematic Review with Meta-Analysis","volume":"14","author":"Magni","year":"2024","journal-title":"Nurs. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Caballero, E., Ortega-Donaire, L., and Sanz-Martos, S. (2024). Immersive Virtual Reality for Pain and Anxiety Management Associated with Medical Procedures in Children and Adolescents: A Systematic Review. Children, 11.","DOI":"10.3390\/children11080975"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1111\/jocn.70335","article-title":"Virtual Reality for Managing Procedural Pain and Distress in Paediatrics: A Scoping Review","volume":"35","author":"Huang","year":"2026","journal-title":"J. Clin. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Herrera, M.D.L.C., Fuster-Casanovas, A., Catalina, Q.M., Mensa, M.C., Guitart, I.V., Sede\u00f1o, A.A., Vidal-Alaball, J., and Carri\u00f3n, S.G. (2025). Use of virtual reality in the reduction of pain after the administration of vaccines among children in primary care centers in Central Catalonia: Randomized clinical trial. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0322840"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8164180","DOI":"10.1155\/nuf\/8164180","article-title":"Virtual Reality as a Nonpharmacological Tool for Reducing Pain, Fear and Distress During Venipuncture in Children: A Quasi-Experimental Study","volume":"2026","author":"Sanad","year":"2026","journal-title":"Nurs. Forum"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"114803","DOI":"10.1016\/j.jpeds.2025.114803","article-title":"A Randomized Controlled Trial of Commercially Available Virtual Reality for Intravenous Cannulation-Related Distress in Children","volume":"288","author":"Ali","year":"2026","journal-title":"J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101886","DOI":"10.1016\/j.ejon.2020.101886","article-title":"The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: Randomized controlled trial","volume":"50","author":"Ellidokuz","year":"2021","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/1043454220975702","article-title":"Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study","volume":"38","author":"Semerci","year":"2021","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/PEC.0000000000003319","article-title":"Virtual Reality as Active Distraction in Laceration Repair: A Game Changer?","volume":"41","author":"McEvoy","year":"2025","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"389","DOI":"10.17796\/1053-4625-45.6.5","article-title":"Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections","volume":"45","author":"Kumari","year":"2021","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e732","DOI":"10.1016\/j.pmn.2026.03.001","article-title":"Effect of Virtual Reality Vs Bubble Play in Catheterization: Randomized Clinical Trial","volume":"27","author":"Zengin","year":"2026","journal-title":"Pain Manag. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.1016\/j.pedn.2021.01.001","article-title":"The Effect of Three Different Methods on Venipuncture Pain and Anxiety in Children: Distraction Cards, Virtual Reality, and Buzzy\u00ae (Randomized Controlled Trial)","volume":"58","author":"Erdogan","year":"2021","journal-title":"J. Pediatr. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zavlanou, C., Savary, V., Mermet, S., Sander, D., Corradi-Dell\u2019aCqua, C., Rudrauf, D., Tisserand, Y., and Sahyoun, C. (2024). Virtual reality vs. tablet for procedural comfort using an identical game in children undergoing venipuncture: A randomized clinical trial. Front. Pediatr., 12.","DOI":"10.3389\/fped.2024.1378459"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1097\/CORR.0000000000002889","article-title":"Virtual Reality Distraction Is No Better Than Simple Distraction Techniques for Reducing Pain and Anxiety During Pediatric Orthopaedic Outpatient Procedures: A Randomized Controlled Trial","volume":"482","author":"Fabricant","year":"2024","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1111\/jan.16991","article-title":"Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial","volume":"82","author":"Guingo","year":"2026","journal-title":"J. Adv. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.pedn.2026.03.022","article-title":"The influence of different immersive virtual reality devices on children\u2019s pain during needle-based procedures: A network meta-analysis and systematic review","volume":"88","author":"Shi","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e53196","DOI":"10.2196\/53196","article-title":"Exploring Relations Between Unique Patient Characteristics and Virtual Reality Immersion Level on Anxiety and Pain in Patients Undergoing Venipuncture: Secondary Analysis of a Randomized Control Trial","volume":"26","author":"Gold","year":"2024","journal-title":"J. Med. Internet Res."},{"key":"ref_20","first-page":"163","article-title":"Age and Sex Differences of Virtual Reality Pain Alleviation Therapeutic During Pediatric Burn Care: A Randomized Clinical Trial","volume":"1","author":"Jones","year":"2024","journal-title":"J. Med. Ext. Real."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/scs.13128","article-title":"Children\u2019s perceptions of interactive virtual-reality interventions implemented before and after intravenous cannulation","volume":"37","author":"Whu","year":"2023","journal-title":"Scand. J. Caring Sci."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Tinka, D., Shafaie, M.M., Prukner, P., and Kov\u00e1cs, M. (2026). Age-Specific Responses to Immersive Virtual Reality During Pediatric Venipuncture: Evidence from Routine Clinical Practice. Healthcare, 14.","DOI":"10.3390\/healthcare14020173"},{"key":"ref_23","unstructured":"Shafaie, M.M., and Hedayati, M. (2025, January 11\u201312). Artificial Intelligence in Predicting Biomechanical Effects of Striatal-Locomotor Tasks: Application in Fall Risk Assessment and Rehabilitation. Proceedings of the 11th International Conference on Applied Research in Basic Sciences, Engineering and Technology, Tbilisi, Georgia."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.pedn.2026.03.035","article-title":"Balancing technology and nursing care in paediatric practice\u2014Registered Nurses\u2019 experiences of XR distraction being used during needle-related procedures","volume":"88","author":"Jungner","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_25","first-page":"179","article-title":"Implementation of Virtual Reality Pain Alleviation Therapeutic into Routine Pediatric Clinical Care: Experiences and Perspectives of Stakeholders","volume":"1","author":"Girin","year":"2024","journal-title":"J. Med. Ext. Real."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1542\/hpeds.2020-003822","article-title":"Resource use during pediatric venipuncture with virtual reality: Secondary analysis of a randomized controlled pilot trial","volume":"11","author":"Canares","year":"2021","journal-title":"Hosp. Pediatr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1111\/jan.16417","article-title":"Acceptability and Usability of Smileyscope Virtual Reality for Paediatric Pain Management During Burn Procedures: Perspectives of Patients, Carers and Clinicians","volume":"81","author":"Storey","year":"2025","journal-title":"J. Adv. Nurs."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e66656","DOI":"10.2196\/66656","article-title":"Factors Influencing Virtual Reality as a Distraction Tool for Venipuncture in Children: Observational Pilot Feasibility Study","volume":"13","author":"Worth","year":"2025","journal-title":"JMIR Serious Games"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"604","DOI":"10.15388\/Tibe.2025.24.3A.3","article-title":"The Financial Sustainability of Robot-Assisted Surgery (RAS)","volume":"24","author":"Tinka","year":"2025","journal-title":"Transform. Bus. Econ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.pedn.2026.01.026","article-title":"Virtual reality for pediatric procedural pain: An umbrella review and re-analysis of meta-analytic evidence","volume":"87","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.pedn.2025.12.015","article-title":"The application of virtual and augmented reality in hospitalized pediatric nursing interventions: An integrative literature review","volume":"86","author":"Kim","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"100550","DOI":"10.1016\/j.ijnsa.2026.100550","article-title":"Managing pediatric pain during needle procedures: A narrative review of virtual reality and Buzzy as distraction-based interventions","volume":"10","author":"Medland","year":"2026","journal-title":"Int. J. Nurs. Stud. Adv."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1177\/18632521251414463","article-title":"Virtual reality as a distraction technique in pediatric patients undergoing orthopedic procedures: A systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Alharran","year":"2026","journal-title":"J. Child. Orthop."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Cocchi, E., Bloise, S., and Marchetti, F. (2026). Age matters in pediatric pain care: Bayesian meta-reanalysis of virtual reality trials. Pediatr. Res., 1\u20137.","DOI":"10.1038\/s41390-026-05243-6"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/jamapediatrics.2022.4426","article-title":"Effect of a Virtual Reality Environment Using a Domed Ceiling Screen on Procedural Pain during Intravenous Placement in Young Children: A Randomized Clinical Trial","volume":"177","author":"Park","year":"2023","journal-title":"JAMA Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ni Lee, H., Bae, W., Park, J.W., Jung, J.Y., Hwang, S., Kim, D.K., and Kwak, Y.H. (2021). Virtual reality environment using a dome screen for procedural pain in young children during intravenous placement: A pilot randomized controlled trial. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0256489"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9973","DOI":"10.24294\/jipd9973","article-title":"Precision surgery: The introduction of the da Vinci Robotic Surgical System in Hungary","volume":"9","author":"Tinka","year":"2025","journal-title":"J. Infrastruct. Policy Dev."},{"key":"ref_38","unstructured":"Shafaie, M.M., and Salehnia, A. (2025, January 11\u201312). Cognitive Factors Effects on Maximal Voluntary Contraction (MVC). Proceedings of the 11th International Conference on Applied Research in Basic Sciences, Engineering and Technology, Tbilisi, Georgia."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"107623","DOI":"10.1016\/j.burns.2025.107623","article-title":"The beneficial impact of virtual reality in the burn wound care of pediatric patients: An updated systematic review and meta-analysis","volume":"51","author":"Lou","year":"2025","journal-title":"Burns"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"102695","DOI":"10.1016\/j.ejon.2024.102695","article-title":"The use of immersive virtual reality for managing physical and psychological distress in children and adolescents with cancer undergoing chemotherapy via implanted vascular access device needle insertion: A systematic review","volume":"73","author":"Tsitsi","year":"2024","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wei, Q., Sun, R., Liang, Y., and Chen, D. (2024). Virtual reality technology reduces the pain and anxiety of children undergoing vein puncture: A meta-analysis. BMC Nurs., 23.","DOI":"10.1186\/s12912-024-02184-5"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"533","DOI":"10.3345\/cep.2022.01193","article-title":"Virtual reality for pain reduction during intravenous injection in pediatrics: A systematic review and meta-analysis of controlled clinical trials","volume":"66","author":"Jenabi","year":"2023","journal-title":"Clin. Exp. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.pedn.2023.08.014","article-title":"Virtual reality vs. buzzy\u00ae. efficacy in pain and anxiety management during pediatric venipuncture. Systematic review and meta-analysis","volume":"73","year":"2023","journal-title":"J. Pediatr. Nurs."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Wang, Y., Guo, L., and Xiong, X. (2022). Effects of Virtual Reality-Based Distraction of Pain, Fear, and Anxiety During Needle-Related Procedures in Children and Adolescents. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.842847"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jen.2025.08.003","article-title":"Effect of Distracting Methods on Procedure-Related Fear, Anxiety, and Pain During Intramuscular Injection: A Randomized Controlled Trial","volume":"52","year":"2026","journal-title":"J. Emerg. Nurs."},{"key":"ref_46","first-page":"162","article-title":"Virtual Reality Headset Use During Venipuncture in Children: Impact on Fear and Pain Levels","volume":"36","year":"2026","journal-title":"Psychiatry Clin. Psychopharmacol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/jocn.17287","article-title":"The effect of virtual reality versus standard-of-care treatment on pain perception during paediatric vaccination: A randomised controlled trial","volume":"34","year":"2025","journal-title":"J. Clin. Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e530","DOI":"10.1016\/j.pmn.2025.06.014","article-title":"Virtual Reality for Pain Relief in Children During Vaccination: Randomized Pilot Study","volume":"26","author":"Vitor","year":"2025","journal-title":"Pain Manag. Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/NAN.0000000000000603","article-title":"Effectiveness of Virtual Reality on Pain During Peripheral Intravenous Catheterization in the Emergency Room: A Randomized Clinical Trial","volume":"48","author":"Ullman","year":"2025","journal-title":"J. Infus. Nurs."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1089\/cyber.2023.0454","article-title":"Virtual Reality Distraction for Needle-Related Pain and Distress in Children: A Multicenter Randomized Controlled Trial","volume":"27","author":"Czub","year":"2024","journal-title":"Cyberpsychology Behav. Soc. Netw."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e383","DOI":"10.1016\/j.pedn.2024.07.029","article-title":"Technology versus nostalgia; A randomized controlled trial of the effect of virtual reality and kaleidoscope on pediatric pain, fear and anxiety management during immunization","volume":"78","author":"Dilek","year":"2024","journal-title":"J. Pediatr. Nurs."},{"key":"ref_52","first-page":"25","article-title":"Usefulness of virtual reality in the management of pain associated with venepuncture: A multicentre randomized clinical trial","volume":"100","author":"Peris","year":"2024","journal-title":"Ann. Pediatr. (Engl. Ed.)"},{"key":"ref_53","first-page":"e3385","article-title":"Effect of virtual reality distraction on venipuncture pain in children in the emergency room","volume":"15","year":"2024","journal-title":"Rev. Cuid."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lee, J., Ryu, J.-H., Seo, S.H., Han, S., and Park, J.-W. (2024). Virtual reality vs. tablet video for venipuncture education in children: A randomized clinical trial. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0307488"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"126481","DOI":"10.1016\/j.vaccine.2024.126481","article-title":"Virtual reality for routine immunisations in needle phobic children with and without developmental disabilities: A pilot study","volume":"42","author":"Makhijani","year":"2024","journal-title":"Vaccine"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"101268","DOI":"10.1016\/j.ienj.2023.101268","article-title":"Can virtual reality reduce pain and anxiety in pediatric emergency care and promote positive response of parents of children? A quasi-experimental study","volume":"68","year":"2023","journal-title":"Int. Emerg. Nurs."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1089\/g4h.2022.0232","article-title":"The Effect of Virtual Reality on Pain Experienced by School-Age Children During Venipuncture: A Randomized Controlled Study","volume":"12","author":"Orhan","year":"2023","journal-title":"Games Health J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e230001","DOI":"10.1001\/jamanetworkopen.2023.0001","article-title":"Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture: A Randomized Clinical Trial","volume":"6","author":"Wong","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4421","DOI":"10.1007\/s00431-023-05116-8","article-title":"Virtual reality hypnosis for needle-related procedural pain and fear management in children: A non-inferiority randomized trial","volume":"182","author":"Berg","year":"2023","journal-title":"Eur. J. Pediatr."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Atzori, B., Vagnoli, L., Graziani, D., Hoffman, H.G., Sampaio, M., Alhalabi, W., Messeri, A., and Lauro-Grotto, R. (2022). An Exploratory Study on the Effectiveness of Virtual Reality Analgesia for Children and Adolescents with Kidney Diseases Undergoing Venipuncture. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19042291"},{"key":"ref_61","first-page":"87","article-title":"Effectiveness of Virtual Reality Interactive Play for Children During Intravenous Placement: A Randomized Controlled Trial","volume":"16","author":"Hsu","year":"2022","journal-title":"Asian Nurs. Res. (Korean Soc. Nurs. Sci.)"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Ryu, J.-H., Han, S.-H., Hwang, S.M., Lee, J., Do, S.-H., Kim, J.-H., and Park, J.-W. (2022). Effects of Virtual Reality Education on Procedural Pain and Anxiety During Venipuncture in Children: A Randomized Clinical Trial. Front. Med., 9.","DOI":"10.3389\/fmed.2022.849541"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1111\/aas.14120","article-title":"A randomized controlled trial on virtual reality distraction during venous cannulation in young children","volume":"66","author":"Thybo","year":"2022","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_64","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":"ref_65","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00431-020-03771-9","article-title":"Virtual reality for intravenous placement in the emergency department\u2014A randomized controlled trial","volume":"180","author":"Goldman","year":"2021","journal-title":"Eur. J. Pediatr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/AJP.0000000000000894","article-title":"Virtual Reality to Reduce Procedural Pain during IV Insertion in the Pediatric Emergency Department: A Pilot Randomized Controlled Trial","volume":"37","author":"Litwin","year":"2021","journal-title":"Clin. J. Pain"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s43678-020-00006-6","article-title":"Distraction in the Emergency department using Virtual reality for INtravenous procedures in Children to Improve comfort (DEVINCI): A pilot pragmatic randomized controlled trial","volume":"23","author":"Osmanlliu","year":"2021","journal-title":"Can. J. Emerg. Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/jocn.15088","article-title":"Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial","volume":"29","author":"Chen","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jopan.2019.08.010","article-title":"The Effect of Virtual Reality and Kaleidoscope on Pain and Anxiety Levels During Venipuncture in Children","volume":"35","author":"Polat","year":"2020","journal-title":"J. Perianesthesia Nurs."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5817\/CP2020-1-3","article-title":"Mobile virtual reality distraction reduces needle pain and stress in children","volume":"14","author":"Piskorz","year":"2020","journal-title":"Cyberpsychology"},{"key":"ref_71","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":"Ayar","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s41347-020-00146-7","article-title":"Effectiveness of Virtual Reality Gaming on Pain Reduction in Children during PIV\/PICC Placement","volume":"5","author":"Wong","year":"2020","journal-title":"J. Technol. Behav. Sci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"eAO1327","DOI":"10.31744\/einstein_journal\/2025AO1327","article-title":"Impact of a serious immersive virtual reality game in managing pain during venous or catheter procedures in Pediatric Oncology","volume":"23","author":"Silva","year":"2025","journal-title":"Einstein"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Reitze, A., Voigt, M., Klawonn, F., Dusch, M., Grigull, L., and M\u00fccke, U. (2024). Impact of virtual reality on peri-interventional pain, anxiety and distress in a pediatric oncology outpatient clinic: A randomized controlled trial. BMC Pediatr., 24.","DOI":"10.1186\/s12887-024-04952-3"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"909","DOI":"10.4103\/ijcm.ijcm_988_22","article-title":"Effectiveness of Virtual Reality Distraction on Pain Perception and Fear among Children with Cancer Undergoing IV Cannulation","volume":"48","author":"Amali","year":"2023","journal-title":"Indian J. Community Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/AJP.0000000000001017","article-title":"A Pilot Randomized Controlled Trial of Virtual Reality Distraction to Reduce Procedural Pain during Subcutaneous Port Access in Children and Adolescents with Cancer","volume":"38","author":"Hundert","year":"2022","journal-title":"Clin. J. Pain"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e12419","DOI":"10.1111\/jspn.12419","article-title":"Comparing novel virtual reality and nursing standard care on burn wound care pain in adolescents: A randomized controlled trial","volume":"29","author":"Jeffs","year":"2024","journal-title":"J. Spec. Pediatr. Nurs."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1093\/jbcr\/irac149","article-title":"Virtual Reality as an Adjunctive Non-pharmacological Therapy to Reduce Pain in School-Aged Children With Burn Wounds","volume":"44","author":"Wang","year":"2023","journal-title":"J. Burn. Care Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/j.burns.2020.04.006","article-title":"Effects of a projector-based hybrid virtual reality on pain in young children with burn injuries during hydrotherapy sessions: A within-subject randomized crossover trial","volume":"46","author":"Khadra","year":"2020","journal-title":"Burns"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.pedn.2025.11.043","article-title":"Virtual reality, pre-procedural anxiety, and post-procedural pain in children outpatient care: A randomised controlled trial","volume":"86","author":"Ciolini","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"4106657","DOI":"10.1155\/nuf\/4106657","article-title":"Effect of Three Multisensory Stimulation Modalities on Needle-Related Procedural Pain, Fear, and Anxiety Among Children: Randomized Controlled Trial","volume":"2025","author":"Elhalafawy","year":"2025","journal-title":"Nurs. Forum"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"162696","DOI":"10.1016\/j.jpedsurg.2025.162696","article-title":"Effects of virtual reality distraction on pain, stress, and heart rate during pediatric ingrown toenail surgery: A randomized controlled trial","volume":"60","author":"Felnhofer","year":"2025","journal-title":"J. Pediatr. Surg."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Pras, Y.G., Indursky, A., Pras, S.G., Schaffer, O., Niazov, E., and Zmora, O. (2024). Infectious Diseases-Approved Virtual Reality Goggles for Common Procedures in Pediatric Surgical Patients. J. Clin. Med., 13.","DOI":"10.3390\/jcm13185572"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1302\/1863-2548.14.200090","article-title":"The use of virtual reality in reducing anxiety during cast removal: A randomized controlled trial","volume":"14","author":"Jivraj","year":"2020","journal-title":"J. Child. Orthop."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"14375","DOI":"10.1038\/s41598-026-44390-y","article-title":"VR-guided deep breathing during needle procedures in children","volume":"16","author":"Karppa","year":"2026","journal-title":"Sci. Rep."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.pedn.2024.09.008","article-title":"Golden Breath: Feasibility and acceptability of a biofeedback-based virtual reality game on reducing children\u2019s needle-related pain and fear","volume":"79","author":"Aydos","year":"2024","journal-title":"J. Pediatr. Nurs."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"151615","DOI":"10.1016\/j.soncn.2024.151615","article-title":"A Biofeedback Based Virtual Reality Game for Pediatric Population (BioVirtualPed): A Feasibility Trial","volume":"40","author":"Semerci","year":"2024","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"102621","DOI":"10.1016\/j.ejon.2024.102621","article-title":"The effect of a biofeedback-based virtual reality game on pain, fear and anxiety levels during port catheter needle insertion in pediatric oncology patients: A randomized controlled study","volume":"70","author":"Semerci","year":"2024","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Jysk\u00e4, I., Turunen, M., Maleki, A.C., Karppa, E., Palmu, S., Viik, J., M\u00e4kel\u00e4, J., and Puura, K. (2023). Effects of Using Guided Deep Breathing Exercises in a Virtual Natural Environment to Reduce Stress during Pediatric Treatment. Healthcare, 11.","DOI":"10.3390\/healthcare11243140"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.mcpdig.2023.05.001","article-title":"Virtual Reality Hypnoanxiolysis and Analgesia for Emergency Department Needle-Related Procedures: A Prospective Interventional Cohort Pilot Study Implementation","volume":"1","author":"Barrett","year":"2023","journal-title":"Mayo Clin. Proc. Digit. Health"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1007\/s10995-020-02955-x","article-title":"Child and Parent Perspectives on the Acceptability of Virtual Reality to Mitigate Medical Trauma in an Infusion Center","volume":"24","author":"Easterlin","year":"2020","journal-title":"Matern. Child Health J."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s10055-026-01317-2","article-title":"Mindfulness-based guided relaxation exercises in a virtual natural environment to reduce periprocedural pain and anxiety in pediatrics","volume":"30","author":"Turunen","year":"2026","journal-title":"Virtual Real."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"163042","DOI":"10.1016\/j.jpedsurg.2026.163042","article-title":"A randomized control trial for assessing virtual reality for perioperative anxiolysis and postoperative pain modulation in adolescents undergoing MIRPE","volume":"61","author":"Trinh","year":"2026","journal-title":"J. Pediatr. Surg."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s00431-026-07020-3","article-title":"The effect of virtual reality and Buzzy\u00ae on pain, fear, and anxiety during skin prick testing in children: A randomized controlled trial","volume":"185","year":"2026","journal-title":"Eur. J. Pediatr."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s00431-026-07077-0","article-title":"The effect of virtual reality glasses used during inhaler treatment on anxiety, fear and vital signs in children: A randomized controlled trial","volume":"185","author":"Kara","year":"2026","journal-title":"Eur. J. Pediatr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.pedn.2026.05.020","article-title":"Preparation of pediatric patients with the \u201cSuper Heart Team Ready for Action\u201d virtual reality animated film before cardiac catheterization: A randomized controlled trial","volume":"89","author":"Zengin","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.pedn.2026.05.026","article-title":"Impact of virtual reality on fear and pain in pediatric patients undergoing preoperative preparation: A randomized controlled study","volume":"89","year":"2026","journal-title":"J. Pediatr. Nurs."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Xie, S., Yin, F., Wang, M., Wang, F., Zhu, Y., Zhao, Y., Qiu, Y., Chen, X., and Yang, Y. (2026). Dynamic assessment of pain, fear, and physiological stress during pediatric intravenous cannulation: A randomized controlled trial of virtual reality distraction. BMC Nurs., 25.","DOI":"10.1186\/s12912-026-04906-3"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Efe, Y.S., Usta, E., Roba, A.A., \u00c7al\u0131\u015f\u0131r, \u00d6., and Turan, C. (2026). Preoperative virtual reality education for children undergoing surgery: A randomized controlled trial. Sci. Rep.","DOI":"10.1038\/s41598-026-58392-3"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Felnhofer, A., Aberle, J.S., Weiss, L., Winder, J., Marceta-Pavlovic, S., Palmisani, F., Giordano, V., Wagner, M., Greber-Platzer, S., and Metzelder, M. (2026). Children\u2019s sense of presence in immersive virtual reality for pediatric surgery. Virtual Real.","DOI":"10.1007\/s10055-026-01419-x"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"101080","DOI":"10.1016\/j.chbr.2026.101080","article-title":"Human-robot interaction based on artificial intelligence in clinical healthcare centers: A systematic review and meta-analysis","volume":"22","author":"Shafaie","year":"2026","journal-title":"Comput. Hum. Behav. Rep."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/316\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:22:13Z","timestamp":1788862933000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":101,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nursrep16090316"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16090316","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}