The Effects of Virtual Reality on Hope and Travel Expectations in Healthy and Hospitalized Children: Quasi-Experimental Design Approach.

Background: Virtual reality (VR) has become a powerful tool for enhancing the experiences of patients with critical illnesses, particularly hospitalized children with leukemia. Since traveling is nearly impossible for them, St Jude has teamed up with the travel company Expedia to launch "Dream Adventures," a pilot program that offers immersive VR experiences, allowing children to explore new destinations from the comfort of the hospital.

Objective: The aim of this study was to evaluate the pleasurable experience of VR and its impact on healthy and hospitalized children's travel expectations and hope by using electrocardiography (ECG) and questionnaires to enhance research objectivity.

Methods: Participants were children aged 7-18 years, divided into 2 distinct groups: 30 healthy children and 18 hospitalized children with leukemia. Both groups received the same VR intervention and were assessed using a 1-group pretest-posttest design. The questionnaires were designed to assess differences in the children's sense of hope and travel expectations, and their physiological data were collected through ECG.

Results: The results indicated a statistically significant increase in hope levels from pre-VR to post-VR intervention in both healthy children (preintervention: mean 5.83, SD 0.87; postintervention: mean 6.36, SD 0.76; P=.002) and hospitalized children (preintervention: mean 5.51, SD 1.17; postintervention: mean 5.73, SD 1.15; P=.03), as determined by paired samples 2-tailed t tests. Furthermore, an independent samples 2-tailed t test revealed a significant difference in postintervention hope levels between the hospitalized children (mean 5.73, SD 1.15) and healthy children (mean 6.36, SD 0.76; P=.05). Then, we further compared the mean differences in hope scores from preintervention to postintervention. Healthy children demonstrated a greater increase (an increase of 0.53, from 5.83 to 6.36) than the hospitalized children (an increase of 0.22, from 5.51 to 5.73). In terms of physiological responses, ECG indicators such as SD of all normal-to-normal intervals and low-frequency power revealed significant differences in autonomic nervous system activity between the 2 groups. Healthy children exhibited higher sympathetic activation, suggesting greater emotional engagement during the VR experience, whereas hospitalized children demonstrated more attenuated responses. The consistency between physiological data and self-reported measures strengthens the construct validity of the instruments used and enhances the overall reliability of the study findings.

Conclusions: The VR intervention significantly increased hope levels in both healthy children and hospitalized children with leukemia, with a greater improvement observed among healthy participants. Therefore, this study suggests that when designing interventions for hospitalized children, more targeted emotional support strategies should be considered. Future studies are recommended to explore different types of VR content and the medical conditions of hospitalized children.