Interactive vs non-interactive virtual reality for pain, anxiety, and emotional behaviour during venipuncture in children: a randomized trial

This randomized controlled trial evaluated the effects of interactive and non-interactive virtual reality (VR) distraction on pain, anxiety, procedure-related emotional behaviour, and parent and nurse satisfaction during venipuncture in school-age children. The study was conducted in the phlebotomy unit of a children’s hospital with 86 children aged 6–12 years. Participants were assigned to three groups using stratified randomization: interactive VR, non-interactive VR video, and usual care. Pain was measured using the Wong-Baker FACES Pain Rating Scale, anxiety using the Children’s Anxiety Scale-State, and procedure-related emotional behaviour using the Children’s Emotional Manifestation Scale. Parent and nurse satisfaction with the distraction process were assessed using 0–10 numeric rating scales. The groups were similar in terms of sociodemographic and clinical characteristics. Pain scores were significantly lower in the interactive VR group than in the non-interactive VR video and usual care groups. No statistically significant between-group difference was found in pre- or post-procedure anxiety scores. Both VR groups had more positive emotional manifestation scores and higher parent and nurse satisfaction than the usual care group, but these outcomes did not differ significantly between the two VR groups. These findings suggest that VR distraction may be useful during venipuncture in children. Interactivity may provide additional benefit mainly for pain reduction, whereas both VR formats may support more positive procedural behaviour and higher satisfaction compared with usual care.