The Impact of a 360-Degree Virtual Reality Educational Video on Mitigating Preoperative fear and Postoperative Pain in Children Undergoing Tonsillectomy/Adenoidectomy: A Blind, Randomized, Controlled Study

Aidah Alkaissi*, Naseem Abed Rabou, Mohammed Torman, Maysam Abu Alroub, Ilham Awwad

An-Najah National University, Nursing and Midwifery Department, College of Medicine and Health Sciences, Nablus, Palestine

Background: The health of children is greatly impacted by excessive stress and discomfort, which can result in behavioral problems including weeping, resistance, and hyperactivity during medical procedures. It is therefore imperative that interventions, such as education and therapeutic play, be developed and assessed by clinical experts in order to assist children in managing their fear and anxiety during hospital visits and procedures. It has been shown that preoperative educational virtual reality video distraction reduces children's fear prior to surgery and their postoperative pain and discomfort.

 Objective: The purpose of this research is to carefully assess how immersive 360-degree educational video in Virtual Reality (VR) affects preoperative fear and postoperative pain in a population of children undergoing tonsillectomy who are between the ages of 6 and 12.

Methodology: In this randomized control trial, 92 pediatric participants were randomized into two groups: an experimental group (EMG; n=46) that watched a 360° educational film through virtual reality, and a control group (CG; n=46). The Wong-Baker Faces Pain Rating Scale and the Children's Fear Scale were used as assessment instruments to quantify pain and fear quantitatively.

Results: A substantial difference (mean = 3.07) was revealed by baseline fear metrics in the EMG, and this difference decreased after the intervention (mean = 1.89, p < 0.001). There was a significant decrease in fear indices (mean = 1.8) in the EMG after watching the 360-degree educational film, compared to the CG (mean = 2.91), p < 0.001. Furthermore, the mean postoperative pain ratings on the EMG were recorded at 5.91, considerably lower than the mean of 7.11 (p < 0.001) on the CG.

Conclusion: In pediatric tonsillectomy patients, the use of a 360° immersive educational film in a virtual reality environment has been shown to reduce preoperative fear and postoperative pain, highlighting the technology's potential as a therapeutic adjunct in pediatric surgical treatment.

Key words: video 360^o, fear, pain, preoperative, pediatrics, virtual Reality (VR)