VR for Preoperative Anxiety in Children

Study Overview
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Brief Summary
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All of the tools currently available for preoperative preparation of children either use a third person approach (i.e., use media whereby they watch a video or look at pictures of another child receiving an anesthetic), provide tours at some time previous to the operation date, or are shown the equipment that they will encounter during their anesthetic. No preoperative programme currently allows the child to experience the entire chain of events from leaving the preoperative preparation area (and their parents), walking to the operating area, being initially prepared for and receiving anesthesia and recovering from anesthesia, in real time and from a first person perspective. As such the investigators are carrying out this study to assess whether virtual reality preoperative preparation is effective in reducing anxiety at induction of anesthesia.

Detailed Description
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The investigators' goal in this study is to investigate the effects of virtual reality preoperative preparation on anxiety in children at induction of anesthesia. The hypothesis is that utilisation of this novel 1st person immersive preparatory method will lead to an enhanced understanding of what will happen to the child (in addition to what the environment looks and sounds like) when they have their anesthetic. The investigators believe this enhanced understanding and preparation will lead to the reduction in anxiety levels before and during the induction of anesthesia, and will also lead to a reduction in postoperative negative behaviour disorders.

Official Title
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Virtual Reality for Educating and Reducing Preoperative Anxiety in Children - A Randomised Control Trial

Conditions
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Anxiety

Intervention / Treatment
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* Behavioral: slideshow
* Behavioral: virtual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged between 6 -18 ASA physical status 1-3 Admitted for elective surgery (day case and inpatient cases) Cognitively normal Exclusion Criteria: ASA physical status 4-5 Non-English speaking Significant visual and auditory disorders not allowing them to use the technology Epilepsy Mobility problems that would make using the technology difficult or harmful to them (i.e., reduced movement of neck) Cognitive impairment Postoperative PICU care anticipated

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: slideshow<br>Participant receives traditional slideshow presentation for preoperative preparation | Behavioral: slideshow<br>* Participants will be shown a slideshow showing a child being prepared for surgery<br>|
| Other: virtual<br>Participant receives virtual reality presentation for preoperative preparation | Behavioral: virtual<br>* Participants will be shown an immersive virtual reality preparation for surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anxiety in children | measured using the modified Yale Preoperative Anxiety Scale (mYPAS) | Day of surgery, immediately following consent | 
| Change in child anxiety | measured using the modified Yale Preoperative Anxiety Scale (mYPAS) | Day of surgery, immediately preceding surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Induction compliance | measured using the Induction Compliance Checklist | Day of surgery, immediately preceding surgery | 
| Anesthetic requirements | measurement includes recording dose of anesthetic(s) used | Day of surgery, intra-operatively | 
| Post-hospitalization negative behaviours | measured using the Posthospitalization Behaviour Questionnaire (PHBQ) | Two to three days after surgery |