Golden Breath: feasibility and acceptability of a biofeedback-based virtual reality game on reducing children's needle-related pain and fear

Abstract

Background: Needle procedures can cause pain and fear in children. Current literature reports that biofeedbackbased virtual reality applications may help alleviate children's pain and fear. This study aims to evaluate the feasibility, acceptability, and safety of the newly developed game Golden Breath, which uses biofeedbackbased virtual reality to reduce children's needle-related pain and fear. Methods: The development of Golden Breath includes;(1) development of the application's features based on needs assessment, (2) gamification of the application content based on literature, (3) development of the prototype, (4) expert evaluation and feedback on the application content, (5) usability testing by 11 children (4-12 years). Results: Regarding acceptability, the expert evaluation showed a high usability of the system. All children provided positive feedback and reported high satisfaction with Golden Breath. The game was feasible and effective for reducing children's pain and fear levels during needle procedures. Golden Breath was deemed safe for children because it did not cause symptoms such as dizziness, vomiting, or nausea. Conclusion: The expert evaluation, children's feedback, and pilot study results showed that the Golden Breath game is feasible, acceptable, and safe for children during the needle-related procedure. The pilot study revealed that the Golden Breath game effectively reduced pain and fear during blood sampling in children. Practice to implications: It is recommended that healthcare professionals use Golden Breath to optimize the wellbeing of children receiving treatment for chronic and acute diseases.