VCU initiative links VR headset use to lower pre-surgery anxiety in children
A quality-improvement initiative involving 80 pediatric patients demonstrated measurable drops in distress, fear, and blood pressure before operations.
A team led by Dayanjan Wijesinghe at Virginia Commonwealth University integrated a virtual reality intervention into a pediatric preoperative holding area in Richmond, Virginia, during a nine-month quality-improvement initiative. In a study published in PLOS Digital Health (doi.org/10.1371/journal.pdig.0001219), researchers evaluated within-subject changes in 80 children aged 6–15 scheduled for elective surgery 
doi.orgdoi.orgdoi.orgOpen source ↗. Using a Meta Quest headset, patients entered a custom environment featuring an interactive children's room or a beach scene.
Following the VR exposure, self-reported distress on a 0–10 Numerical Rating Scale decreased by a median of 2.0 points, dropping from a baseline median of 3.0 down to 1.0 (p < 0.001) doi.orgdoi.orgdoi.orgOpen source ↗. Fear scores on the 0–4 Children's Fear Scale declined by a median of 1.0 point, moving from 1.0 to 0.0 (p < 0.001) doi.orgdoi.orgdoi.orgOpen source ↗. The researchers noted that 46 of the 80 children met the threshold for clinically meaningful improvement in distress, while 44 achieved the threshold for fear reduction doi.orgdoi.orgdoi.orgOpen source ↗.
Physiological indicators and acceptance
The intervention also coincided with decreases in autonomic arousal. The children's heart rate dropped by a mean of 5.8 beats per minute, and systolic blood pressure fell by an average of 4.1 mmHg (both p < 0.001) doi.orgdoi.orgdoi.orgOpen source ↗. Acceptance rates were high among stakeholders: 91% of the children reported willingness to use the headset again, 95% of parents indicated they would recommend the intervention, and all participating nurses endorsed the workflow doi.orgdoi.orgdoi.orgOpen source ↗. Adverse effects were rare and minor, occurring in 3 out of 80 participants doi.orgdoi.orgdoi.orgOpen source ↗.
Observational study limitations
The initiative relied on an uncontrolled, single-arm pre-post design without a comparison group. According to the authors, the observed declines in anxiety cannot be attributed exclusively to the VR software doi.orgdoi.orgdoi.orgOpen source ↗. The results may partly stem from natural settling over time, non-specific attention, habituation to the environment, or regression to the mean doi.orgdoi.orgdoi.orgOpen source ↗. The authors concluded that controlled comparative clinical trials remain necessary before such digital interventions are routinely adopted in pediatric surgical care doi.orgdoi.orgdoi.orgOpen source ↗.
