Pain and anxiety
Compared to standard care, the virtual reality intervention had a large
effect reducing worst pain with a 2.2 score difference (28% reduction,
score 7.85 vs. 5.65, 95% CI 3.79 – 3.79, p=0.011, Cohen’s d 0.82),
average pain with a 2.3 difference (38% reduction, score 6.0 vs. 3.7,
95% CI 0.61-3.99, p=0.009, Cohen’s d 0.81), and anxiety with a 2.15
difference (39% reduction, scores 5.45 vs. 3.3, 95% CI 0.38-3.92,
p=0.024, Cohen’s d 0.73)14 (Table 2, Appendix S1).
In order to examine whether the observed effects of virtual reality were
robust, multiple regression models were fitted for each pain and anxiety
outcome, to estimate the effect of the virtual reality condition, whilst
controlling for baseline (expected) pain/anxiety, parity, menopausal
condition and cervical stenosis (Table 3; Appendix S1). For worst pain
scores, the virtual reality condition accounted for a 2.11-point
decrease in experienced pain, compared with the control group (p=0.011;
R2=0.24), after controlling for baseline scores and covariates. For
average pain scores, a 2.28-point decrease in experienced pain was
observed (p=0.01; R2=0.24) and for anxiety scores, a 2.13-point decrease
(p=0.024; R2=0.16).
Follow up questionnaire results revealed that all (100%) of the women
who received the virtual reality intervention were happy to have the
procedure again in the outpatient setting. Fifteen percent (6/40) women
receiving standard care expressed their views that they would have liked
to have the procedure done under general anaesthetic instead of the
outpatient setting.
The gynaecologists performing the procedure reported that the
intervention was feasible in 90% (18/20) and thought to be helpful for
the particular patient in 85%(17/20) of cases. The staff nurses
assisting the procedure reported that the intervention was feasible in
85% (17/20) and thought to be helpful for the particular patient in
85%(17/20) of cases