Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Department of Pain and Translational Symptom Science, School of Nursing and Department of Anesthesiology School of Medicine, University of Maryland, Baltimore, MD.
Palliat Support Care. 2022 Aug;20(4):471-481. doi: 10.1017/S1478951521002017.
OBJECTIVE: Virtual reality (VR) has the potential to improve pain and pain-related symptoms. We examined the feasibility, acceptability, safety, and impact of a 30-min virtual underwater/sea environment (VR Blue) for reducing pain and pain-related symptoms in advanced colorectal cancer patients. A qualitative exit interview was conducted to understand preferences, thoughts, and feelings about the VR session. METHOD: Participants ( = 20) had stage IV colorectal cancer and moderate-to-severe pain. Participants completed a 30-min VR Blue session that visually and aurally immersed them in virtual ocean scenarios. Feasibility was assessed by accrual ( = 20), protocol adherence (≥80% completing VR Blue), and completed data (≥80% assessment completion). Acceptability was determined by patients reporting ≥80% intervention satisfaction. Safety was determined by ≥80% of patients completing the session without self-reported side effects. Measures of pain, tension, relaxation, stress, anxiety, and mood were collected before, during, and after the VR Blue session. A semi-structured qualitative interview was conducted after VR Blue to assess participants' VR experiences. RESULTS: All participants (100%) completed the VR Blue session. There was 100% data collection at the pre- and post-assessments. Satisfaction with VR Blue was high = 3.3 (SD = 0.4) (83%). No significant side effects were reported. Pain decreased by 59% (Pre- = 3 [1]; Post- = 1 [1]). Tension decreased by 74% (Pre- = 30 [24]; Post- = 8 [13]). Relaxation improved by 38% (Pre- = 62 [21]); Post- = 86 [17]). Stress decreased by 68% (Pre- = 24 [24]; Post- = 8 [14]). Anxiety decreased by 65% (Pre- = 20 [23]; Post- = 7 [13]). Mood improved by 70% (Pre- = 13 [16]; Post- = 4 [11]). Qualitative data suggested a positive response to the VR Blue protocol. SIGNIFICANCE OF RESULTS: This work supports the feasibility, acceptability, and safety of VR Blue for advanced colorectal cancer patients. Participants showed significant pre-post improvement in pain and pain-related symptoms hinting to the potential feasibility of VR interventions in this population. Larger, randomized trials with a control condition are needed to examine the efficacy of VR-based interventions for patients with advanced colorectal cancer and pain.
目的：虚拟现实（VR）有可能改善疼痛和相关症状。我们研究了 30 分钟虚拟水下/海洋环境（VR Blue）用于减轻晚期结直肠癌患者疼痛和相关症状的可行性、可接受性、安全性和影响。通过定性退出访谈了解参与者对 VR 体验的偏好、想法和感受。
方法：参与者（n=20）患有 IV 期结直肠癌和中重度疼痛。参与者完成了 30 分钟的 VR Blue 疗程，该疗程通过视觉和听觉将他们沉浸在虚拟海洋场景中。通过以下指标评估可行性：入组（n=20）、遵守方案（完成 VR Blue 的比例≥80%）和完成数据（评估完成比例≥80%）。接受度由患者报告的干预满意度≥80%确定。安全性由≥80%的患者在没有自我报告的副作用的情况下完成疗程来确定。在 VR Blue 疗程前后采集疼痛、紧张、放松、压力、焦虑和情绪的测量值。在 VR Blue 后进行半结构化定性访谈，以评估参与者的 VR 体验。
结果：所有参与者（100%）均完成了 VR Blue 疗程。在预评估和后评估时均达到了 100%的数据采集。VR Blue 的满意度很高（=3.3（SD=0.4）（83%））。没有报告明显的副作用。疼痛降低了 59%（术前=3[1]；术后=1[1]）。紧张度降低了 74%（术前=30[24]；术后=8[13]）。放松度提高了 38%（术前=62[21]；术后=86[17]）。压力降低了 68%（术前=24[24]；术后=8[14]）。焦虑降低了 65%（术前=20[23]；术后=7[13]）。情绪改善了 70%（术前=13[16]；术后=4[11]）。定性数据表明参与者对 VR Blue 方案有积极的反应。
意义：这项工作支持 VR Blue 用于晚期结直肠癌患者的可行性、可接受性和安全性。参与者在疼痛和相关症状方面表现出显著的前后改善，这暗示了 VR 干预在该人群中的潜在可行性。需要更大的、随机对照试验和对照条件来研究基于 VR 的干预措施对晚期结直肠癌和疼痛患者的疗效。
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