The Effect of Video Streaming With Virtual Reality on Anxiety and Pain During Bone Marrow Aspiration and Biopsy Procedure

The efficacy of virtual reality in adults during puncture biopsy: A protocol of a systematic review and meta-analysis

BACKGROUND

Puncture biopsy is a primary method for obtaining tissue or cell samples from tumors for histopathological diagnosis. However, patients often experience pain, anxiety, and discomfort during the procedure. Virtual reality is a novel technology developed through advancements in computer skill, and it is utilized in healthcare as a cognitive approach to relieve pain and relaxation. However, there is controversy in published trials regarding the efficacy of virtual reality in adults during puncture biopsy. Therefore, a synthesis of objective and accurate data is needed to support the efficacy of virtual reality for pain relief during puncture biopsy in adults.

METHOD AND ANALYSIS

To identify suitable randomized controlled trials, published literature in eight electronic databases will be searched, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan-fang Data, and Chinese Biomedical Database (CBM). The collected data will be consolidated and subjected to meta-analysis by using RevMan 5.4. Mean difference will describe the continuous variables. 95% confidence intervals (CI) will characterize the interval estimates. Model categories will be selected based on heterogeneity. The quality of the inclusion of randomized controlled trials in terms of methodological quality will be assessed by the Cochrane Risk of Bias Assessment Tool. Additionally, strength and certainty of the evidence will be assessed by the GRADE system.

DISCUSSION

The following protocol delineates the fundamental process and methodology to be employed in a systematic review and meta-analysis of data pertaining to the efficacy of virtual reality in the context of adult puncture biopsy. The results of the study will furnish healthcare professionals with evidence-based clinical evidence, thereby facilitating sound clinical decision-making and yielding beneficial consequences for the clinical domain.

TRIAL REGISTRATION

PROSPERO registration number: CRD42024539303.

The effectiveness of non-pharmacological interventions on reducing pain in patients undergoing bone marrow aspiration and biopsy: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Patients often consider bone marrow aspiration and biopsy to be one of the most painful medical procedures. The effectiveness of non-pharmacological interventions to reduce pain during bone marrow aspiration and biopsy remains unclear.

AIM

To synthesize existing evidence regarding the effectiveness of non-pharmacological interventions in mitigating procedural pain among patients undergoing bone marrow aspiration and biopsy.

DESIGN

A systematic review and meta-analysis of randomized controlled trials.

METHODS

Six electronic databases, including PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library and Web of Science were searched from inception to July 15, 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 2.0. Meta-analysis was conducted using STATA 16. The certainty of the evidence was assessed by the GRADE approach.

RESULTS

This meta-analysis included 18 studies derived from 17 articles involving a total of 1017 participants. The pooled results revealed statistically significant pain reduction effects using distraction (SMD: -.845, 95% CI: -1.344 to -.346, p < .001), powered bone marrow biopsy system (SMD: -.266, 95% CI: -.529 to -.003, p = .048), and acupoint stimulation (SMD: -1.016, 95% CI: -1.995 to -.037, p = .042) among patients undergoing bone marrow aspiration and biopsy. However, the pooled results on hypnosis (SMD: -1.228, 95% CI: -4.091 to 1.515, p = .368) showed no significant impact on pain reduction. Additionally, the pooled results for distraction did not demonstrate a significant effect on operative anxiety (MD: -2.942, 95% CI: -7.650 to 1.767, p = .221).

CONCLUSIONS

Distraction, powered bone marrow biopsy system and acupoint stimulation are effective in reducing pain among patients undergoing bone marrow aspiration and biopsy.

PATIENT OR PUBLIC CONTRIBUTION

Not applicable.

RELEVANCE TO CLINICAL PRACTICE

This meta-analysis highlights the effectiveness of distraction, powered bone marrow biopsy system and acupoint stimulation for reducing pain in patients undergoing bone marrow biopsy. Healthcare professionals should consider integrating these interventions into pain management practices for these patients.

REGISTRATION

(PROSPERO): CRD42023422854.

Improving immersive experiences in virtual natural setting for public health and environmental design: A systematic review and meta-analysis of randomized controlled trials

In recent years, virtual reality (VR) technology has emerged as a powerful tool in the field of therapeutic landscapes. For hospitalized patients or individuals with limited mobility, VR provides highly personalized therapy by simulating authentic natural environments within a safe, convenient, and engaging setting. This study investigated the effectiveness of immersing patients in virtual natural environments for health recovery and compared the varying impacts of different types of landscapes on patients' recovery levels. The aim was to complement traditional medical approaches and enhance environmental design in the field of public health. Researchers systematically reviewed databases (January 2018 to August 2, 2023) to identify randomized controlled trials comparing the efficacy of virtual nature immersion with other treatments. The inclusion/exclusion criteria were established based on the population, intervention, comparison, outcomes, study design, and other aspects (expanded PICO) framework. The Cochrane tool was employed to assess the risk of bias. Meta-analysis was conducted by pooling the mean differences with a 95% confidence interval. Among 30 trials, a total of 2123 patients met the inclusion criteria, with 15 studies included in the meta-analysis. 30 trials met the criteria. Results show significant improvements in pain, anxiety, fear, and some physiological indicators with virtual nature-based treatments. On the other hand, natural scenes incorporating blue and green elements have been applied more extensively and have shown more significant effects. In comparison to conventional methods, this study strongly advocates that virtual reality environments are a crucial tool in bridging the gap between patients and nature, demonstrating their potential to reshape medical interventions and improve environmental design in the field of public health.