Effectiveness of Audio Visual Therapy in Reducing Anxiety and Pain in Children During Medical Procedures: Review Literature

Authors

  • Oki Setyawati Universitas Jenderal Soedirman
  • Haryati Purwandari Universitas Jenderal Soedirman
  • Kuat Widodo Universitas Jenderal Soedirman

DOI:

https://doi.org/10.37287/ijghr.v8i4.1944

Keywords:

anxiety, audiovisual, children

Abstract

Children often experience anxiety and fear when undergoing medical procedures. Audiovisual educational media can be used as a distraction and an educational tool to reduce this problem. To review the empirical evidence on the development and effectiveness of audiovisuals in reducing children pain, and anxiety during medical procedures. This is a review literature and retrieved articles from PubMed, Scopus, ScienceDirect, and Wiley databases published between 2020 and 2025. A total of 8,077 articles were initially identified through the database search using keywords audiovisual OR Virtual reality AND paediatric OR children AND anxiety. The study selection process was conducted following the PRISMA flow diagram, which involved screening, eligibility assessment, and removal of duplicates.  The 8 articles were reviewed using JBI RCT appraisal tool and showed moderate to high quality. The selection followed the PRISMA diagram, with thematic analysis applied for data synthesis. The audiovisual media is proven effective as a non-pharmacological intervention to reduce anxiety, pain, and increase positive behaviour of children when undergoing medical procedures. Audiovisual have rule to distract children from pain and effect on the reducing anxiety including increase positive behaviour during procedures.

References

Almarzouq, S. S. F. S., Chua, H., Yiu, C. K. Y., & Lam, P. P. Y. (2024). Effectiveness of nonpharmacological behavioural interventions in managing dental fear and anxiety among children: A systematic review and meta-analysis. Healthcare (Switzerland), 12(5). https://doi.org/10.3390/healthcare12050537

Appel, L., Appel, E., Kisonas, E., Lewis-Fung, S., Pardini, S., Rosenberg, J., Appel, J., & Smith, C. (2024). Evaluating the impact of virtual reality on the behavioral and psychological symptoms of dementia and quality of life of inpatients with dementia in acute care: Randomized controlled trial (VRCT). Journal of Medical Internet Research, 26. https://doi.org/https://doi.org/10.2196/51758

Bagher, S. M., Felemban, O. M., Alandijani, A. A., Tashkandi, M. M., Bhadila, G. Y., & Bagher, A. M. (2023). The effect of virtual reality distraction on anxiety level during dental treatment among anxious pediatric patients: a randomized clinical trial. Journal of Clinical Pediatric Dentistry, 47(4), 63–71. https://doi.org/10.22514/jocpd.2023.036

Bahrololoomi, Z., Vaez, K., Yekani, A. H., Irannezhad, M., & Parvizi, Z. (2025). Comparative efficacy of virtual reality headset and auditory distraction for reducing anxiety and pain during inferior alveolar nerve block in 7–10-year-old children: A clinical trial. BMC Pediatrics, 25(1). https://doi.org/10.1186/s12887-025-05427-9

Bahrololoomi, Z., Zein Al-Din, J., Maghsoudi, N., & Sajedi, S. (2024). Efficacy of virtual reality distraction in reduction of pain and anxiety of pediatric dental patients in an Iranian population: A split-mouth randomized crossover clinical trial. International Journal of Dentistry, 2024. https://doi.org/10.1155/2024/1290410

Bali, K., Ailawadi, R., Karuna, Y. M., Srikant, N., Rao, A., Nayak, P. A., & Thimmaiah, C. (2025). Assessment of smartphone-based active distraction in association with audioanalgesia for overcoming airotor-related anxiety in children: A randomized controlled trial. BMC Research Notes, 18(1). https://doi.org/10.1186/s13104-025-07119-0

Bhusari, B. N., Hugar, S. M., Gokhale, N., Kajjari, S., Karmarkar, S., & Sahai, V. (2025). Binaural auditory beats vs music of choice as audio distraction behaviour guidance technique among children: A randomized controlled trial. Journal of Oral Biology and Craniofacial Research, 15(1), 163–169. https://doi.org/10.1016/j.jobcr.2024.12.019

Cunningham, A., McPolin, O., Fallis, R., Coyle, C., Best, P., & McKenna, G. (2021). A systematic review of the use of virtual reality or dental smartphone applications as interventions for management of paediatric dental anxiety. BMC Oral Health, 21(1), 1–11. https://doi.org/10.1186/s12903-021-01602-3

Delgado, A., Ok, S.-M., Ho, D., Lynd, T., & Cheon, K. (2021). Evaluation of children’s pain expression and behavior using audio visual distraction. Clinical and Experimental Dental Research, 7(5), 795–802. https://doi.org/10.1002/cre2.407

Gómez-Polo, C., Vilches, A. A., Ribas, D., Castaño-Séiquer, A., & Montero, J. (2021). Behaviour and anxiety management of paediatric dental patients through virtual reality: A randomised clinical trial. Journal of Clinical Medicine, 10(14). https://doi.org/10.3390/jcm10143019

Gorowska, M., Tokarska, K., Zhou, X., Gola, M. K., & Li, Y. (2022). Novel approaches for treating Internet Gaming Disorder: A review of technology-based interventions. Comprehensive Psychiatry, 115, 152312. https://doi.org/https://doi.org/10.1016/j.comppsych.2022.152312

Gozin, F., Tabe Bordbar, F., & Esmaeili, M. (2022a). Audio-visual storytelling for reducing dental anxiety in Iranian children: A randomized controlled trial. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 23(6), 953–960. https://doi.org/10.1007/s40368-022-00742-6

Gozin, F., Tabe Bordbar, F., & Esmaeili, M. (2022b). Audio–visual storytelling for reducing dental anxiety in Iranian children: A randomized controlled trial. European Archives of Paediatric Dentistry, 23(6), 953–960. https://doi.org/10.1007/s40368-022-00742-6

Igelström, H., Carlsson, M., Hauffman, A., von Essen, L., Grönqvist, H., Johansson, B., & Olsson, E. M. G. (2023). Long-term effects on depression and anxiety of an internet-based stepped care intervention for patients with cancer and symptoms of depression and anxiety. The U-CARE AdultCan trial. Internet Interventions, 32, 100625. https://doi.org/https://doi.org/10.1016/j.invent.2023.100625

Jamil, F., Khan, S. Y., & Jindal, M. K. (2023). Effectiveness of Audiovisual Distraction Technique and Filmed Modeling on anxiety and fear in pediatric dental patients. International Journal of Clinical Pediatric Dentistry, 16(4), 598–602. https://doi.org/10.5005/jp-journals-10005-2627

Jin, Y., Jiang, A., Jiang, W., Wu, W., Ye, L., Kong, X., Liu, L., & Jin, Z. (2021). Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: A randomized controlled study. BMC Ophthalmology, 21(1), 163. https://doi.org/10.1186/s12886-021-01922-6

Kolhe, S., Dialani, P., Bondarde, P., Pande, R., Patil, P., & Vishwakarma, A. P. (2024). A comparative evaluation of the effects of white noise, brown noise, and pink noise on dental anxiety of pediatric patients undergoing dental extraction treatment: A randomized control study. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 42(4), 273–279. https://doi.org/10.4103/jisppd.jisppd_69_24

Linthoingambi, A., Harsimran, K., Rishika, C., & Ramakrishna, Y. (2022). Effectiveness of intellectual color game, audio-visual and stress ball distraction methods on gagging and anxiety management in children. Journal of Clinical Pediatric Dentistry, 46(6), 6–10. https://doi.org/10.22514/jocpd.2022.019

Laksono, S., (2022). Kesehatan digital dan disrupsi digital pada layanan kesehatan di rumah sakit. Jurnal Kebijakan Kesehatan Indonesia, 11(1), 36-42.

Loveys, K., Antoni, M., Donkin, L., Sagar, M., & Broadbent, E. (2023). Comparing the feasibility and Acceptability of a virtual human, teletherapy, and an e-Manual in delivering a stress management intervention to distressed adult women: Pilot study. JMIR Formative Research, 7. https://doi.org/https://doi.org/10.2196/42390

Mahmoudi, E., Yejong Yoo, P., Chandra, A., Cardoso, R., Denner, D. S. C., Majnemer, A., & Shikako, K. (2024). Gamification in mobile apps for children with disabilities: Scoping review. JMIR Serious Games, 12. https://doi.org/https://doi.org/10.2196/49029

Montgomery, R. M., Boucher, E. M., Honomichl, R. D., Powell, T. A., Guyton, S. L., Bernecker, S. L., Stoeckl, S. E., & Parks, A. C. (2021). The effects of a digital mental health intervention in adults with cardiovascular disease risk factors: Analysis of real-world user data. JMIR Cardio, 5(2). https://doi.org/https://doi.org/10.2196/32351

Oktay, S., Söğütlüler, T., Avcil, S., Akçanal Şeker, C., Öner, H., Öztürk, H., Tosun, A., & Özsunar, Y. (2025). Using audiovisual intervention to reduce anxiety and improve image quality in pediatric magnetic resonance imaging. Pediatric Radiology, 55(8), 1582–1590. https://doi.org/10.1007/s00247-025-06276-5

Oudkerk Pool, M. D., Hooglugt, J.-L. Q., Kraaijeveld, A. J., Mulder, B. J. M., de Winter, R. J., Schijven, M. P., Robbers-Visser, D., Boekholdt, S. M., Bouma, B. J., & Winter, M. M. (2022). Pre-procedural virtual reality education reduces anxiety in patients undergoing atrial septal closure – Results from a randomized trial. International Journal of Cardiology Congenital Heart Disease, 7, 100332. https://doi.org/https://doi.org/10.1016/j.ijcchd.2022.100332

Sarkar, U., Lee, J. E., Nguyen, K. H., Lisker, S., & Lyles, C. R. (2021). Barriers and facilitators to the implementation of virtual reality as a pain management modality in academic, community, and safety-net settings: Qualitative analysis. Journal of Medical Internet Research, 23(9), 1–9. https://doi.org/10.2196/26623

Shekhar, S., Suprabha, B. S., Shenoy, R., Rao, A., & Rao, A. (2022). Effect of active and passive distraction techniques while administering local anaesthesia on the dental anxiety, behaviour and pain levels of children: A randomised controlled trial. European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry, 23(3), 417–427. https://doi.org/10.1007/s40368-022-00698-7

Shields, G., Rowlandson, A., Davies, L., Leadbitter, K., Smallman, R., Langhorne, S., Chu, P., Emsley, R., Bee, P., Hackett, L., Dunkerley, A., Harrison, L., Ellis, C., Hutton, T., Butter, C., Goldie, C., James, K., & Green, J. (2025). A post-diagnostic psycho-education, acceptance and commitment therapy programme for caregivers of children recently diagnosed with autism: A randomised controlled trial-based cost-effectiveness analysis (REACH-ASD Trial). EClinicalMedicine, 88, 103470. https://doi.org/https://doi.org/10.1016/j.eclinm.2025.103470

Singh, Y., Parameshwarappa, P., Mathew, M. G., Meghana, S. B., Kenchappa, M., & Nagaveni, N. B. (2023). Comparison of distraction techniques using salivary biomarkers during local anaesthesia administration in children aged 3-5 years: A clinical study. Indian Journal of Dental Research : Official Publication of Indian Society for Dental Research, 34(2), 169–173. https://doi.org/10.4103/ijdr.ijdr_132_22

Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., & Hopp, L. (2020). Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. Available from https://s ynthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-04

Van Dalen, M., Pasmans, S. G. M. A., Aendekerk, E. W. C., Mathijssen, I. M. J., Koudstaal, M. J., Williamson, H., Hillegers, M. H. J., Utens, E. M. W. J., & Okkerse, J. M. E. (2022). Acceptability and feasibility of an online psychosocial intervention for Dutch adolescents with a visible difference: A mixed-methods study. Body Image, 41, 298–307. https://doi.org/https://doi.org/10.1016/j.bodyim.2022.03.003

Van der Vleuten-Chraibi, S., Nauts, S., Barańska, D., Inarejos Clemente, E. J., Sterup Bovin, J., Najafi, N., Luetkens, J. A., Alison, M., Biermann, H. M., Peckman, F., & Saini, P. (2025). Magnetic resonance imaging related anxiety and workflow: Impact of a child-friendly audio-visual intervention. Pediatric Radiology, 55(9), 1934–1942. https://doi.org/10.1007/s00247-025-06308-0

Villarreal-Zegarra, D., Alarcon-Ruiz, C. A., Melendez-Torres, G. J., Torres-Puente, R., Navarro-Flores, A., Cavero, V., Ambrosio-Melgarejo, J., Rojas-Vargas, J., Almeida, G., Albitres-Flores, L., Romero-Cabrera, A. B., & Huarcaya-Victoria, J. (2022). Development of a framework for the implementation of synchronous digital mental health: Realist synthesis of systematic reviews. JMIR Mental Health, 9(3). https://doi.org/https://doi.org/10.2196/34760

Wu, Y., Li, X., Zhou, Y., Gao, R., Wang, K., Ye, H., Lyu, N., Wang, C., Zhang, N., Wang, Z., & Fan, Q. (2023). Efficacy and cost-effectiveness analysis of internet-based Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Randomized controlled trial. Journal of Medical Internet Research, 25. https://doi.org/https://doi.org/10.2196/41283

Zaidman, L., Lusky, G., Shmueli, A., Halperson, E., Moskovitz, M., Ram, D., & Fux-Noy, A. (2023). Distraction with virtual reality goggles in paediatric dental treatment: A randomised controlled trial. International Dental Journal, 73(1), 108–113. https://doi.org/10.1016/j.identj.2022.06.003

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Published

2026-08-02

How to Cite

Setyawati, O., Purwandari, H., & Widodo, K. (2026). Effectiveness of Audio Visual Therapy in Reducing Anxiety and Pain in Children During Medical Procedures: Review Literature. Indonesian Journal of Global Health Research, 8(4), 533–544. https://doi.org/10.37287/ijghr.v8i4.1944