虚拟现实在癌症患者症状管理中的有效性：一项系统评价和荟萃分析。

Effectiveness of Virtual Reality in Symptom Management of Cancer Patients: A Systematic Review and Meta-Analysis.

作者信息

Wu Yuan, Wang Nannan, Zhang Huichao, Sun Xuhan, Wang Yuqing, Zhang Yuxi

机构信息

School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China.

Geriatric Hematology/Radiotherapy Ward, the First Affiliated Hospital of Nanjing Medical University (Y.Z.), 300 Guangzhou Road, Nanjing, Jiangsu, China.

出版信息

J Pain Symptom Manage. 2023 May;65(5):e467-e482. doi: 10.1016/j.jpainsymman.2023.01.023. Epub 2023 Feb 8.

DOI:10.1016/j.jpainsymman.2023.01.023

PMID:36758907

Abstract

CONTEXT

Although the survival rate of cancer patients has been increasing, such patients often experience severe physical and psychological burdens due to the effects of the disease and therapy. Multiple virtual reality (VR)-based interventions have been used to help improve physical and psychological symptoms and quality of life in cancer patients.

OBJECTIVE

This study aimed to assess the effects of VR-based interventions on anxiety, pain, depression, fear, distress, and quality of life in cancer patients.

METHODS

We conducted systematic searches in the PubMed, Web of Science, CINAHL, EMBASE, Cochrane Library, Scopus and APA PsycINFO databases from their inception to August 16, 2022. Two reviewers independently selected studies and extracted articles that met strict inclusion and exclusion criteria. Quality assessments of the included studies were performed according to the Cochrane risk assessment tool, and data analysis was performed using RevMan 5.4 software.

RESULTS

A total of 12 studies including 425 participants in the intervention group and 400 participants in the control group were selected for the final analysis. The results showed a significant difference between the VR and control groups for anxiety (standard mean difference [SMD] =-0.83, 95% CI -1.25 to -0.42, P < 0.001), SMD = pain (SMD =-0.86, 95% CI -1.36 to -0.35, P < 0.001), depression (SMD = -0.46, 95% CI -0.74 to -0.18, P = 0.001), fear (MD = -0.82, 95% CI -1.60 to -0.03, P = 0.04), and distress (SMD = -1.16, 95% CI -1.96 to -0.37, P = 0.004). However, no significant difference was observed in quality of life (SMD = 1.01, 95% CI -0.67 to 2.70, P = 0.24).

CONCLUSIONS

VR interventions were effective in improving physical and psychological symptoms in cancer patients. Due to the limited number of studies, small sample sizes, and moderate to high heterogeneity, these results should be interpreted with caution. More rigorous, comprehensive and high-quality randomized controlled trials (RCTs) are needed to validate the results of this study.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022304931;https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=304931.

摘要

背景

尽管癌症患者的生存率一直在提高，但由于疾病和治疗的影响，这些患者常常承受着严重的身心负担。多种基于虚拟现实（VR）的干预措施已被用于帮助改善癌症患者的身体和心理症状以及生活质量。

目的

本研究旨在评估基于VR的干预措施对癌症患者焦虑、疼痛、抑郁、恐惧、痛苦和生活质量的影响。

方法

我们在PubMed、科学网、护理学与健康领域数据库（CINAHL）、EMBASE、考克兰图书馆、Scopus和美国心理学会心理学文摘数据库（APA PsycINFO）中进行了系统检索，检索时间范围从各数据库创建至2022年8月16日。两名评审员独立筛选研究并提取符合严格纳入和排除标准的文章。根据考克兰风险评估工具对纳入研究进行质量评估，并使用RevMan 5.4软件进行数据分析。

结果

最终分析共纳入12项研究，干预组有425名参与者，对照组有400名参与者。结果显示，VR组和对照组在焦虑方面存在显著差异（标准均差[SMD]=-0.83，95%置信区间[-1.25，-0.42]，P<0.001）、疼痛（SMD=-0.86，95%置信区间[-1.36，-0.35]，P<0.001）、抑郁（SMD=-0.46，95%置信区间[-0.74，-0.18]，P=0.001）、恐惧（MD=-0.82，95%置信区间[-1.60，-0.03]，P=0.04）和痛苦（SMD=-1.16，95%置信区间[-1.96，-0.37]，P=0.004）。然而，在生活质量方面未观察到显著差异（SMD=1.01，95%置信区间[-0.67，2.70]，P=0.24）。