Date of Award

Winter 12-13-2025

Degree Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

First Advisor

Jerica Mason, DNP

Second Advisor

Lisa Pullen, PhD

Third Advisor

Raleigh Todd, DNP

Abstract

Pediatric surgery is common, but it often causes considerable anxiety and pain. A staggering percentage of children experience preoperative anxiety, which can heighten pain, delay recovery, and contribute to complications such as emergence delirium and longer-term behavioral issues (Fortier & Kain, 2015). Virtual reality (VR), which immerses users in computer-generated environments, has been proposed as a distraction technique to reduce these challenges. This Doctor of Nursing Practice (DNP) project conducted a scoping review to examine the effectiveness of VR in reducing perioperative pain and anxiety in pediatric patients. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) methodology. Across the included studies, VR generally reduced self-reported pain and anxiety compared with standard care or other distraction strategies. Meta-analyses reported moderate to large effect sizes for pain (standardized mean differences [SMDs] between −0.67 and −1.55) and for anxiety (SMDs between −0.74 and −1.32) (Eijlers et al., 2019; Niaz et al., 2023; Tas et al., 2022). Outcomes were commonly measured with validated tools such as the Faces Pain Scale–Revised, Wong- Baker FACES, Numerical Rating Scale, Children’s Fear Scale, and the modified Yale Preoperative Anxiety Scale. The findings were consistent with the Gate Control Theory of Pain, which describes how sensory and psychological factors influence pain perception (Katz & Rosenbloom, 2015). VR appears to be safe, feasible, and acceptable to children and families. However, variability in procedures, study designs, and outcome measures limits direct comparison, and more large-scale standardized trials are needed to clarify VR’s role in pediatric perioperative care.

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