Department of Biomedicine and Prevention, PhD School in Nursing Science and Public Health, University of Rome "Tor Vergata", Viale Montpellier, 1, 00133, Rome, Italy.
Department of Medicine and Surgery, Research Unit Nursing Science, Campus Bio-Medico of Rome University, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
Eur J Oncol Nurs. 2023 Jun;64:102340. doi: 10.1016/j.ejon.2023.102340. Epub 2023 May 16.
This Systematic review and meta-analysis aimed to assess the effectiveness of Virtual Reality on anxiety, fatigue and pain in patients with cancer during chemotherapy and provide evidence for decision-making in clinical practice.
A systematic literature search was performed in the databases PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature and the Cochrane Library. Risk of Bias was used to assess the quality of individual studies, and Grading of Recommendations Assessment, Development and Evaluation was used to assess confidence for each individual outcome. A random-effects model was used to examine the overall effect.
Four randomized controlled trials and four crossover studies were included, with an overall sample of 459 patients. Results showed that Virtual Reality compared with standard care had a significant reduction of anxiety only (MD = -6.57, 95% CI: -11.59 to -1.54, p = 0.01) but with considerable heterogeneity (I = 92%), while Virtual Reality was not significantly different from integrative interventions. The trials included showed small sample sizes, lack of statistical power, low methodological quality, high heterogeneity, and different Virtual Reality technology types, lengths and frequencies.
The quality of evidence is very low and the strength of recommendation is weak. Further research has large potential for reducing uncertainty about the effects of Virtual Reality in patients with cancer receiving chemotherapy. This study was registered with PROSPERO as CRD42020223375.
本系统评价和荟萃分析旨在评估虚拟现实在癌症化疗患者的焦虑、疲劳和疼痛方面的有效性，并为临床实践中的决策提供证据。
在 PubMed、Web of Science、Scopus、Cumulative Index of Nursing and Allied Health Literature 和 Cochrane Library 数据库中进行了系统文献检索。使用偏倚风险评估来评估个体研究的质量，并使用推荐评估、制定和评估分级法来评估每个个体结局的置信度。使用随机效应模型来检验总体效果。
共纳入 4 项随机对照试验和 4 项交叉研究，总体样本量为 459 例患者。结果表明，与标准护理相比，虚拟现实仅在焦虑方面有显著降低（MD=-6.57，95%CI：-11.59 至-1.54，p=0.01），但存在较大异质性（I=92%），而虚拟现实与综合干预无显著差异。纳入的试验显示样本量小、缺乏统计学效力、方法学质量低、异质性高，且虚拟现实技术类型、时长和频率不同。
证据质量极低，推荐强度较弱。进一步的研究有很大的潜力降低对接受化疗的癌症患者使用虚拟现实效果的不确定性。本研究已在 PROSPERO 注册，注册号为 CRD42020223375。
