Mindfulness-based guided relaxation exercises in a virtual natural environment to reduce periprocedural pain and anxiety in pediatrics

Abstract The fear of needles is a common cause of stress and negative patient experiences in pediatrics. This article reports the effects and user experience of using a mindfulness-based guided relaxation exercise in a virtual natural environment to address patient stress during an intravenous cannulation procedure of 20 children with a mean age (SD) of 10.6 (± 1.26) years. This was an extension study to prior research, which found positive results with deep breathing exercises in a virtual natural environment in this use context. The key findings of this preliminary study include significantly reduced stress levels during the virtual reality intervention according to the heart rate variability measurements (SDNN, p = 0.006; Stress Index, p = 0.037) and lower level of pain experienced during the cannulation than the children expected (VAS-A Pain, p = 0.037). The user experience was positive among patients and pediatricians and no adverse effects were found. Comparison to the deep breathing exercise suggests improved pain reduction and higher patient satisfaction with this mindfulness-based method but also implies a less reliable stress-reducing effect for patients with strong fear of needles. These results illustrate the feasibility of this method for addressing periprocedural pain and anxiety in pediatrics, particularly regarding minor to medium cases.