Preconsultation Anxiety and Pain during Blood Collection: Impact of Virtual Reality in Children with Cancer – Randomized Clinical Trial

Abstract Virtual reality (VR) has expanded into diverse healthcare contexts, including pediatric oncology, in which it serves as a non-pharmacological tool for pain and anxiety relief. To analyze the effect of VR glasses on pain and anxiety before a medical consultation during initial blood collection in pediatric oncology patients. We conducted a randomized, comparative clinical trial with convenience sampling and RedCap (Vanderbilt University) randomization. Data were collected via author-developed semi-structured questionnaires. The precollection measures included participant and companion characteristics, previous experiences, and baseline pain/anxiety. After the collection, pain and anxiety related to medical consultation were assessed; the intervention group also evaluated the VR experience, while the companions rated the procedure. The quantitative analysis used the t-test, the Mann-Whitney, the Fisher's exact, the Chi-squared, and the Kolmogorov-Smirnov tests; qualitative data underwent descriptive thematic analysis. The sample included 46 patients (50% of male individuals; mean age: 11.1 years among the controls, and 12.5 years among the intervention group). Pain during blood collection was reported by 56.5% of the controls and 60.9% of the intervention group. Virtual reality significantly reduced preconsultation anxiety in the intervention group (pre- versus postcollection). Previous diagnosis and preprocedural pain did not affect pain or anxiety during blood collection. The companions strongly endorsed VR (95.7% reported benefits). Virtual reality glasses effectively reduced preconsultation anxiety but did not significantly affect pain. High acceptance among patients and companions supports VR's potential for replication in similar clinical settings.