Suture is a frequent medical procedure for treatment and management of wound bleeding in the emergency department. However, the procedure often provoke anxiety and pain. 1-2 Failure to manage patients' anxiety and pain during the medical procedures can cause difficulties for health care providers to complete the procedures and reduce the success rates. 3 Experience of anxiety and pain may also increase the need for medication, reduce patients' satisfaction rate and cause negative physiological parameters such as increased blood pressure and heart rate. 4-5.~Traditionally, nonpharmacological intervention such as listening to music, chatting, and guided imagery is used to reduce patient's anxiety and pain. However these measures fail to provide significant distraction for patient with suture because patients would inevitably see the procedure that causes considerable distress during the procedure. Thus, the development of further strategies to provide a significant distraction to alleviate patients' anxiety and pain during suture is warranted.~With advanced technologies, virtual reality (VR) provides significant distraction. Clinical trials indicate that use of VR achieved a statistically significant decrease in anxiety and pain in different operations such as hand 6, lipoma incision 7, Gynecology 8, and debridement 9. However, only a handful of studies conducted among adult patient with ambulatory laceration repairing examined the effectiveness of VR in anxiety and pain. To the best of our knowledge, no study specifically focus on the effects of VR on anxiety and pain in Chinese adult patients undergoing an awake suture in emergency room in Hong Kong.~Eighty participants will be assigned to the experimental group or control group by the computer generated random numbers.~After written informed consent are obtained from patients, the baseline data (T0) will be obtained from the participants including sociodemographic, anxiety, blood pressure, and pulse rate. Subsequently, randomization is conducted by computer generated random codes. Throughout the procedure (T1), the additional medication use and physiological parameters will be recorded. The pain and satisfaction will also be assessed by visual analogue scales after the procedure.~Data will be analyzed using IBM SPSS 23.0. Descriptive statistics, including frequency, percentage, mean and standard deviation will be used to describe the data. Chi-square tests compare categorical variables, and independent t-tests compare continuous variables. RMANOVA compare change over time between the two groups. Two-tailed tests will be used with a significant level of 0.05.
The goal of this clinical trial is to examine the effectiveness of virtual reality (VR) in alleviating anxiety and pain among adult patients undergoing an awake minor suture. The main questions it aims to answer are:~How effective is VR intervention in reducing anxiety among adult patients undergoing an awake minor suture?~How effective is VR intervention in reducing pain level among adult patients undergoing an awake minor suture?~How effective is VR intervention in reducing the medication requirement of adult patients undergoing an awake minor suture?~How effective is VR intervention in reducing the physiological parameters including blood pressure and pulse rate, in adult patients undergoing an awake minor suture?~How effective is VR intervention in enhancing procedure satisfaction in adult patients undergoing an awake minor suture?~A RCT will be adopted. Participants will be randomly assigned to either an experimental group or control group.