Immersive Virtual Reality Satisfies the Women in Labor by Distracting Them From Their Labor Pain in Labor on Latent and Active Phase
Condition: Labor Pain
MeSH terms: Labor Pain
Study type: Interventional

Summary: 
      This is a randomized control study with 42 laboring women allocated to virtual reality
      intervention and control groups. The objective of this study, to evaluate the effectiveness
      of immersive virtual reality in laboring women on patient satisfaction and pain relief. The
      satisfaction of patients was measured with a "Virtual reality satisfaction survey" which was
      prepared by the investigators. Pain levels were assessed by a virtual pain rating scale in
      the early and the active phase of labor in both groups.
    

Detailed description: 
      Labor is a long and painful process for women. For avoiding or alleviating pain, adjuvant
      treatments such as hydrotherapy, yoga, hypnosis, acupuncture, and relaxation techniques could
      be used. Recent literature indicates the successful use of immersive virtual reality for a
      variety of painful medical procedures. Immersive virtual reality is hypothesized to reduce
      pain through distraction, a non-pharmacologic attentional mechanism. The user's brain is
      preoccupied with the flood of information presented by the virtual environment restricting
      the mind from processing pain signals. The investigators hypothesized that laboring women
      find immersive virtual reality as a beneficial tool for their overall labor and delivery
      experience. The 42 laboring women were randomized into two arms: virtual reality group (
      intervention group) and control group. The investigators used Oculus Quest All-in-one VR
      Gaming Headset (128 GB) VR system. Before the intervention, the authors introduced the
      equipment and instructed study participants on how to wear and activate the headsets. Anxiety
      and depression scales were also applied on admission. The laboring women who enrolled in the
      VR group first wore the headsets in early labor (Cervical dilation 3 cm) for 20 minutes. The
      patients were offered to choose among several virtual environments including orange sunset,
      green meadows, black beginning, red savannah, blue deep, blue moon, blue ocean, white winter,
      and red fall. Cards printed out from the images of the Nature Trek application representing
      these novel immersion options were provided to the patients to help them pick up their
      preferred environment in advance. The second implementation of VR headsets was after the
      epidural analgesia in the active phase of labor for another 20 minutes (Cervical dilation
      6-7cm). After the second intervention, the "Virtual Reality Satisfaction Survey" was applied
      by the authors. Patients were asked to fill out a visual pain rating scale right before and
      after the VR use in early and active labor. The primary objective of this study was to
      assessed whether immersive virtual reality provided pain relief in the latent or active phase
      of labor. The authors also evaluated anxiety and depression in both groups on admission as
      potential confounders. Anxiety and depression levels, assessed with the Beck Anxiety
      Inventory and Beck Depression Inventory. Patient satisfaction with the use of VR was assessed
      by a "Virtual Reality Satisfaction Survey" 10 question survey prepared by our team: 0 being
      the lowest and 100 being the highest possible VR satisfaction score.The investigators also
      asked these women whether the participants would like to use VR in future labor. Patient
      satisfaction with overall labor and delivery experience was assessed using a Visual Analog
      Scale (VAS). All discharged women were called a week following discharge and asked to rate
      their overall childbirth experience on a scale from 0 to 10. Zero indicates the most negative
      experience possible and 10 indicates the highest satisfaction possible. The authors
      classified a score of 8 to 10 as high satisfaction. Pain scores both in early and active
      labor in each group were assessed using Wong-Baker Faces Pain Rating Scale.
    

Intervention name(s): Oculus Quest All-in-one VR Gaming Headset (128 GB) VR system
Intervention type(s): Device
Intervention description(s): The laboring women who enrolled in the VR group were offered to choose among several virtual environments including orange sunset, green meadows, black beginning, red savannah, blue deep, blue moon, blue ocean, white winter, and red fall. Cards printed out from the screenshots of the Nature Trek application representing these novel immersion options were provided to the patients to help them pick up their preferred environment in advance.
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: 42 laboring women allocated to intervention group and control group randomly
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Labor; Immersive Virtual Reality; Non-pharmacologic Treatment; Anxiety; Depression