Table 1.

Characteristics of the sample, protocol, and intervention.

Study	Design	Population	Outcomes	Intervention	Timing	Results	Limitations	Selection Criteria
Alemi M et al. [19]	RCT	11 participants with any type of cancer. 7–12 years (Mean = 9.45) GC: n = 5 GI: n = 10; 4 dropouts Does not specify gender	Anxiety: MASC. Depression: CDI. Anger: CIA.	Use of the Robot NAO in 8 scenarios (8 sessions during 3 weeks) Different roles in each session.	Pretest: Before 1st session Post-test: after 3 weeks of intervention	GI: Decrease anxiety, depression and anger. GC: No differences	Small sample Difficulty to complete 8 sessions They knew the research team before study	Pediatric sample. Participants in active oncological treatment.
Fazelniya Z et al. [20]	RCT with two step test plan of before and after the intervention	64 participants with cancer in active Chemotherapy treatment 8–12 years (Mean = 10.05) GC: n = 32; (Mean age: 10.2) GI: n = 32; (Mean age: 9.9) 30 girls (46.88%)	Quality of Life: PedsQL with specific dimensions for pediatric cancer (pain and anxiety)	GI: Play a Videogame 3 h peer week 1 month GC: Care routine	Pretest: Before intervention Post-test: Immediately after the intervention Follow-up: 4 weeks in the intervention’s period	GI: Improve quality of life after intervention and 1 month of follow-up GC: No changes	Small sample Short follow-up. Use of other ways to education during the study	Pediatric sample with any type of cancer. Ability to read and use videogames. No physical or mental deficits before the disease.
Jibb L et al. [25]	A pilot one-group pre-post study	N = 40 participants with cancer 12–18 years old (Mean: 14.2) 17 girls (43%)	Effectiveness of the mobile App: AES. Pain: BPI. Interference of pain: PROMIS-PPI-SFS Quality of Life: PedsQL. Self-efficacy: GSE-Sherer.	Use an app during 28 days and participants’ valuation after intervention.	Pretest: Before intervention Post-test after Intervention Follow up: 28 days in the intervention’s period.	GI: Improves pain intensity and interference. Good adherence although it was reduced over time	Pilot Study. Small sample. No control group.	Pediatric sample Active oncological treatment at least 2 months Pain registers higher than 3 (VAS) at least once a week prior selection. Not comorbidities. Not final phase of life.
Atzori B et al. [21]	RCT	N= 15 participants with cancer (n = 11) and hematological diseases. (n = 4). GC: n = 15 GI: n = 15 (They all go through both conditions) 5 girls (33.3%) Mean age: 10.92	Pain: VAS Quality of VR: Self-administered questionnaire. Sickness: VAS Fun: VAS	GI: Use of VR during a venous puncture. GC: A conversation as a distraction	A single measurement after the application of the invasive technique.	GI: Improve pain after use VR during invasive technique. Higher level of fun. GC: Higher level of pain. No sickness differences between groups.	Small sample. Use of a care standard as an intervention in the GC instead of a Conventional intervention.	Pediatric sample with oncological and hematological diseases. Participants without physical or mental deficits before disease. Able to wear a helmet and willing to interact with the VR environment.
Nilsson et al. [22]	RCT	42 participants with any type of cancer. 5–18 years (Mean age: 11) GC: n = 21 (Mean age: 11) GI: n = 21 (Mean age: 11) 4 dropouts. 17 girls (40.5%)	Pain: CAS, FAS, FLACC, Heart rate.	VR as a distraction during a puncture.	Test before intervention, during intervention and immediately after the intervention. No follow up.	No significant differences between GC and GI.	Small sample. Difficulty to adapt the VR to the procedure.	Pediatric sample with any type of cancer. No cognitive impairments.
Li et al. [23]	Quasi experimental control group pre-post between-subject design.	122 participants with any type of cancer 8–16 years (No mean age in total group) GC: n = 70 (Mean age: 12.1) GI: n= 52 (Mean age: 11.6) No dropouts. 57 girls (46.7%)	State Anxiety: CSAS-C; Depressive symptom: CES-DC	Game of Virtual reality in groups	Two phases: pre-test (phase 1), a washing period, (1 month), post-test (phase 2). No follow up.	GI: Decrease depressive symptom. No significative differences in anxiety. GC: No changes.	Little generalizable results. Difficulty to participate in intervention after chemotherapy	Pediatric sample with any type of cancer. No cognitive or learning problems.
Li et al. [24]	Quasi experimental control group pre-post between-subject design.	122 participants with any type of cancer. 8–16 years. GC: n = 70 (Mean age: 12.1) GI: n= 52 (Mean age: 11.6). No dropouts. 57 girls (46.7%).	Depressive symptom: CES-DC.	Game of Virtual reality in groups	Two phases: pre-test (phase 1), a washing period, (1 month), post-test (phase 2). No follow up	GI: Decrease depressive symptom. GC: No changes.	Little generalizable results. Difficulty to participate in intervention after chemotherapy	Pediatric sample with any type of cancer. No cognitive or learning problems.
Jibb L et al. [18]	Parallel Clinical randomized trial	N= 40 participants with cancer 4–9 years old. Mean of age: 6.2 16 girls (40%) GI: n = 19 GC: n = 21	Pain: FPS-R Stress: BAADS Fear: CFS	Robot that uses cognitive-behavioral interventions or dances and sings during puncture.	Pretest: Pain level in previous punctures. Post-test: Immediately after the intervention.	There were not differences in pain, fear and stress levels in both groups.	Results difficult to generalize (single site study). Limited robot ability to assess impact on pain	Pediatric sample. In active oncological treatment at least 1 month since diagnosed. No previous physical or mental problems. Previously exposed to venous punctures.

Abbreviations: AES: Acceptability E-Scale; App: Application; BAADS: Behavioral Approach-Avoidance and Distress Scale; BPI: Brief Pain Inventory; CAS: Color Analogue Scale; CDI: Children’s Depression Inventory; CES-DC: Center for Epidemiologic Studies Depression Scale For Children; CFS: Children’s Fear Scale; CIA: Children’s Inventory of Anger; CSAS-C: Chinese Version of the State Anxiety Scale for Children; FAS: Facial Affective Scale; FLACC: the Face, Legs, Activity, Cry and Consolability Scale; FPS-R: Faces Pain Scale-Revised; GSE-Sherer: General Self-Efficacy Scale; MASC: Multidimensional Anxiety Scale for Children; N= Total number of participants; n= Number of participants in a group; PedsQL: Pediatric Quality of Life Inventory; PROMIS-PPI-SFS: Patient Reported Outcomes Measurement Information System Pediatric Pain Interference Short form Scale; RCT: Randomized Controlled Trial; VAS: Visual Analogue Scale; VR: Virtual Reality. Countries where the studies were conducted: Canada [18,25], Iran [19,20], China [23,24], Sweden [22], and Italy [21].