Virtual Reality-Based 360° Clinic Walkthrough for Reducing Examination Anxiety in Preschool Children

Berker Okay100 enrolled

Overview

This prospective, double-blind, randomized controlled trial investigates whether a short, 360° virtual reality (VR) pre-examination walkthrough can reduce anxiety, behavioral distress, and physiological stress responses in preschool children undergoing routine outpatient physical examination. A total of 100 children aged 3-5.5 years were randomized to either a VR group, which viewed a 3-minute real-clinic 360° video via VR goggles, or a control group, which experienced routine waiting only. Primary outcome measures include the Face-Legs-Activity-Cry-Consolability (FLACC) score and crying duration during examination. Secondary outcomes include heart and respiratory rate changes, Wong-Baker Faces Pain Rating Scale (WBS) scores, parent satisfaction, and physician-rated examination ease. The study aims to determine whether immersive, procedure-specific VR preparation can improve examination experience and cooperation while reducing stress for both children and caregivers.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

100

Conditions

Anxiety Stress, Psychological Fear

Interventions

irtual Reality 360° Clinic WalkthroughBEHAVIORAL

A brief, 3-minute 360° video recorded in the actual pediatric outpatient clinic, viewed via VR goggles before examination. The content is child-friendly, non-invasive, and designed to familiarize children with the clinical environment and examination steps to reduce anticipatory anxiety and distress.

Eligibility

Sex: ALLMin age: 36 MonthsMax age: 66 MonthsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Children aged 3 to 5.5 years (36-66 months) * Clinically stable and presenting for routine outpatient physical examination * Able to engage with a short audiovisual VR/360° video * Written informed consent from a parent or legal guardian * Verbal assent from the child when appropriate Exclusion Criteria: * Severe neurodevelopmental delay or communication difficulty * Autism spectrum disorder or significant behavioral dysregulation * History of epilepsy or photosensitivity * Visual or hearing impairment preventing VR use * Acute illness requiring urgent intervention * Body temperature ≥ 38.0°C at presentation * Previous exposure to VR or 360° clinic simulations * Concomitant sedative medication use * Refusal of participation by parent or child

Outcomes

Primary Outcomes

FLACC (Face-Legs-Activity-Cry-Consolability) behavioral distress score during examination

Behavioral distress and pain level during physical examination, assessed using the FLACC scale (score range 0-10; higher scores indicate greater distress).

Time frame: During the physical examination (same clinic visit).

Secondary Outcomes

Crying duration during examination

Duration of crying (in seconds) recorded with a stopwatch during physical examination; shorter duration reflects lower procedural distress.

Time frame: During the physical examination (same clinic visit).

Parent satisfaction score

Parent-rated satisfaction with the examination process, measured using a 5-point Likert scale (1 = very poor, 5 = excellent).

Time frame: Immediately after the physical examination (same clinic visit).