Distraction Using Virtual Reality Reduces Pain and Anxiety After PCI
Penggunaan Realitas Virtual untuk Mengalihkan Perhatian Mengurangi Nyeri dan Kecemasan Setelah PCI
- Authors
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Ali Hassan Ibrahim Shutnan
Adult Nursing Department, college of nursing , Karbala -
Hassan Abdullah Athbi
Adult Nursing Department, college of nursing , Karbala
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- Keywords:
- Virtual Reality, Anxiety, Pain, Percutaneous Coronary Intervention, Distraction Techniquex
- Abstract
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Background: Cardiovascular diseases remain the leading cause of death globally, with percutaneous coronary intervention (PCI) being a common treatment modality. However, post-PCI patients frequently experience significant pain and anxiety. Specific Background: Conventional pain management strategies are often pharmacological and may involve adverse effects, prompting exploration of non-invasive alternatives like virtual reality (VR). Knowledge Gap: Although VR has been explored in various medical contexts, its efficacy in post-PCI recovery remains under-researched. Aims: This randomized clinical trial aimed to evaluate the effect of VR-based distraction on pain and anxiety levels in post-PCI patients. Results: A total of 144 patients were divided equally into intervention and control groups. The VR group, exposed to 3D natural scenes with soothing music, showed significantly lower mean pain (29.60 vs. 57.97) and anxiety scores (2.90 vs. 5.15) than the control group (p < 0.001 for both). Novelty: This study provides robust clinical evidence that immersive VR distraction can be an effective adjunct to standard post-PCI care. Implications: Integrating VR into post-PCI protocols may enhance patient comfort, reduce reliance on medication, and improve recovery experiences without added clinical risk.
Highlight :- Virtual reality effectively reduces pain and anxiety levels after PCI.
- There was a significant difference between the intervention and control groups.
- This distraction technique is non-invasive and easy to apply clinically.
Keywords : Virtual Reality, Anxiety, Pain, Percutaneous Coronary Intervention, Distraction Technique
- References
-
1. B. A. Bergmark, N. Mathenge, P. A. Merlini, M. B. Lawrence-Wright, and R. P. Giugliano, "Acute Coronary Syndromes," The Lancet, vol. 399, no. 10332, pp. 1347–1358, 2022, doi: 10.1016/S0140-6736(21)02391-6.
2. K. S. da Silva Pontes et al., "Effects of Probiotics on Body Adiposity and Cardiovascular Risk Markers in Individuals With Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials," Clinical Nutrition, vol. 40, no. 8, pp. 4915–4931, 2021, doi: 10.1016/j.clnu.2021.06.023.
3. M. Gholami, Z. Tagharrobi, K. Sharifi, and Z. Sooki, "Using Medicinal Plants Among Patients With Cardiovascular Diseases and Their Related Factors: A Cross-Sectional Study," Journal of Holistic Nursing and Midwifery, vol. 32, no. 4, pp. 283–291, 2022, doi: 10.32598/jhnm.32.4.2271.
4. H. A. Athbi and H. B. Hassan, "Health Beliefs of Patients With Coronary Heart Disease Toward Secondary Prevention: The Health Beliefs Model as a Theoretical Framework," Indian Journal of Public Health Research & Development, vol. 1, no. 1, pp. 821–826, 2019, doi: 10.5958/0976-5506.2019.00161.X.
5. World Health Organization, "Cardiovascular Diseases (CVDs)," 2021. [Online]. Available: [https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)]
6. M. Keshvari et al., "The Effect of Virtual Reality Distraction on Reducing Patients' Anxiety Before Coronary Angiography: A Randomized Clinical Trial Study," Egyptian Heart Journal, vol. 73, no. 1, p. 8, 2021, doi: 10.1186/s43044-021-00224-y.
7. Y. Ki, "Health-Related Quality of Life in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study," Journal of Nursing Research, vol. 30, no. 1, p. e186, 2022, doi: 10.1097/jnr.0000000000000465.
8. Ministry of Health/Environment/Kerbala Health Director, "Department's Statistics," 2023. [Online]. Available: [https://moh.gov.iq/?article=6979]
9. A. K. Johnson et al., "Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors," Journal of the American Heart Association, vol. 9, no. 9, p. e014372, 2020, doi: 10.1161/JAHA.119.014372.
10. S. García-Bravo et al., "Virtual Reality and Video Games in Cardiac Rehabilitation Programs: A Systematic Review," Disability and Rehabilitation, vol. 43, no. 4, pp. 448–457, 2021, doi: 10.1080/09638288.2019.1631892.
11. B. Seymour and F. Mancini, "Hierarchical Models of Pain: Inference, Information-Seeking, and Adaptive Control," NeuroImage, vol. 222, p. 117212, 2020, doi: 10.1016/j.neuroimage.2020.117212.
12. M. Muller et al., "Cold Pain Hypersensitivity Predicts Trajectories of Pain and Disability After Low Back Surgery: A Prospective Cohort Study," Pain, vol. 162, no. 1, pp. 184–194, 2021, doi: 10.1097/j.pain.0000000000002006.
13. M. Senbekov et al., "The Recent Progress and Applications of Digital Technologies in Healthcare: A Review," International Journal of Telemedicine and Applications, vol. 2020, p. 8830200, 2020, doi: 10.1155/2020/8830200.
14. V. Micheluzzi et al., "Effectiveness of Virtual Reality on Pain and Anxiety in Patients Undergoing Cardiac Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials," Current Problems in Cardiology, p. 102532, 2024, doi: 10.1016/j.cpcardiol.2024.102532.
15. J. Verain, C. Trouillet, F. Moulin, and C. Christophe, "Efficacy of Virtual Reality Therapy Versus Pharmacological Sedation for Reducing Pain and Anxiety During Coronary Catheterisation Procedures: A Prospective Randomised Controlled Trial," Health Science Reports, vol. 7, no. 10, p. e2151, 2024, doi: 10.1002/hsr2.2151.
16. A. Chuan et al., "Virtual Reality for Acute and Chronic Pain Management in Adult Patients: A Narrative Review," Anaesthesia, vol. 76, no. 5, pp. 695–704, 2021, doi: 10.1111/anae.15202.
17. G. C. Burdea and P. Coiffet, Virtual Reality Technology, 2nd ed. Hoboken, NJ: John Wiley & Sons, 2024.
18. D. Kanschik et al., "Virtual and Augmented Reality in Intensive Care Medicine: A Systematic Review," Annals of Intensive Care, vol. 13, no. 1, p. 81, 2023, doi: 10.1186/s13613-023-01176-z.
19. Z. S. Bashir et al., "The Effectiveness of Virtual Reality on Anxiety and Pain Management in Patients Undergoing Cardiac Procedures: A Systematic Review and Meta-Analysis," Cureus, vol. 16, no. 4, 2024, doi: 10.7759/cureus.57557.
20. M. R. Begum and M. A. Hossain, "Validity and Reliability of Visual Analogue Scale (VAS) for Pain Measurement," Journal of Medical Case Reports and Reviews, vol. 2, no. 11, 2019. [Online]. Available: [www.jmcrr.info](http://www.jmcrr.info).
21. L. R. Joseph and D. S. Palappallil, "Neck Disability Index, Visual Analog Scale, and Likert Scale in Patients Receiving Pharmacotherapy for Neck Pain: How Good Do They Correlate?," National Journal of Physiology, Pharmacy and Pharmacology, vol. 7, no. 3, p. 328, 2017, doi: 10.2147/PPA.S168885.
22. N. M. Alavi, "Effectiveness of Acupressure to Reduce Pain in Intramuscular Injections," Acute Pain, vol. 9, no. 4, pp. 201–205, 2007, doi: 10.1016/j.acpain.2007.09.002.
23. S. J. Hughes, Kozier and Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, 11th ed. Boston, MA: Pearson, 2022.
24. M. P. Jensen, C. Chen, and A. M. Brugger, "Interpretation of Visual Analog Scale Ratings and Change Scores: A Reanalysis of Two Clinical Trials of Postoperative Pain," Journal of Pain, vol. 4, no. 7, pp. 407–414, 2003, doi: 10.1016/S1526-5900(03)00716-8.
25. M. Keshvari et al., "The Effect of Virtual Reality Distraction on Reducing Patients' Anxiety Before Coronary Angiography: A Randomized Clinical Trial Study," Egyptian Heart Journal, vol. 73, p. 8, 2021, doi: 10.1186/s43044-021-00224-y.
26. H. A. Athbi and H. B. Hassan, "Health Beliefs of Patients With Coronary Heart Disease Toward Secondary Prevention: The Health Beliefs Model as a Theoretical Framework," Indian Journal of Public Health Research & Development, vol. 1, no. 1, pp. 821–826, 2019, doi: 10.1016/j.jpsychores.2004.11.010.
27. M. M. A. da Cruz et al., "Acute Hemodynamic Effects of Virtual Reality–Based Therapy in Patients of Cardiovascular Rehabilitation: A Cluster Randomized Crossover Trial," Archives of Physical Medicine and Rehabilitation, vol. 101, no. 4, pp. 642–649, 2020, doi: 10.1016/j.apmr.2019.12.006.
28. L. Mu et al., "Obesity Prevalence and Risks Among Chinese Adults: Findings From the China PEACE Million Persons Project, 2014–2018," Circulation: Cardiovascular Quality and Outcomes, vol. 14, no. 6, p. e007292, 2021, doi: 10.1161/CIRCOUTCOMES.120.007292.
29. C. D. Fryar et al., "Hypertension Prevalence, Treatment, and Control Among Adults: Los Angeles County and the United States, 2015–2018," Centers for Disease Control and Prevention. [Online]. Available: [https://dx.doi.org/10.15620/cdc:134503]
30. N. C. Barragan et al., "Narrowing Cardiovascular Disease Health Disparities by Advancing the Role of Pharmacists Through a Multisector Consortium," Journal of Public Health Management and Practice, vol. 30, pp. S130–S136, 2024, doi: 10.1097/phh.0000000000001929.
31. B. Atzori et al., "Virtual Reality Analgesia During Venipuncture in Pediatric Patients With Onco-Hematological Diseases," Frontiers in Psychology, vol. 9, p. 2508, 2018, doi: 10.3389/fpsyg.2018.02508.
32. Z. Bashir et al., "Protocol: Effectiveness of Virtual Reality on Anxiety and Pain Management in Patients Undergoing Cardiac Procedures: A Protocol for Systematic Review and Meta-Analysis," Open Heart, vol. 10, no. 1, 2023, doi: 10.1136/openhrt-2023-002305.
33. S. Addab et al., "Use of Virtual Reality in Managing Paediatric Procedural Pain and Anxiety: An Integrative Literature Review," Journal of Clinical Nursing, vol. 31, no. 21–22, pp. 3032–3059, 2022, doi: 10.1111/jocn.16217.
34. Q. Huang et al., "Using Virtual Reality Exposure Therapy in Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials," Value in Health, vol. 25, no. 2, pp. 288–301, 2022, doi: 10.1016/j.jval.2021.04.1285.
35. N. Demeter, N. Josman, E. Eisenberg, and D. Pud, "Who Can Benefit From Virtual Reality to Reduce Experimental Pain? A Crossover Study in Healthy Subjects," European Journal of Pain, vol. 19, no. 10, pp. 1467–1475, 2015, doi: 10.1002/ejp.678.
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