The new VR game was designed specifically for hospital situations feared by all children – and their parents: blood samples, removal of plasters or insertion of an ear tube or an IV line.
Virtual Reality has already been tested and introduced as a method to distract children and young people in hospital, for example during quarantine or in connection with burns treatment. However, many of the games downloaded from the internet are not suitable for hospital situations in which children need to sit still, as Søren Walther Larsen from the Paediatric Pain Knowledge Centre explained. Søren Walther Larsen is the facilitator of the project for Rigshospitalet.
A child playing the game while having an IV/venflon inserted.
After testing a number of existing VR games, Khora and Rigshospitalet established the criteria for a game in injection situations and similar. The result was the Ballade på Badebroen (trouble on the jetty) VR game.
Picture from the 'Ballade på Badebroen' (trouble on the jetty) VR game.
The game has been designed as a shooting game in which the child shoots water balloons with a slingshot at cheeky seagulls stealing fish from the child.
Unlike traditional VR games in which the players wear headphones and are in a world of their own, Ballade på Badebroen was designed specifically for hospital situations. For example, the sound is played out loud, so that nurses and physicians can hear the sound from the game and ask questions about what is happening, thereby maintaining contact with the child. The child can control the game using only one hand, so the other hand can lie calmly with the physician or the nurse taking a blood sample or inserting an IV.
"The game has also been adjusted to hospital situations. For example none of the action in the game goes on behind the child," explained Thomas Saaby Noer from Khora, and he continued:
"This prevents the child from fidgeting or turning to look backwards. We've incorporated elements such as starfish on the screen edges and ships sailing past, so there's something to talk about with the child during a procedure. This was very important to the Paediatric Pain Knowledge Centre, as these elements can be used to talk about fantasy journeys or other topics if a child doesn't want to play the game, but just look at it. Last, but not least, the game is different from traditional VR games as it doesn't include elements that can frighten the child. This prevents the child from becoming nauseous during a procedure. All this means that the game is fun and harmless without huge or scary surprises,"
An important precondition for the game to work in hospital situations as a conversational topic, distraction and entertainment is that the nurse or the person who is to interact with the child during the procedure knows the game and knows what is going on.
Nurse Trine Pedersen from the Department of Anaesthesiology - Juliane Marie Centre has helped test the game. Knowing the game has helped her use it in practice. "Because I can hear the sound, I can keep track of the game, and during the procedure I can talk to the child about details of the game, such as 'How many seagulls have you shot now?' and 'Are there any starfish on the boat?'. This means that I can show the child that we're in this playful activity together, while the physician inserts an IV line into the child's arm, for example," explained Trine.
Søren Walther-Larsen stressed that the children know what is going to happen in the situation. "But the children are so immersed in the game that it takes their minds off an otherwise painful and frightening procedure.
Yesterday, we had a patient who was deeply involved in the game during an injection, and after a while he asked: 'When's the needle coming?' He hadn't even noticed that the procedure was over," said Søren Walther-Larsen.
The video shows a child, trying the VR-game while getting an IV,
at Videnscenter for Børnesmerter.
NB! The video is in danish.
The VR game is now for use at the Paediatric Pain Knowledge Centre, where staff are pleased with the solution and see great potential in the game.
"We've already tested the game on several children, and they've all been excited about the game and the method," said Søren Walther-Larsen. "Some of the children are already looking forward to their next hospital visit and to playing the game again. And even though the game's designed for children between 5 and 12, we also have 14-year-olds who want to try it," he said.
The next step in the development of the game is to document the effect. Khora and Rigshospitalet are planning to do this by conducting a survey of two different groups of children to investigate whether the game is better, worse or in the same as other distraction methods otherwise used at the Paediatric Pain Knowledge Centre, such as soap bubbles, fantasy journeys, music, etc.
If the effect proves to be as good as expected, the Knowledge Centre hopes to be able to spread the method to all interested parties nationally and internationally, so that children all over the world can feel more comfortable in a difficult situation.