Comparison of the effect of virtual reality-based games and cartoon watching on anxiety, fear, and pain in children with acute lymphoblastic leukemia during chemotherapy

Comparison of the effect of playing and watching cartoons through virtual reality on anxiety, fear, and pain in children with acute lymphoblastic leukemia during chemotherapy in pediatric oncology departments of medical centers affiliated with Hamadan University of Medical Sciences

A clinical trial with two intervention groups and one control group, Without blinding, randomized, on 93 children. Randomization is performed using a block design.

The study is being conducted at the Oncology Center of Ekbatan Hospital affiliated with Hamadan University of Medical Sciences. Playing virtual reality games and watching cartoons with virtual reality glasses is performed from 10 minutes before the start of chemotherapy until the end of it (approximately 1 hour). In the control group, playing games and watching cartoons with virtual reality is not performed. Pain intensity, fear, and anxiety will be recorded.

Acute lymphoblastic leukemia, first course of chemotherapy, no gastrointestinal diseases, no speech, vision, or hearing impairments, and no intellectual disability, under treatment with vincristine. Exclusion criteria: unwillingness to continue participation in the study.

Virtual Reality Gaming Group: A 3D game appropriate to the child's gender and interests is selected, starting 10 minutes before chemotherapy and continuing throughout it (approximately one hour).Virtual Reality Cartoon Viewing Group: A 3D cartoon appropriate to the child's gender and interests is selected, starting 10 minutes before chemotherapy and continuing throughout it (approximately one hour).Control Group: Receives no virtual reality intervention, and the intensity of pain, fear, and anxiety is recorded 10 minutes before, during, and immediately after chemotherapy.

The intensity of pain, fear, and anxiety

For random allocation into three groups (playing with virtual reality, watching cartoons with virtual reality, and control), a block randomization method with blocks of 6 will be used. This method involves creating 20 blocks of 6 units each (60 combinations), with each block including two participants for each group. The three letters A (playing with virtual reality), B (watching cartoons with virtual reality), and C (control) are written on pieces of paper and placed in an envelope. The random order of drawing the letters determines the groups, for example, A for playing with virtual reality, B for watching cartoons with virtual reality, and C for control. Then, 20 blocks of six-letter combinations such as AABBCC and ABCABC are written on paper and placed in an envelope. The blocks are selected randomly with replacement. Children are assigned to groups based on the order of the selected blocks.