Effectiveness of Virtual Reality in Pain Management, Anxiety Control, and Patient Satisfaction in Bronchoscopy: A Systematic Review Protocol

Bronchoscopy is a common invasive procedure that can cause significant anxiety, discomfort, and pain in patients. Virtual reality (VR) has emerged as a promising non-pharmacological intervention to alleviate these negative experiences and improve patient outcomes. This systematic review aims to comprehensively synthesize the current evidence on the effectiveness of VR in enhancing pain management, anxiety control, and patient satisfaction during bronchoscopy procedures. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically search multiple electronic databases, including PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO, and Scopus, from their inception to July 2025. Randomized controlled trials (RCTs) comparing VR interventions to standard care or other non-pharmacological interventions in adult patients undergoing bronchoscopy will be included. The primary outcomes of interest are pain intensity, anxiety levels, and patient satisfaction, measured using validated scales or questionnaires. Secondary outcomes will include physiological parameters, procedure duration, medication use, and adverse events related to VR interventions. Two reviewers will independently screen studies, extract data, and assess risk of bias using the Cochrane Risk of Bias tool for RCTs and the ROBINS-I tool for non-randomized studies. If feasible, a meta-analysis will be conducted to quantitatively synthesize the results. Subgroup and sensitivity analyses will be performed to explore potential sources of heterogeneity and assess the robustness of the findings. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to evaluate the overall certainty of evidence for each outcome. This systematic review protocol is guided by established frameworks, including the PICO (Population, Intervention, Comparison, Outcome), PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols), and FINER (Feasible, Interesting, Novel, Ethical, and Relevant) criteria. By providing a transparent and rigorous evaluation of the effectiveness of VR in improving patient experience during bronchoscopy, this review will offer valuable insights to inform clinical practice, guide health policy decisions, and identify areas for future research.