The Impact of Virtual Reality with Relaxation Music and Distraction Cards on Pain, Anxiety, and Satisfaction Levels of Women with an Intrauterine Device: A Randomized Controlled Trial

Introduction Approximately 161 million women worldwide use intrauterine devices (IUDs), but insertion can cause pain and anxiety. This study examined the effects of virtual reality (nature video and music) and distraction cards on pain, anxiety, and satisfaction during IUD insertion. Methods This randomized controlled study included 117 women undergoing IUD insertion, assigned randomly to 1 of 3 groups: virtual reality (nature video and music), distraction cards, or control (n = 39 each). Measures included a demographic form, the State‐Trait Anxiety Scale, the Newcastle Satisfaction with Nursing Care Scale, and the Visual Analog Scale. These were administered to all 3 groups at 4 time points: (1) speculum insertion, (2) tenaculum application, (3) IUD insertion, and (4) 15 minutes after IUD insertion. Pulse rate and oxygen saturation were also recorded. Results The women's mean (SD) age was 30.2 (6.5) years. A significant effect was observed for group assignment ( F 2,114 = 18.754; η 2 = .248; P < .001). A significant group*time interaction was found for anxiety ( F 2,114 = 18.270; η 2 = .243; P < .001) and pain scores ( F 2,114 = 25.309; η 2 = .309; P < .001). Anxiety scores were significantly higher in the control group than in the virtual reality and distraction card groups ( P < .001). After the procedure, anxiety increased in the control group but decreased significantly in the virtual reality group ( P < .001). Pain scores were also consistently higher in the control group across all time points ( P < .001). Pain peaked during IUD insertion in the distraction card and control groups but was significantly lower 15 minutes postinsertion than after tenaculum application. These pain and anxiety differences were clinically significant. Discussion Using virtual reality and distraction cards during IUD insertion reduced pain and anxiety and increased satisfaction. Findings support the use of noninvasive, user‐friendly techniques as complementary therapies during IUD insertions. ClinicalTrials.gov Identifier : NCT05655052.