495 - The Effect of Virtual Reality Game Preparation for the Management of Anxiety in Children Scheduled for an MRI (IMAGINE): a Randomized Controlled Trial

Publication Number: 4486.495

Julien Gardner, Universite de Montreal Faculty of Medicine, Montreal, PQ, Canada; Christine Genest, Université de Montréal, Montréal, PQ, Canada; Pascale Ouimet, CHU Sainte-Justine, Montreal, PQ, Canada; Kate St-Arneault, Universite de Montreal, Montréal, PQ, Canada; Jessy Bergeron, CIUSSS de l'Est-de-l'Île-de-Montréal, Laval, PQ, Canada; Estelle Guingo, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, PQ, Canada; Julie Lebeau, CIUSSS de l'Est-de l'Île-de-Montréal, Terrebonne, PQ, Canada; Sylvain Deschênes, Université de Montréal, Montreal, PQ, Canada; Stéphane Guay, Universite de Montreal Faculty of Medicine, Montréal, PQ, Canada; Nicole Hung, Universite de Montreal Faculty of Medicine, Montreal, SK, Canada; Gabrielle Gilbert, Centre hospitalier universitaire Sainte-Justine, Montréal, PQ, Canada; Sylvie Le May, CHU Sainte-Justine, Montreal, PQ, Canada

Background: Magnetic resonance imaging (MRI) is known to cause anxiety and fear, especially in pediatric populations, due to claustrophobia and loud noises. This type of radiological examination requires the patient to remain still, which can be challenging for an anxious child to do for an extended period. Many studies have demonstrated virtual reality's (VR) potential for anxiety management. However, few have examined the efficacy of VR in reducing fear and anxiety for children preparing for an MRI.

Objective: The purpose of this study was to assess the efficacy of a VR MRI simulation game, compared to standard care, in reducing procedural anxiety and fear in children scheduled for an MRI.

Design/Methods: A prospective randomized controlled trial was conducted at two pediatric health centres, CHU Sainte-Justine and Maisonneuve-Rosemont Hospital, in Montreal. One hundred children aged 6 to 17 years, scheduled for an MRI and without an epilepsy diagnosis, were randomly assigned to an experimental group (VR preparation program) or a control group (information provided by a radiology technician). Anxiety was measured using the State-Trait Anxiety Inventory-Child (STAI-C) and Salivary Alpha-Amylase (SAA, a biomarker for anxiety), while fear was measured with the Child Fear Scale (CFS), before (T0) and after the MRI (T1). Child and parental satisfaction were also collected after the MRI, along with procedure-related information, such as the presence of side effects.

Results: After adjusting for age and sex, there was no significant difference between the mean difference (T1-T0) in anxiety (p = 0.69) or fear (p = 0.56). Analyses on mean SAA differences (T1-T0) are presented in Table 1, while results on Graphic Rating Scores on VR gameplay, in Table 2. After the MRI, participants in the experimental group rated their level of fun at 7.8/10 (SD=2.3) and their likelihood to recommend the game at 8.4/10 (SD=2.0), while parents reported an overall satisfaction of 9.1/10 (SD=1.3). Only one participant (2.0%) experienced vertigo during the VR intervention.

Conclusion(s): Results have not demonstrated that the VR preparation program is superior to standard procedures for managing children's fear and anxiety before an MRI. However, high satisfaction levels from both parents and children indicate an interest in using immersive technology to better prepare children for an MRI and to potentially increase patient satisfaction.

Table 1. Log-transformed salivary alpha-amylase levels


Table 2. Scores on the Graphic Rating Scores on gameplay (n=48)