Virtual Reality (VR) to Decrease Perioperative Anxiety in Pediatrics.
Introduction.
Preoperative anxiety manifests as natural responses to health concerns. Dehghan et al. (2019) point out that such reactions may occur at any given time during medical encounters. Furthermore, these stress levels may aggravate in situations involving the need for surgery and during hospitalization. Notable examples of some of the signs may entail increased heart rate, irritation, distraction, and fear. As such, preoperative anxiety culminates as a potential threat to patients, considering that it results in changes in psychological responses. If not addressed in time, these psychological responses may lead to increased heart rate and blood pressure, which may endanger patients’ health (Dehghan et al., 2019). Notably, despite preoperative anxiety being a general health concern; nevertheless, it is predominantly more fatal in children since they need special attention. In their earlier years, children are more vulnerable to the condition because stress levels interfere with the typical pattern of their health and environment (Eijlers et al., 2019). This outcome is further made worse since they have inferior coping mechanisms for addressing stressful situations. Therefore, the introduction of virtual reality in pediatrics focuses on reducing perioperative anxiety by either minimizing pain medications and altering the discernment of pain.
Virtual Reality Hypnosis (VRH) Reduces Pain Medications.
Virtual reality reduces anxiety and pain associated with medical procedures. According to “ASA” (2018), VRH plays a crucial role in not only the reduction of stress but also in total postoperative opioid consumption as well as vomiting after scoliosis surgery. In an independent study conducted by “ASA” (2018), two groups comprising of children were used to evaluate the efficacy of VR. With a total of 21 participants, one group was subjected to VRH support alongside postoperative pain management after surgery. Theses measures comprised of patient-regulated analgesia with opioids. Alternatively, the other group consisting of 11 children failed to receive VRH. Thus, children who received VRH were provided with helmets and googles linked to software (“ASA,” 2018). These devices functioned to minimize stress and post-painful actions. Thus, participants selected and heard comforting voices and music, which, in turn, induced hypnosis.
Consequently, children subjected to VRH required less supplemental treatment. In this case, only 20 percent were given pain medication, unlike 62.5 percent of the other group. “ASA” (2018) further points out that while only 37.5 percent of children exposed to VRH needed anti-stress medicines, 100 percent of participants from the control group required medication. Moreover, the use of postoperative morphine was considerably higher in the control section. The control group consequently consumed 2.15 milligrams per kilogram (mg/kg) in contrast to 1.18 mg/kg by the group treated to VRH. “ASA” (2018) explains that morphine, in this case, acts as a sedating agent and may hinder patients from both walking and eating relatively quickly. Meaning, the significant drop in morphine utilization among children exposed to VRH means that they recover quickly. Patients treated to the VRH group took 23 hours, whereas the control group took 33 hours to sit up and walk (“ASA,” 2018). Therefore, it is evident that virtual reality minimizes perioperative anxiety in pediatrics.
Virtual Reality Influences Perception of Pain
The second study done by “ASA” (2018) was aimed at using VR to influence the perception of pain. It examined over 600 patients of ages ranging from 6 to 8 years. Here, the participants were provided with new VR games, which allowed both users and clinicians to adjust the games in real-time hence adjusting the cognitive load. These approaches were seemingly aimed at increasing the games’ potential to distract patients’ to alleviate their notion of pain. According to the sentiments fronted by the study’s co-author Thomas J. Caruso, “if people are stressed about anything, then, it is more likely that they will report pain” (“ASA,” 2018).
Unlike previous technologies that failed to respond to motion, VR takes into consideration changes in patients’ positions.
Notably, the program’s reorientation feature allows the alternation of the horizontal line. Samuel Rodriguez, who is the study’s lead author, further mentions that it can move every time patients head positions changes (“ASA,” 2018),). More importantly, the program also allows for the adjustment of the patients’ cognitive load. These outcomes are possible because clinicians can utilize faster music, a variety of colors, and enhanced gameplay. In the long-run, the games’ ability to distract the patients can be used to reduce anxiety in pediatrics. Notable applications may include cases such as minor medical procedures like in vitro placement, would care, nasal endoscopy, cast removal, and surgical pin removal, which occur between a timeframe of 2 to 20 minutes (“ASA,” 2018). Consequently, the results indicated that VR games reduced anxiety and patients’ notion of pain. The advantages linked to this approach are that there are neither negative impacts nor patient fanatism, in a broader range of outpatient and inpatient situations. Therefore, virtual reality qualifies as a non-pharmacological treatment plan that can be utilized to befuddle patients and restrict patient motion in a wide variety of pediatrics settings.
Imaginal Technology of Virtual Reality
The artificial environment created by VR can be likened to actual life. It is considered as an “ecological lab” wherein feelings, behavior, and human behaviors can be regulated. As such, the perceptual experience can be formulated in the absence of sensory input (Ryu et al., 2018). Consequently, images can be created directly from immediate perceptual information and previously stored data in long-term memory. In modern-day, imagination, which is an integral part of virtual reality, plays a critical role in influencing significant characteristics among patients suffering from anxiety. Such forms of stress may emanate from traumatic events, social phobia, or depression. Hence, in such a case, mental imagery may be used to amplify emotional impacts (Ryu et al., 2018). This view is based on the fact that the representation takes attention away from external environments. The resultant outcome makes the internal cognition of patients more believable and is linked with more powerful emotions. Thus, mental imageries can induce learning and advance behaviors that lessen perioperative anxiety.
Seemingly, the VR field can be used to translate behavior, emotional and physiological responses. It can develop simulative surroundings acceptable by patients from the viewpoint of sensory evidence (Eijlers et al., 2019). This deliberation is based on the idea that VR is an advanced imaginal system that is as effective as the reality in enhancing positive cognitive, emotional, and behavioral responses. For this reason, it finds application in the reduction of perioperative anxiety in pediatrics because it treats psychological disorders. Arguably, VR can be touted to be more efficacious than conventional imagery simulations (Eijlers et al., 2019). Various advantages presented by the technique supports this assertion. For instance, mental images remain in patients’ minds for as long as clinical diagnosis goes on, and there is no need to evoke any imagination. Significantly, among patients who may have encountered awkward moments leading to anxiety, VR provides them with an environment to relieve possible traumatic experiences and face them (Eijlers et al., 2019). As such, VR can induce positive emotions through positive virtual environments, an approach that is useful in eliminating anxiety and negative thoughts.
Conclusion
The technological revolution has positively impacted health care outcomes. As such, a tool like virtual reality has been at the forefront of promoting the psychological well-being of patients suffering from perioperative anxiety. The technique has its advantages, and these manifest in various ways. Firstly, virtual reality is entirely immersed in the virtual environments of clinical diagnoses. The notion of interacting with the natural environment is possible because of the sense of presence. This outcome makes pediatrics a successful tool since it has considerably higher efficacy levels, which, in turn, results in patients’ satisfaction and the decline of symptoms. Concerning clinical psychology, VR plays a crucial role in helping patients to connect with others and share experiences with others, including caregivers, family, and friends (imagery technology). Conversely, despite the advantages of fronted by VR, other obstacles still exist. The first obstacle in the cost of the devices, mainly when designing and constructing virtual environments. Secondly, most VR systems are not interoperable, and both the software and clinical protocols lack standardization. Although, generally, the future of VR in treating and reducing perioperative anxiety is headed towards a positive direction.