Henrik Hjelmgren, Johanna Granhagen Jungner, Cecilia Bartholdson, Klas Kalholm, Anna Stålberg
Parents play a crucial role in supporting their children during pediatric hospital visits, where needle-related procedures are commonly performed. Both children and parents may experience distress related to needles, which can make these procedures more challenging. Adequate distraction, such as extended reality, may help to mitigate these potential difficulties. The aim of this study was to explore parents' perspectives on their child's use of extended reality as a distraction during a needle-related procedure. In this exploratory and prospective mixed-methods study, a total of 30 parents completed a study-specific survey and 26 were interviewed. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using reflexive thematic analysis informed by Braun and Clarke. Parents generally reported positive experiences with XR distraction, with high mean scores for recommending the XR device to other children undergoing a similar procedure (VR 5.00; AR 4.86, scale 1-5). Parent-reported child pain was low in both groups (mean 0.93 for VR and 1.38 for AR, NRS 0-10). Some differences in parents' responses between virtual and augmented reality were observed; however, the study was not designed or powered to detect differences between the two approaches. Nevertheless, parents perceived both approaches as supporting pain and anxiety relief during the needle-related procedure. Five themes were developed through the qualitative analysis: A rewarding addition for the child, Redirection of the child's attention, The importance of the user perspective, Diversified emotional reactions among parents, and Modified roles for nurses and parents. In conclusion, parents viewed extended reality distraction as a valuable tool for supporting children during needle-related procedures. They described its potential to alleviate distress, redirect attention, and provide moments of calm and reassurance for both children and adults. While some concerns were raised, the overall parental perspective was that extended reality can serve as a meaningful resource in clinical care. The findings suggest that future implementation should adopt a flexible, family-centered approach that balances the technological benefits with the preservation of therapeutic relationships.