Rodríguez de Galvis Solmar, Guerrero Rodríguez Elena, Audije-Gil Julia, Hernández Sandra Hernández, Argilés-Huguet Marta, Botella Ana, Burgos Villulas Marina, Casaux-Huertas Ana, González Sánchez Isabel, Marín López María Teresa, Manso Paula, Hernán David, Dapena Fabiola, Arenas Jiménez María Dolores
Unidad de Investigación, Fundación Renal Española, Madrid, 28003, Spain.
CSMIJ Pirineu Sant Joan de Deu Terres, Lleida, Spain.
Patient Prefer Adherence. 2025 Jul 17;19:2069-2079. doi: 10.2147/PPA.S517622. eCollection 2025.
Virtual reality (VR) helps control symptoms during procedures in chronic patients. This study analyzes VR's effect on pain and anxiety in hemodialysis (HD) patients at two points: the vascular access puncture and disconnection.
A prospective, non-randomized, crossover, multicenter pilot study assessing pre- and post-intervention outcomes with VR headsets. The intervention group used VR for up to 13 sessions, around the puncture, and at the end of the session. Pain was measured with the Faces Pain Scale - Revised (FPS-R) and anxiety with the Visual Analogue Scale for Anxiety (VAS-A). Usability and patient satisfaction with VR were also evaluated.
A total of 73 patients (66.2 ± 13.3 years, 67% men) were included. At the start, 8.2% declined to wear the VR headset. The average number of sessions with the headset was 6.5 ± 4.8, with 23.3% completing all 13 sessions. Pain during punctures significantly improved with VR (1.26 vs 0.97; p = 0.039), while anxiety improved non-significantly. Anxiety during disconnection slightly increased, but also not significantly. Patients with higher initial pain and anxiety levels during puncture and disconnection showed significant improvement, while those with lower initial levels worsened (p < 0.05 in all cases). The HD population showed varying levels of acceptance of VR.
VR headsets help reduce pain during punctures, especially in patients with more intense pain. The effect on anxiety reduction during punctures or at the end of the session is inconclusive, with better results in those with higher anxiety levels. VR acceptance in the HD population is variable.
虚拟现实（VR）有助于控制慢性病患者在治疗过程中的症状。本研究从两个方面分析VR对血液透析（HD）患者疼痛和焦虑的影响：血管通路穿刺和透析结束时。
一项前瞻性、非随机、交叉、多中心的试点研究，使用VR头戴设备评估干预前后的结果。干预组在穿刺前后及透析结束时使用VR，最多进行13次。使用面部疼痛量表修订版（FPS-R）测量疼痛，使用焦虑视觉模拟量表（VAS-A）测量焦虑。还评估了VR的可用性和患者满意度。
共纳入73例患者（66.2±13.3岁，67%为男性）。开始时，8.2%的患者拒绝佩戴VR头戴设备。头戴设备的平均使用次数为6.5±4.8次，23.3%的患者完成了全部13次。使用VR后穿刺时的疼痛显著改善（1.26对0.97；p=0.039），而焦虑改善不显著。透析结束时的焦虑略有增加，但也不显著。穿刺和透析结束时初始疼痛和焦虑水平较高的患者有显著改善，而初始水平较低的患者则有所恶化（所有情况p<0.05）。HD患者对VR的接受程度各不相同。
VR头戴设备有助于减轻穿刺时的疼痛，尤其是疼痛较剧烈的患者。在穿刺时或透析结束时对减轻焦虑的效果尚无定论，焦虑水平较高的患者效果更好。HD患者对VR的接受程度不一。
