An immersive virtual reality (IVR) intervention may help manage anxiety and acute nausea in first-time chemotherapy pediatric recipients, according to results of a study published in the European Journal of Oncology Nursing.

Anxiety is common among pediatric patients receiving their first course of chemotherapy and patients with high anxiety during early chemotherapy treatments are at risk for presenting with anxiety during later cycles.

This exploratory randomized controlled trial sought to evaluate the feasibility and utility of using an IVR intervention for anxiety management. Nineteen patients aged 6 to 12 years who were scheduled to receive their first intravenous chemotherapy treatment at the Hong Kong Children’s Hospital were randomly assigned to the IVR cohort (9 patients) or received usual care (10 patients). The IVR intervention comprised cartoon movies that were delivered 4 hours before the first chemotherapy session and during the first and second administration.

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The intervention and usual care participants were mean age 10.33 and 9.11 years, 55.6% and 70% were boys, and 55.5% and 40% had bone cancer, respectively.

During the first and second chemotherapy administration the participants watched the IVR videos for an average of 41.33 and 21.88 minutes, respectively.

At baseline, the intervention and usual care cohorts reported similar anxiety scores (mean, 19.33 vs 20.20) but the IVR participants reported lower anxiety scores after the first (mean, 14.22 vs 20.70; P =.842), before the second (mean, 16.67 vs 20.10; P =.182), and after the second (mean, 13.89 vs 20.90; P =.002) administration.

The IVR participants also reported lower acute nausea scores after the second chemotherapy administration compared with the usual care cohort (mean, 0.52 vs 2.32; P =.022).

This trial was exploratory and was not powered to detect significant differences.

These data indicated that an IVR intervention was feasible in the pediatric chemotherapy setting and may help manage patient anxiety and nausea.


Wong CL, Li CK, Choi KC, et al. Effects of immersive virtual reality for managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: an exploratory randomised controlled trial. Eur J Oncol Nurs. 2022;61:102233. doi:10.1016/j.ejon.2022.102233