Impact of virtual reality on pain, anxiety and depression in pediatric patients with end-stage kidney disease on regular hemodialysis through arteriovenous fistula: a randomized control double blinded trial

Background One of the most challenging issues that faces pediatric patients with end-stage kidney disease (ESKD) on regular hemodialysis (HD) is the recurring exposure to needle-pricks that lasts lifelong. Finding a noninvasive distractive tool that can aid in diminishing pain, anxiety, and depression among children undergoing regular HD through arteriovenous fistula (AVF) will be of great value in improvement of quality of life. Virtual reality (VR) is evolving as an encouraging distraction technique. This work aimed to study the effectiveness of VR technique on pain during arteriovenous cannulation and on the reduction of anxiety and depression in pediatric patients with end-stage renal disease undergoing regular HD. Patients and methods This randomized control double-blinded study included 60 patients with ESKD on regular HD through AVF aged 8–18 years and classified equally into groups A (VR) and B (controls). All children were asked to complete the child anxiety-related emotional disorders and children’s depression inventory at the start of the study and after 3 months. The pain score was recorded by using Wong–Baker faces pain rating scale. Results Pain, child anxiety-related emotional disorders and children’s depression inventory scores were insignificantly different at baseline between both groups and were significantly lower at follow-up in group A than group B ( P <0.05). Patient satisfaction was significantly higher in group A than in group B. Conclusions VR is an effective noninvasive distractive tool for the reduction of pain and subsequently the reduction of anxiety and depression in pediatric patients with ESKD on regular HD through AVF.