Research Article| Volume 61, 102233, December 2022

Effects of immersive virtual reality for managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: An exploratory randomised controlled trial

Published:November 02, 2022DOI:


      • Immersive virtual reality (IVR) is an interactive form of distraction intervention.
      • Paediatric patients experience anxiety, nausea and vomiting during chemotherapy.
      • This exploratory trial applied IVR to paediatric patients undergoing chemotherapy.
      • IVR is feasible and acceptable to paediatric patients receiving chemotherapy.
      • IVR may be effective in managing anxiety and nausea in paediatric cancer patients.



      To assess the feasibility and acceptability of immersive virtual reality for managing anxiety, nausea and vomiting amongst paediatric patients with cancer receiving their first chemotherapy.


      An exploratory randomised control trial supplemented with qualitative interviews was conducted to enrol Chinese paediatric patients receiving their first intravenous chemotherapy. Participants were randomly assigned to intervention (three immersive virtual reality sessions) or control (standard care) groups. The main outcome measures included (1) feasibility parameters; (2) anxiety, nausea and vomiting; and (3) satisfaction with the chemotherapy procedures. Qualitative data were collected by semi-structured individual interviews with patients, parents and nurses.


      A total of 19 patients, 19 accompanying parents and 9 nurses were recruited. Results suggested that the intervention was feasible as evidenced by the high consent rate, low withdrawal rate and attrition rate. The intervention group showed significantly better improvement in anxiety at T2 [Hedges’ effect size, ES = 1.25, 95% confidence interval (CI): 0.22–2.17)] and T4 [ES = 1.87, 95% CI: 0.72–2.85], as well as greater reduction in acute nausea at T4 [ES = 0.97, 95% CI: 0.02–1.87] than the control group. Qualitative data yielded three categories including positive experiences and perceived benefits of the intervention, and suggested improvements.


      This study demonstrated the potential effectiveness, feasibility and acceptability of immersive virtual reality for managing anxiety and acute nausea amongst paediatric patients with cancer receiving their first chemotherapy.


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