Background: Pain is an inherently human experience with the Arteriovenous Fistula
Puncture, especially among children. Thus, it becomes of utmost importance to devote modern
technologies to lessen this annoying sensation aside from the suffering from the disease itself.
Thereof, this study aimed to evaluate the effect of immersive virtual reality intervention during
arteriovenous fistula puncture on pain intensity among children undergoing hemodialysis in El
Beheira Governorate, Egypt. Methods: A non-randomized controlled trial was executed in eight
governmental hemodialysis units (that were assigned to receive pediatric cases), representing eight
administrative districts. All the available children who fulfilled the inclusion criteria were
incorporated in the study (36 children). Five tools were used: Socio-demographic and Medical
History Structured Interview Schedule, Physiological Pain Indicators, Numerical Pain Rating Scale,
Procedural Behavior Rating Scale and the Gold-Rizzo Immersion and Presence Inventory. Results:
The Analysis of Covariance test (ANCOVA) proved a large effect size of virtual reality intervention
on all pain measures (η2≥0.06). A statistically significant improvements in the mean scores of all
the physiological pain measures was found after virtual reality intervention as compared to baseline
(P0=<0.05) and standard care (P2<0.05). Most of the studied children reported either mild (58.3%)
or moderate (27.8%) pain with no severe pain after virtual reality intervention with a statistically
significant mean difference compared to the baseline (p0<0.001) and standard care (p < /span>2<0.001). A
significant difference was proved between the virtual reality intervention and standard care
concerning the observed pain behaviors during the procedure (p < /span>2<0.001). A high level of immersion
with the virtual reality intervention was revealed among the studied children with a mean percent
score of 90.97 ± 7.23. Conclusion & recommendations: Virtual Reality intervention proved to be
efficient in lessening pain intensity among children undergoing hemodialysis. Thereof, it is
recommended to be incorporated in the routine care of pediatric hemodialysis units.