Stress Inoculation Through Virtual Reality in the Pediatric Electrophysiology Laboratory

Stanford University40 enrolled

Overview

The goal of this study is to assess the utility of virtual reality technology to aid in the mental health of patients with cardiac disease, specifically looking at decreasing anxiety and perceptions of pain from stressful procedures in the pediatric electrophysiology laboratory.

The investigators will perform a pilot study of 40 patients who are randomized to either standard of care preparation for an electrophysiology procedure (control arm) vs. Virtual Reality preparation (VR arm). Participants in control arm will have standard preparation for a procedure including discussion of the procedure with the provider the day before the procedure with all questions answered at that time. VR arm participants will have access to the Virtual Reality tour and gear 1 week prior to the procedure. VR arm participants will be instructed to watch the Virtual Reality tour at least three times prior to the procedure but will be encouraged to watch as often as the participants would like. The Virtual Reality equipment will measure how often participants complete the tour. All participants will undergo anxiety measures a total of four times: once at time of recruitment, day of procedure and then 1 week and 4 weeks post procedure. Participants will have cortisol salivary swabs performed 1 week before procedure (before VR use), pre-op visit, day of procedure, and immediately following procedure. Heart rate and blood pressure will be measured on day of procedure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Stress, Psychological Stress, Physiological Anxiety Pain Perception

Interventions

Use of Virtual Reality AppBEHAVIORAL

The VR app will consist of relaxation techniques as well as a virtual tour of the hospital (pre-op area, IV placement, cath lab, and post-op area).

Eligibility

Sex: ALLMin age: 10 YearsMax age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Pediatric Cardiology patients between the age of 10 and 20 years old * Undergoing cardiac electrophysiology procedure Exclusion Criteria: * Inability to wear virtual reality glasses * Patients under 10 years old * Prior psychiatric illness

Locations (1)

Stanford University / Lucile Packard Children's Hospital

Stanford, California, United States

Outcomes

Primary Outcomes

Change in anxiety levels from baseline in patients as measured by the State Trait Anxiety Inventory (STAI).

State -Trait Anxiety Inventory (STAI) is a widely used self-report measure that estimates situational (state) and baseline (trait) anxiety in adults and children. It is both valid and reliable and routinely used in measuring anxiety associated with medical procedures. The pediatric version is available for use with upper elementary, or junior high or high school aged children.

Time frame: At time of recruitment, day of procedure, 1 week post procedure, and 4 weeks post procedure

Secondary Outcomes

Change in anxiety levels from baseline in patients as measured by Visual Analog Scale of Anxiety

Visual Analog Scale of Anxiety (VAS) is a widely used self-reported and observational measure of anxiety. Patients place a vertical line along a 10 cm horizontal line which is anchored with the descriptors "not at all anxious" and "extremely anxious" and 10 markings 1 cm apart. This simple format of assessing anxiety is often used in operating rooms or before medical procedures given its brevity and ease of administration is fast-paced settings. It has been correlated with STAI scores.

Time frame: At time of recruitment, day of procedure

Change in parent observation of child behavior from baseline as measured by Child Behavior Checklist (CBCL)

Child Behavior Checklist (CBCL) is a rating form of child behavior completed by parents. It has been developed for children aged 6-18 years. This checklist groups into sets of behaviors: internalizing, externalizing and total problems.

Time frame: At time of recruitment and 4 weeks post procedure

Change in anxiety levels from baseline in parents as measured by parental STAI

Data from ClinicalTrials.gov

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