EFFECTIVENESS OF VIRTUAL REALITY DISTRACTION THERAPY IN REDUCING PROCEDURAL PAIN AMONG PEDIATRIC PATIENTS

Background: Procedural pain and anxiety are common in pediatric care and can negatively impact cooperation, recovery, and future healthcare interactions. Non-pharmacological strategies, particularly immersive virtual reality (VR), have emerged as promising adjuncts to improve patient comfort during minor but distressing procedures. Objective: To evaluate the effectiveness of immersive VR distraction therapy in reducing procedural pain intensity, anxiety, and behavioral distress in pediatric patients compared to standard care in outpatient hospital settings. Methods: A randomized controlled trial was conducted over six months in three private hospitals in Lahore, Faisalabad, and Multan, Pakistan. A total of 140 children aged 6–12 years undergoing venipuncture, intravenous cannulation, or dressing changes were randomized equally to VR distraction or standard care. Pain intensity was assessed immediately post-procedure using the Wong-Baker FACES Pain Rating Scale. Secondary outcomes included procedural anxiety (Child Fear Scale) and observed distress (OSBD-R). Data were analyzed using independent t-tests for continuous variables, with statistical significance set at p<0.05. Results: The VR group reported significantly lower pain scores (mean 3.05 ± 0.98) compared to the control group (mean 5.06 ± 1.18; p=0.001). Anxiety scores were also reduced in the VR group (3.04 ± 0.99) versus control (4.25 ± 1.16; p=0.001). Observed distress was markedly lower in the VR group (1.86 ± 0.65) than in controls (3.11 ± 0.86; p=0.001). No adverse events were reported, and VR was well tolerated across all sites. Conclusion: Immersive VR distraction significantly reduced pain, anxiety, and distress in pediatric patients undergoing minor procedures, supporting its use as an effective, feasible, and non-pharmacological adjunct in routine outpatient care.