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针对临床评估时原发性脑肿瘤患者的痛苦和焦虑的虚拟现实干预的可行性和初步疗效:一项 2 期临床试验的研究方案。

Feasibility and preliminary efficacy of a virtual reality intervention targeting distress and anxiety in primary brain tumor patients at the time of clinical evaluation: Study protocol for a phase 2 clinical trial.

机构信息

Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.

出版信息

BMC Cancer. 2023 Mar 21;23(1):262. doi: 10.1186/s12885-023-10671-2.

Abstract

BACKGROUND

Primary brain tumor (PBT) patients experience higher levels of distress and anxiety than other solid tumor patients, particularly at the time of clinical evaluation when uncertainty about disease status is high ("scanxiety"). There is promising evidence supporting use of virtual reality (VR) to target psychological symptoms in other solid tumor patients, though PBT patients have not been studied extensively in this context. The primary aim of this phase 2 clinical trial is to establish the feasibility of a remote VR-based relaxation intervention for a PBT population, with secondary aims designed to determine preliminary efficacy of improving distress and anxiety symptoms.

METHODS

PBT patients (N = 120) with upcoming MRI scans and clinical appointments who meet eligibility will be recruited to participate in a single arm trial conducted remotely through the NIH. Following completion of baseline assessments, participants will complete a 5-min VR intervention via telehealth using a head-mounted immersive device while under supervision of the research team. Following the intervention, over the course of 1 month patients can use VR at their discretion with follow-up assessments done immediately post-VR intervention, as well as 1 week and 4 weeks later. Additionally, a qualitative phone interview will be conducted to assess patient satisfaction with the intervention.

DISCUSSION

Use of immersive VR is an innovative interventional approach to target distress and scanxiety symptoms in PBT patients who are at high risk for experiencing these symptoms leading into their clinical appointments. Findings from this study may inform design of a future multicenter randomized VR trial for PBT patients and may aid in development of similar interventions for other oncology populations.

TRIAL REGISTRATION

Clinicaltrials.gov (NCT04301089), registered 9 March 2020.

摘要

背景

原发性脑肿瘤(PBT)患者比其他实体瘤患者经历更高水平的痛苦和焦虑,尤其是在疾病状态不确定的临床评估时(“扫描焦虑”)。有证据表明,虚拟现实(VR)可用于治疗其他实体瘤患者的心理症状,但在这种情况下,尚未对 PBT 患者进行广泛研究。这项 2 期临床试验的主要目的是确定针对 PBT 人群的远程基于 VR 的放松干预措施的可行性,次要目的旨在确定改善痛苦和焦虑症状的初步疗效。

方法

符合条件的即将进行 MRI 扫描和临床预约的 PBT 患者(N=120)将被招募参与通过 NIH 远程进行的单臂试验。完成基线评估后,参与者将通过远程医疗使用头戴式沉浸式设备完成 5 分钟 VR 干预,同时由研究团队进行监督。干预后,在接下来的 1 个月内,患者可以自行决定使用 VR,在立即进行 VR 干预后、1 周后和 4 周后进行随访评估。此外,还将进行定性电话访谈,以评估患者对干预措施的满意度。

讨论

使用沉浸式 VR 是一种创新的干预方法,可针对可能出现这些症状的 PBT 患者的痛苦和扫描焦虑症状进行治疗,这些患者在临床预约前面临着出现这些症状的高风险。这项研究的结果可能为未来针对 PBT 患者的多中心随机 VR 试验设计提供信息,并有助于为其他肿瘤患者开发类似的干预措施。

试验注册

Clinicaltrials.gov(NCT04301089),于 2020 年 3 月 9 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a8f/10032008/4203e2111bb5/12885_2023_10671_Fig1_HTML.jpg

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