Virtual Reality

Virtual Reality

PEP Topic 

Virtual reality is a computer-simulated environment, with sensory stimuli and interactive software and hardware, that creates the feeling of being physically present in an imaginary place. Virtual reality was evaluated as an intervention that could distract patients with cancer, preventing CINV during chemotherapy. The effect of virtual reality on anxiety, depression, and fatigue has also been studied.

Effectiveness Not Established

Research Evidence Summaries

Li, W.H., Chung, J.O., & Ho, E.K. (2011). The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer. Journal of Clinical Nursing, 20, 2135–2143.

doi: 10.1111/j.1365-2702.2011.03733.x

Study Purpose:

To examine the effectiveness of play, consisting of virtual reality computer games, in reducing anxiety and symptoms of depression in children hospitalized for cancer treatment

Intervention Characteristics/Basic Study Process:

Children hospitalized for cancer treatment were invited to participate in the study. Patients received 30 minutes of a play intervention, consisting of virtual reality gaming, five days per week. Play was in a small-group setting that included no more than four patients. A historical comparison group was used in the study. Study measures were obtained at hospital admission and at day 7.

Sample Characteristics:

  • The study reported on a sample of 122 pediatric patients.
  • Patient age range was 8–16 years.
  • The sample was 53% male and 47% female.
  • Most patients had leukemia or lymphoma and were undergoing inpatient treatment.
  • At baseline, patients had high anxiety and depression scores.


  • Single site
  • Inpatient setting
  • China

Phase of Care and Clinical Applications:

  • Phase of care: active antitumor treatment
  • Clinical application: pediatrics

Study Design:

 Prospective, single-blind trial with historical control comparison

Measurement Instruments/Methods:

  • State-Trait Anxiety Inventory for Children
  • Center for Epidemiological Studies Depression Scale for Children


ANOVA showed a main effect for time, suggesting significantly lower anxiety and depression symptoms in the group that participated in the play intervention. There were no significant differences in baseline scores between groups. In both groups, anxiety scores declined between baseline and day 7.


Play involving virtual reality may reduce symptoms of depression in children hospitalized for cancer treatment.


  • The study had risk of bias due to no random assignment and no appropriate attentional control condition.
  • Several age groups were involved. The study did not include subgroup analysis, to see if effects varied in different age and education groups.

Nursing Implications:

Findings suggest that use of virtual reality play may help pediatric inpatients being treated for cancer. Further well-designed research in this area is warranted. It is unclear if virtual reality is more effective than other means of distraction.