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