Patient and staff experience
Semi-structured interviews were conducted with patients (16 who received virtual reality intervention and 12 patients who had standard care), 2 clinical staff and 3 nursing staff (Appendix S2). Thematic analysis of interview transcripts provided rich insights into patients’ experience of the VR intervention. A range of representative quotes from patients (Appendix S2) illustrates the possible mechanisms by which virtual reality immersion was reported to influence the experience of pain and anxiety. Positive experiences included a sense of relaxation that distracted from pain, as a result of calming visual imagery, environmental immersion and narrated soothing metaphors about pain control and deflection. Some patients appreciated the fact that the VR headset blocked sight of doctors and equipment that they found particularly anxiety provoking. Although patients generally reported that the VR did not remove their pain entirely, they reported that the distraction element helped control pain and immediate recovery from instances of sharp pain during the procedure. In contrast, some patients reported no effect of the VR technology on experienced levels of pain or that it was only effective during low to moderate pain. Views were mixed on whether the lack of situational awareness of the consultation room was of benefit and some patients preferred to be more aware of the procedure or be able to talk unimpeded with the doctor. A minority of patients reported wearing the VR headset to be uncomfortable and claustrophobic, or that the sense of motion in the VR environment induced nausea.