Non-Wearable Audiovisual Distraction for Children's Medical Anxiety in the ED

August 9, 2026 updated by: National Taiwan University Hospital

Effectiveness of Non-Wearable Immersive Audiovisual Distraction in Alleviating Pediatric Anxiety in Emergency Department: A Stratified Randomized Controlled Trial

Pediatric emergency department (ED) visits often cause significant anxiety and stress for young patients due to unfamiliar environments and invasive medical procedures. Non-pharmacological interventions, such as distraction, are vital for reducing pediatric anxiety and improving procedural outcomes.

This study evaluates the effectiveness of a non-wearable, immersive audiovisual distraction system (LG StanbyME display) in alleviating pediatric anxiety during emergency department care, compared to standard care.

The main questions it aims to answer are:

Does non-wearable audiovisual distraction reduce anxiety levels in pediatric emergency patients compared to standard care?

Does the intervention improve physiological indicators of distress, such as Heart Rate Variability (HRV)?

Participants will:

Be randomly assigned to either the non-wearable audiovisual distraction group or the routine care group.

Undergo continuous physiological monitoring (HRV) and clinical anxiety assessment (mYPAS-SF) during their ED visit.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Pediatric anxiety in emergency settings can lead to uncooperative behavior, prolonged procedure times, and long-term medical fear. Traditional Virtual Reality (VR) headsets often face clinical limitations in pediatric EDs, such as user discomfort, sanitation challenges, and restricted head/eye movement.

To address these barriers, this stratified randomized controlled trial (RCT) introduces a non-wearable, highly mobile immersive display system (LG StanbyME) combined with interactive soothing content and digital companionship.

Pediatric patients aged 3 to 12 years presenting to the Emergency Department of National Taiwan University Hospital Yunlin Branch will be screened for eligibility. Eligible participants will be randomized into two arms:

Experimental Group: Receives non-wearable immersive audiovisual distraction via the mobile display during ED waiting and procedural periods.

Control Group: Receives standard pediatric ED care without digital distraction devices.

Primary outcomes include objective autonomic nervous system activity evaluated through continuous Heart Rate Variability (HRV) monitoring using a wearable ECG recorder (QOCA ecg103). Secondary outcomes include subjective pediatric anxiety scores assessed via the Modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF), parental anxiety, and staff satisfaction.

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Taiwan
    • Yunlin County
      • Douliu, Yunlin County, Taiwan, 640203
        • National Taiwan University Hospital Yunlin Branch
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Pediatric patients aged 6 to 12 years presenting to the Emergency Department.
  • Requiring invasive medical procedures (e.g., blood sampling, intravenous line insertion, or laceration repair/suturing).
  • Patient and legal guardian/parent willing and able to provide informed assent/consent and comply with study protocols.

Exclusion Criteria:

  • Patients with severe developmental delay, cognitive impairment, or neurological disorders affecting communication or behavioral assessment.
  • Patients with severe visual or hearing impairment that prevents interaction with the non-wearable display system.
  • Hemodynamically unstable patients or those requiring immediate life-saving resuscitation.
  • Patients with severe upper body or facial injuries that prevent the placement or operation of continuous ECG recorders.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Audiovisual Distraction Group
Pediatric patients receive non-wearable immersive audiovisual distraction via a mobile display (LG StanbyME presenting low-stimulation, guided soothing videos and simple interactive games) during emergency department procedures.
Behavioral: Non-Wearable Audiovisual Distraction
Implementation of a non-wearable mobile display system (LG StanbyME) providing gentle, low-stimulation audiovisual distraction and digital companionship to alleviate pediatric procedural anxiety.
Active Comparator: Routine Care Group
Pediatric patients receive standard emergency department care without additional digital audiovisual distraction devices.
Other: Routine ED Care
Standard pediatric emergency department care according to clinical guidelines without digital distraction devices.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in Heart Rate Variability High-Frequency Power (HF-HRV)
Time Frame: Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).
Continuous measurement of parasympathetic autonomic activity evaluated via HF power in normalized units (nu) or $ms^2$
Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).
Changes in Heart Rate Variability LF/HF Ratio
Time Frame: Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).
Autonomic nervous system balance assessed via the ratio of Low-Frequency to High-Frequency power.
Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).
Changes in Heart Rate Variability RMSSD
Time Frame: Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).
Short-term parasympathetic modulation evaluated via Root Mean Square of Successive Differences (RMSSD) in milliseconds (ms).
Continuously measured from baseline (wait time, T0) through procedural period (T1/T2) up to 30 minutes post-procedure (recovery period, T3).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pediatric Observational Anxiety Score (mYPAS-SF)
Time Frame: Assessed at baseline (pre-procedure) and immediately post-procedure.
Behavioral anxiety score assessed using the Modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF). The tool evaluates 4 categories (activity, vocalization, emotional expressiveness, and state of arousal), yielding a total score ranging from 22.9 to 100, where higher scores indicate greater procedural anxiety.
Assessed at baseline (pre-procedure) and immediately post-procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Collaborators

National Yunlin University of Science and Technology

Investigators

  • Principal Investigator: Nai-Yun Chang, MD, National Taiwan University Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

August 31, 2027

Study Completion (Estimated)

September 30, 2027

Study Registration Dates

First Submitted

August 2, 2026

First Submitted That Met QC Criteria

August 9, 2026

First Posted (Actual)

August 12, 2026

Study Record Updates

Last Update Posted (Actual)

August 12, 2026

Last Update Submitted That Met QC Criteria

August 9, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 202601226RINE

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data, including demographic characteristics (age, sex), baseline and post-procedural mYPAS-SF scores, and time-domain/frequency-domain Heart Rate Variability (HRV) parameters (HF, LF/HF ratio, RMSSD), will be shared with qualified researchers upon reasonable request.

IPD Sharing Time Frame

Data will become available starting 6 months after publication of the primary manuscript and will remain available for up to 3 years

IPD Sharing Access Criteria

Data will be made available to qualified academic researchers for non-commercial scientific research. Requesters must submit a formal research proposal, sign a Data Use Agreement (DUA) to ensure participant confidentiality, and obtain approval from the Principal Investigator (Dr. Nai-Yun Chang)

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe