Chin Stanley, Cavadino Alana, Akroyd Amelia, Tennant Geraldine, Dobson Rosie, Gautier Adele, Reynolds Lisa
Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.
Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand.
JMIR Cancer. 2022 Jul 22;8(3):e38300. doi: 10.2196/38300.
Connection with nature has well-established physical and psychological benefits. However, women with metastatic breast cancer (MBC) are often unable to access nature because of physical limitations, psychological barriers, and treatment demands. Virtual reality (VR) nature experiences offer an alternative means of connecting with nature and may be of particular benefit to patients with cancer who are house- or hospital-bound.
This study aims to explore whether VR nature experiences are associated with physical and psychological benefits for women with MBC who are disconnected with nature.
This secondary analysis of a previous randomized controlled crossover trial recruited participants from the emailing lists of breast cancer support organizations. Participants were provided VR headsets for daily use in their homes for over 3 weeks. In the first week, participants used 1 of 2 VR nature experiences (Ripple or Happy Place) daily, followed by a 1-week washout period, before using the other VR experience every day for the final week. Outcomes assessed changes between baseline and postintervention scores in quality of life (EQ-5D-5L), pain (Brief Pain Inventory Short Form), fatigue (Functional Assessment of Chronic Illness Therapy-fatigue), depression (Depression, Anxiety, and Stress Scale-depression), anxiety (Depression, Anxiety, and Stress Scale-anxiety), and spiritual well-being (Functional Assessment of Chronic Illness Therapy- Spiritual Well-being) and investigated whether benefits were greater in participants who were not strongly connected with nature at baseline.
A total of 38 women with MBC completed the VR interventions and were included in the analyses. Participants reported significantly less fatigue (P=.001), less depression (P<.001), and greater quality of life (P=.02) following the interventions than at baseline. Women with a weaker connection to nature reported greater fatigue (P=.03), depression (P=.006), and anxiety (P=.001), and poorer spirituality (P=.004) than their strongly connected counterparts. Only those with a weaker baseline connection with nature showed improvements in depression following the intervention (P=.03), with similar trends observed in fatigue (P=.07) and quality of life (P=.10).
This study provides preliminary evidence that feeling connected with nature is associated with better physical and psychological status in patients with MBC and that VR nature interventions might be beneficial for this clinical population. Future studies should focus on activities that encourage connection with nature (rather than simply exposure to nature) and investigate the aspects of VR nature interventions that have the greatest therapeutic potential.
Australian New Zealand Clinical Trials Registry ACTRN12619001480178; https://tinyurl.com/et6z3vac.
与自然接触已被证实对身体和心理有益。然而，转移性乳腺癌（MBC）女性患者常常由于身体限制、心理障碍和治疗需求而无法接触自然。虚拟现实（VR）自然体验提供了一种与自然接触的替代方式，对于居家或住院的癌症患者可能特别有益。
本研究旨在探讨VR自然体验是否对与自然脱节的MBC女性患者的身体和心理有益。
这项对先前随机对照交叉试验的二次分析从乳腺癌支持组织的邮件列表中招募参与者。为参与者提供VR头戴式设备，供其在家中每日使用超过3周。在第一周，参与者每天使用两种VR自然体验（涟漪或快乐之地）中的一种，随后是1周的洗脱期，最后一周每天使用另一种VR体验。评估的结果包括生活质量（EQ-5D-5L）、疼痛（简明疼痛问卷简表）、疲劳（慢性病治疗功能评估-疲劳）、抑郁（抑郁、焦虑和压力量表-抑郁）、焦虑（抑郁、焦虑和压力量表-焦虑）以及精神幸福感（慢性病治疗功能评估-精神幸福感）在基线和干预后得分的变化，并调查基线时与自然联系不紧密的参与者的获益是否更大。
共有38名MBC女性完成了VR干预并纳入分析。与基线相比，参与者在干预后报告的疲劳感明显减轻（P = 0.001）、抑郁感减轻（P < 0.001），生活质量提高（P = 0.02）。与自然联系较弱的女性比联系紧密的女性报告有更严重的疲劳（P = 0.03）、抑郁（P = 0.006）和焦虑（P = 0.001），以及更差的精神状态（P = 0.004）。只有那些基线与自然联系较弱的女性在干预后抑郁有所改善（P = 0.03），疲劳（P = 0.07）和生活质量（P = 0.10）也有类似趋势。
本研究提供了初步证据，表明与自然建立联系与MBC患者更好的身体和心理状态相关，并且VR自然干预可能对这一临床人群有益。未来的研究应关注鼓励与自然建立联系的活动（而不仅仅是接触自然），并研究VR自然干预中具有最大治疗潜力的方面。
澳大利亚新西兰临床试验注册中心ACTRN12619001480178；https://tinyurl.com/et6z3vac
