The effect of virtual reality on Children's anxiety, fear, and pain levels before circumcision

Cyborg Children: A Systematic Literature Review on the Experience of Children Using Extended Reality

This literature review presents a comprehensive and systematic account of research on the experiences of children with extended reality (XR), including VR, AR, and other types of immersive technologies that enhance and augment children's activities. The search on Scopus and Web of Science produced 531 outputs. Content analysis with inter-rater reliability (Krippendorff's α) and Leximancer, a software for text mining, were used for analyzing the material. Four research strands were identified: (1) interventions, treatments, and medical procedures in clinical contexts; (2) teaching and learning enhanced by XR; (3) children's adoption and user experiences; (4) design and prototyping of XR hardware and software for children. The results showed the following findings: (a) studies on children's clinical interventions and treatments using HMD-supported immersive virtual reality comprise the most substantial strand of studies; (b) research in this area, and in teaching and learning studies, has grown dramatically since 2017, while the other areas have been stagnant over the years; (c) AR research is still limited and is mainly applied in educational contexts for design and prototyping; (d) few studies have considered children's perspectives on XR safety issues; (e) research on the use of XR for enhancing social and emotional skills development is underrepresented. Future research should focus on the potential of XR technologies for interventions to enhance children's psychosocial wellbeing and health more broadly. The further implications and study limitations for the fast-developing nature of this transdisciplinary research field are also discussed.

The Effect of Using Virtual Reality During Burn Dressing on Pain, Anxiety and Fear Felt in Children: A Randomized Controlled Trial

This study was conducted to determine the effect of using virtual reality (VR) during burn dressing on the level of fear, anxiety, and pain that children would experience. This randomized controlled trial was conducted in a pretest-posttest design. Randomization of the participants (n = 65) was performed with the block randomization method. Then, 33 children were included in the intervention and 32 children in the control group with simple sequential randomization. The study data were collected using the "Family and Child Personal Information Form," "Physiological Parameters Registration Form," "Wong-Baker Faces Pain Scale," "Children's Fear Scale," and "Children's Anxiety Meter-State." The chi-square test, t-test, Shapiro-Wilk, mean, and percentile distributions were used for the data analysis. After dressing, the physiological parameters of the children who used VR were found to be within normal limits (HR: 108.48 ± 12.43, O2: 98.39 ± 1.14) compared to the children who did not use (HR: 117.38 ± 15.25, O2: 97.81 ± 1.35) (P < .05). After the dressing, children using VR (0.85 ± 1.23) were determined to have less fear than those who did not use them (3.03 ± 1.06), and similarly, children who used VR (2.64 ± 2.73) experienced less anxiety than those who did not use them (5.84 ± 2.26). When the pain levels were evaluated, the VR group (1.79 ± 2.04) was reported to feel less pain compared to the control group (5.50 ± 2.36). The VR used by children aged 5-10 years during burn dressing has been found to affect their physiological parameters and is effective in reducing fear, anxiety, and pain levels.

Effects of Virtual Reality on Pain and Anxiety During Children's Circumcision: A Systematic Review and Meta-Analysis

BACKGROUND

Circumcision-a common pediatric procedure-can cause significant pain and anxiety. Virtual reality has been proposed as a nonpharmacological intervention to alleviate these negative experiences.

OBJECTIVE

This systematic review and meta-analysis was conducted to evaluate the effects of virtual reality interventions on pain and anxiety in children undergoing circumcision.

METHODS

This study comprehensively searched PubMed, Embase, and Cochrane Library for articles published from database inception to October 2, 2023. Randomized controlled trials that investigated the effects of virtual reality interventions on pain and anxiety during circumcision in children were included. The Cochrane risk-of-bias tool was used to appraise the included studies. The primary outcomes were pain and anxiety scores.

RESULTS

Three randomized controlled trials and four data sets involving a total of 224 children were included in our meta-analysis. Virtual reality interventions significantly reduced children's pain and anxiety scores.

CONCLUSIONS

Virtual reality interventions are promising nonpharmacological strategies for alleviating children's pain and anxiety during circumcision. Pediatric healthcare professionals use virtual reality interventions to create a child-friendly and healthy healthcare environment.

The efficacy of finger puppets, distraction cards and kaleidoscope for reducing anxiety in children undergoing day surgery

AIM

This study was conducted to determine the efficacy of finger puppets, distraction cards and kaleidoscope for reducing anxiety in children aged 6-12 years who undergoing day surgery in Turkey.

METHODS

The study was conducted using the "pre-post test unmatched group model", one of the quasi-experimental methods. The study was conducted between April 2023 and January 2024 with children aged 6-12 years who were admitted to the pediatric clinic of a hospital for day surgery in the Southern Marmara region of Turkey. A total of 85 children (including 20 children in the control group, 22 children in the finger puppet intervention group, 21 children in the distraction cards intervention group, and 22 children in the kaleidoscope intervention group) who were hospitalized in the pediatric clinic.

RESULTS

It was determined that there was a statistically significant difference between the pre- and post-intervention the Modified Yale Preoperative Anxiety Scale Child Form (m-YPAS) sub-dimension and total mean scores of the children in the kaleidoscope, finger puppet and distraction cards groups, while there was no difference in the control group children.

CONCLUSION

Kaleidoscope, finger puppet and distraction cards interventions were found to be effective in reducing preoperative anxiety in children and contributed to the national and world literature. It is recommended that further studies be conducted on the effectiveness of the three methods and that other variables that may affect the child's anxiety be addressed.

CONTRIBUTION TO NURSING PRACTICE

This finding can be interpreted as significant and positive in demonstrating that anxiety induced by surgical procedures in children can be effectively managed with non-pharmacological methods.

The effect of virtual reality glasses used during intravenous catheter application on the Child's emotional responses

PURPOSE

This study was conducted to determine the effect of virtual reality glasses used during intravenous catheter insertion on the child's emotional responses.

DESIGN AND METHODS

The sample of the research, which was carried out as a randomized controlled experimental study, consisted of 102 children, including 51 in the control group and 51 in the study group, who were aged between 7 and 12 years and were on treatment in the pediatric emergency department(PED). Research data were collected using a Descriptive Data Form for Children and the Children's Emotional Manifestation Scale. No intervention was applied to the control group. After the tourniquet was tied in the study group, the children started watching a video of their choice through virtual reality glasses. When the process was completed, the video was stopped. During this period, the child was evaluated using the Children's Emotional Manifestation Scale.

RESULTS

A statistically significant difference was found between the Children's Emotional Manifestation Scale scores of the children in the study and control groups (p = 0.000). The scores of the children in the study group were statistically significantly lower than the scores of the children in the control group.

CONCLUSION

During the intravenous catheter insertion process, children who watched cartoons on virtual reality glasses showed less negative emotional behavior than those who did not.

PRACTICE IMPLICATIONS

The use of virtual reality glasses is a developing technology in child health services, and it is recommended to encourage their use in these services.

Safety of virtual reality use in children: a systematic review

The study aimed to systematically review available literature regarding the safety of virtual reality (VR) use via head-mounted display in children under 14 years of age. The study was a systematic review including all study designs. A search was conducted in January 2023 in PubMed and EMBASE using key terms referring to 'virtual reality', 'paediatrics' and 'safety'.  Following title and abstract and full-text screening, data were extracted and a narrative synthesis undertaken. Twenty-six studies met criteria for inclusion in the final review.  Limited data suggest that VR may cause mild cybersickness symptoms (not severe enough to cause participants to discontinue use of VR) and that for children with existing amblyopia using VR may result in double vision, which resolves on cessation of VR exposure.  Two randomised control trials did not report differences in adverse events between the intervention (VR use) and control groups. Reporting of safety data was poor; only two studies used a validated measure, and in the remaining studies, it was often unclear how adverse events were defined (if at all), how they were categorised in terms of severity and how they were recorded.     Conclusion: There is limited evidence regarding any potential harms from short exposure to VR in children under 14 years under supervision. Additional research is required to understand increases in cybersickness during and after VR exposure, and the impact of repeated exposure.  Adverse events need to be accurately and routinely recorded to determine any hitherto unknown safety concerns for children < 14 years using VR. What is Known: • Virtual reality (VR) is increasingly being applied in paediatrics, with benefits in terms of anxiety reduction, improved pain management associated with procedures, as an adjunct to physiotherapy and supporting treatments in autistic spectrum disorder.. • Safety guidance in relation to VR use, particularly in younger children, is limited. What is New: • A systematic review of available literature regarding the safety of VR use via head-mounted display in children under 14 years of age demonstrated limited evidence regarding any potential harms from short exposure to VR.. • Studies rarely report safety data and adverse side effects are poorly defined, measured and/or reported. • The lack of a validated measure for evaluating VR-associated symptoms in children compounds the challenging ethical issues of undertaking research into the effects of VR on younger children.

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.

Goldfish or aquatic turtle? Impact of two animal assisted interventions on children's pain, anxiety, and fear during IV catheterization: A randomized controlled trial

PURPOSE

This study aimed to determine the effect of goldfish and aquatic turtle nursing interventions on children's pain, anxiety, and fear during IV catheter insertion.

DESIGN AND METHODS

The randomized controlled trial included 98 children (control group = 32, goldfish group = 33, aquatic turtle group = 33) aged 5-6 years, attending outpatient clinic for blood sampling and catheterisation procedures. Pain was measured using the Wong Baker Facial Pain Scale, anxiety was measured using the Child Anxiety Scale-State, and child fear was measured using the Child Fear Scale, before, during, and after catheterization.

RESULTS

When analyzing the pain, anxiety, and fear findings, no statistical difference was found between the scores of the mother, child, and researcher before the procedure. During the catheterization procedure, the pain, anxiety, and fear scores of the children in the fish and turtle groups increased statistically less than those in the control group. When analyzing the post-procedure findings, the pain, anxiety, and fear scores of the control group were similar to those before the procedure. In the fish and turtle groups, anxiety and fear scores were statistically the lowest (p < 0.05).

CONCLUSION

It can be concluded that animal-assisted practices reduce anxiety and fear during and after the catheterization procedures while diverting attention from pain.

PRACTICE IMPLICATIONS

Goldfish or aquatic turtle intervention improve children's attitudes toward pain, anxiety, and fear during IV catheter insertion. Pediatric nurses could consider incorporating, such as the animal assisted intervention, into their clinical practice to reduce the pain, anxiety, and fear experienced by children during medical/nursing procedures.

The effect of the distraction methods used before the COVID-19 test on the fear and anxiety levels of children: a RCT study

The current study aimed to investigate the effect of the distraction methods employed before nasopharyngeal swab sampling from children within the scope of the COVID test on their anxiety and fear levels. The study was an RCT with parallel groups conducted according to the CONSORT statement at the pediatric emergency unit of a hospital in Turkey. Children aged 5-10 years were randomized into three groups: Kaleidoscope, Visual Illusion Cards, and control. Data were collected by the researchers using the Descriptive Characteristics Form, the Children's Anxiety Meter-State, and the Children's Fear Scale. According to the reports of the children, the parents, and the nurse, the mean anxiety score and the mean fear score in the experimental groups were significantly lower after the nasopharyngeal swab procedure compared to the control group (p < .05). Fear and anxiety were observed less in the visual illusion cards group and the kaleidoscope group.

Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study

BACKGROUND

Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain.

AIM

This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection.

METHOD

This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4-10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong-Baker FACES Pain Rating Scale, the Child Anxiety Scale-State, and the Child Fear Scale.

RESULTS

After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p<0.001 for all scores).

CONCLUSION

The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection.

The Effect of Distraction Techniques on Pain, Fear, and Anxiety in Children Undergoing Circumcision: A Meta-Analysis of Randomized Controlled Trials

Circumcision is a common pediatric operation, and distraction technique can be used as an adjunct analgesic method during the perioperative period. The study aims to explore the effect of distraction techniques on reducing pain, fear, and anxiety in children undergoing circumcision. The PubMed, ClinicalTrials.gov, and Embase databases were searched for articles published from January 1, 2000, to December 31, 2023. Only randomized controlled trials (RCTs) were included. Meta-analysis and forest plots were carried out using Review Manager 5.4.1 software, and outcomes were reviewed by two authors independently. We used the Risk of Bias assessment form (ROB2) developed by the Cochrane Collaboration to assess the quality of included studies. PRISMA 2020 guidelines were used in this article to achieve the quantitative and qualitative synthesis of data. A total of seven RCTs were included. The intervention group consisted of 417 patients, while the control group had 245 patients. The meta-analysis and sensitivity analysis results showed that the distraction technique could significantly relieve pain (MD -1.3, 95% confidence interval [CI]: [-1.61 to -0.99], p < .00001), fear (SMD -1.04, 95%CI -1.68 to -0.4, p = .001), and anxiety (SMD -1.07, 95%CI [-1.64 to -0.51], p = .0002). Similarly, therapeutic play significant could significantly relieve fear (MD -0.4, 95%CI [-0.71 to -0.1], p = .01) and anxiety (SMD -1.31, 95%CI [-2.59 to -0.04], p = .04), virtual reality (VR) could significantly relieve anxiety (SMD -0.67, 95%CI [-0.98 to -0.37], p < .0001). Distraction techniques can alleviate perioperative pain, fear, and anxiety in children undergoing circumcision.

Is Pain Perception Communicated through Mothers? Maternal Pain Catastrophizing Scores Are Associated with Children's Postoperative Circumcision Pain

The aim of this study was to evaluate the relation of maternal pain catastrophizing score with children who underwent circumcision postoperative pain. This prospective cohort study was performed between March 2022 and March 2023 at Samsun University, Turkey. Demographic characteristics of mothers and children, mothers' education level, presence of chronic pain, and Beck Depression Inventory scores were recorded preoperatively. Pain catastrophizing was assessed by applying the pain catastrophizing scale (PCS) to the mothers of children who experienced postoperative circumcision pain. The mothers were divided into low-pain catastrophizing (Group 1) and high-pain catastrophizing (Group 2) group. A total of 197 mothers and sons participated in the study, with 86 (43.6%) in Group 1 and 111 (56.4%) in Group 2. Significant differences were found between the two groups in terms of the mothers' PCS scores (p < 0.001), education levels (p = 0.004), chronic pain scores (p = 0.022), and Beck Depression Inventory scores (p < 0.001). Our findings showed that children with high pain catastrophizing mothers experience greater postoperative pain than those with low pain catastrophizing mothers. This may be attributable to a mother's specific cognitive style for coping with pain, which is associated with the child's responses to painful experiences.

Effects of Comfort-Oriented Nursing Care Based on the Comfort Theory on Perioperative Anxiety and Fear in Children Undergoing Surgical Circumcision: RCT

PURPOSE

This study explored the effect of comfort-oriented nursing care based on comfort theory on reducing perioperative anxiety and fear in children undergoing surgical circumcision.

DESIGN

Randomized controlled trial.

METHOD

The study was completed with the participation of children circumcised in a hospital in Turkey using the same surgeon, anesthesia, and surgical technique. A total of 120 children meeting the inclusion criteria and providing consent to participate in the study were randomly divided into two equal groups. The study was conducted between June and September 2019. The intervention group received comfort-oriented nursing care based on the comfort theory. The control group received routine nursing care. Data were collected using the Children's Anxiety Meter-State and Children's Fear Scale. Outcome variables were determined at seven measurement points, including baseline, five intermediate points, and at the follow-up visit on the 10th postoperative day.

RESULTS

A statistically significant difference in the fear of the group receiving comfort-oriented nursing care based on comfort theory was noted compared with the control group.

CONCLUSION

Comfort-oriented nursing care based on the comfort theory was effective in reducing perioperative anxiety and fear among children undergoing surgical circumcision. This study is important given that comfort-oriented nursing care based on the comfort theory may be applied to those receiving care in pediatric surgery.

The Use of a Virtual Reality Device (HypnoVR) During Extracorporeal Shockwave Lithotripsy for Treatment of Urinary Stones: Initial Results of a Clinical Protocol

OBJECTIVE

To assess the impact of a Virtual Reality Device (VRD, HypnoVR, Strasbourg, France) on patient-reported pain and anxiety during extracorporeal shockwave lithotripsy (ESWL).

MATERIALS AND METHODS

We enrolled 30 patients submitted to ESWL for urinary stones. Patients with either epilepsy or migraine were excluded. ESWL procedures were performed using the same lithotripter (Lithoskop; Siemens, AG Healthcare, Munich, Germany) at a frequency of 1 Hz delivering 3000 shock waves per procedure. The VRD was installed and started 10 minutes before the procedure. Tolerability of pain and treatment-related anxiety represented the primary efficacy outcomes and were evaluated using: (1) a visual analogue scale (VAS), (2) the short version of the McGill pain questionnaire (MPQ), and (3) the short version of the surgical fear questionnaire (SFQ). Secondary outcomes were VRD ease of use and patient satisfaction.

RESULTS

Median (IQR) age was 57 (51-60) years and body mass index (BMI) was 23 (22-27) kg/m². Median (IQR) stone size was 7 (6-12) mm with a median (IQR) density of 870 (800-1100) HU. Stone location was kidney in 22 (73%), and ureter in 8 (27%) patients. Median (IQR) extra time for installation was 6.5 (4-8) minutes. Overall, 20 (67%) patients were at their first ESWL treatment. Side effects were experienced by only 1 patient. Comprehensively, 28 (93%) patients would recommend and would use VRD again during ESWL.

CONCLUSION

VRD application during ESWL is safe and feasible. The initial report from patients is positive in terms of pain and anxiety tolerance. Further comparative studies are needed.

Virtual reality distraction, a novel tool for pain alleviation during dressing change following surgical drainage of perianal abscess at Day Treatment Centre

Background

The pain induced by postoperative dressing changes adversely influence recovery and quality of life. In this study, we try to evaluate the pain alleviation effect of virtual reality (VR) distraction during postoperative dressing changes of patients who received surgical drainage of perianal abscess.

Methods

This was a prospective, randomized clinical trial. A total of 172 patients with perianal abscess were randomly assigned into control (only analgesics) and VR groups (VR distraction + analgesics). The pain and physiological measurements of all patients were collected before, during, and after the first dressing change following surgery. The difference in pain intensity and physiological parameters measurement between control and VR group was analyzed.

Results

The baseline characteristics of VR and control group were comparable (all P > 0.05). There was no significant difference in mean pain scores prior to and after dressing change between groups (both P > 0.05). Mean pain scores of 5, 10, 15, and 20 min measuring points during the first dressing change were significantly lower in the VR group compared with the control group (all P < 0.05). Pulse rates and oxygen saturation were not significantly different between groups.

Conclusion

VR can be used as an effective adjuvant pain distraction approach for postoperative dressing change.

The effect of storybook reading on children's preoperative fear and anxiety levels: A randomized controlled study

BACKGROUND

The aim of this study was to evaluate the effect of reading a preoperative preparation-themed storybook on children's preoperative fear and anxiety levels.

METHODS

The research design was a randomized controlled experiment. The research sample included 80 children (40 in the story group and 40 in the control group) who met the inclusion criteria. Data collection tools were collected through face-to-face interviews with the 'Survey Form', 'Child Fear Scale (CFS)' and 'Modified Yale Preoperative Anxiety Scale (mYPAS)'. In the research, the book named Elif Has Surgery was used as an intervention tool. In the story group, the preoperative preparation-themed storybook was read to the child in their room at the clinic by their mother within 10 min. The control group received only clinical routine. The study was approved by the ethics committee.

RESULTS

There was a statistically significant difference between the groups in the mean scores of the CFS and mYPAS scales in the control and story groups (p < 0.05).

CONCLUSIONS

This study found that reading a preoperative preparation-themed storybook reduced children's fear and anxiety before surgery. It may be recommended to expand the use of preoperative preparation-themed storybooks in order to prevent fear and anxiety experienced before surgery in paediatric surgery clinics. Story reading is an effective, cheap, non-pharmacological intervention. The clinical trial registration number is NCT05478369.

Effect of a game-based intervention on preoperative pain and anxiety in children: A systematic review and meta-analysis

BACKGROUND

Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological.

AIMS

To determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients.

METHODS

A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication.

RESULTS

26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded.

CONCLUSIONS

Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients.

RELEVANCE TO CLINICAL PRACTICE

In children, preoperative management is a challenging task for healthcare professionals, and game-based strategies could enhance results, improving patients' emotional health and boosting post-surgery recovery. Distractive games-based procedures should be considered for incorporation in the pre-surgery clinical workflow in order to optimise healthcare.

Realidade virtual imersiva nos Cuidados Paliativos: perspectivas para a Reabilitação Total

Resumo Introdução A Realidade Virtual se apresenta como ferramenta promissora para aprimoramento de tecnologias em saúde e potencialização de intervenções para a melhora da funcionalidade e qualidade de vida de pacientes e familiares que enfrentam doenças e/ou condições progressivas ameaçadoras da vida. Objetivo Este ensaio discute o papel promissor da Realidade Virtual Imersiva na reabilitação em Cuidados Paliativos e propõe o conceito de Reabilitação Total como possibilidade para ampliação da concepção de reabilitação atual. Método Apresentamos reflexões baseadas na teoria de Dor Total, própria dos Cuidados Paliativos, e a inserção das Novas Tecnologias na saúde, especialmente no âmbito da reabilitação, por meio de documentos baseados na linha reflexiva que os autores pretendem submeter à apreciação e ao debate público. Resultados É importante e promissor o papel da Realidade Virtual Imersiva em intervenções de saúde, bem como a proposta conceitual de ampliação do conceito e compreensão de Reabilitação, cunhando o termo Reabilitação Total. Além disso, fomentou-se o processo reflexivo de debate sobre as possibilidades terapêuticas e suas inovações. Conclusão A partir da Reabilitação Total, inovações relativas ao cuidado em saúde, sejam tecnológicas e/ou das práticas clínicas, podem ser aprimoradas e disponibilizadas através de intervenções em ambientes físicos e/ou virtuais, tendo como premissas para os processos de reabilitação a funcionalidade global e dignidade da pessoa humana, com ações que envolvam as dimensões física, social, psicológica e espiritual, tal como apresentado pelo conceito de Dor Total.