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虚拟现实在乳腺癌围手术期焦虑和疼痛管理中的有效性:系统评价和荟萃分析。

Effectiveness of Virtual Reality in the Management of Anxiety and Pain Peri-Treatment for Breast Cancer: A Systematic Review and Meta-Analysis.

机构信息

BSN, RN, Master Student, School of Nursing, Qingdao University of China.

PhD, RN, Associate Professor, School of Nursing, Qingdao University of China.

出版信息

J Nurs Res. 2024 Aug 1;32(4):e343. doi: 10.1097/jnr.0000000000000623.

Abstract

BACKGROUND

Breast cancer is the second most common cancer in humans. Its therapy procedures such as breast biopsy can cause anxiety and persistent pain in patients. Virtual reality (VR) has been applied to promote comfort in various populations. However, the effectiveness of VR in relieving pain and anxiety in patients undergoing breast cancer treatment is unclear.

PURPOSE

This study was designed to examine the effect of VR on anxiety and pain in people undergoing treatment for breast cancer.

METHODS

PubMed, Cochrane, Embase, Scopus, Web of Science, and MEDLINE databases were searched for studies involving VR, pain, and anxiety in patients with breast cancer published up to March 2022. The Cochrane Handbook for Systems quality evaluation standard 6.3.0 was followed to assess risk of bias in the identified studies, with the results reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Subsequently, a meta-analysis of the included data was conducted using RevMan 5.3 software.

RESULTS

Six randomized controlled trials and one quasi-experimental study were included. The strength of the evidence ranged from moderate to high. Although VR was found to ameliorate anxiety in patients with breast cancer, only three studies showed statistically significant changes. All of the included studies reported statistically significant improvement in pain levels. In addition, two of the studies reported cybersickness symptoms as a common side effect of VR.

CONCLUSIONS

VR has an important role to play in alleviating pain in patients with breast cancer. However, evidence demonstrating VR's importance in alleviating anxiety symptoms in this population is insufficient. Studies conducted with larger sample sizes and high-quality research methodologies will be necessary to clarify this issue. Clinical nurses should address the potential side effects of VR.

摘要

背景

乳腺癌是人类第二大常见癌症。其治疗程序,如乳房活组织检查,可能会引起患者的焦虑和持续疼痛。虚拟现实(VR)已被应用于促进各种人群的舒适度。然而,VR 在缓解乳腺癌治疗患者的疼痛和焦虑方面的效果尚不清楚。

目的

本研究旨在检查 VR 对接受乳腺癌治疗的患者的焦虑和疼痛的影响。

方法

检索了 PubMed、Cochrane、Embase、Scopus、Web of Science 和 MEDLINE 数据库,以获取截至 2022 年 3 月发表的关于 VR、乳腺癌患者疼痛和焦虑的研究。按照 Cochrane 系统评价手册 6.3.0 评估纳入研究的偏倚风险,结果按照系统评价和荟萃分析报告的首选报告项目进行报告。随后,使用 RevMan 5.3 软件对纳入的数据进行荟萃分析。

结果

纳入了 6 项随机对照试验和 1 项准实验研究。证据强度从中等到高不等。尽管 VR 被发现可改善乳腺癌患者的焦虑,但只有 3 项研究显示出统计学上的显著变化。所有纳入的研究均报告疼痛水平有统计学意义的改善。此外,有两项研究报告了虚拟现实的常见副作用——网络晕动症。

结论

VR 在缓解乳腺癌患者的疼痛方面具有重要作用。然而,证明 VR 在缓解该人群焦虑症状方面的重要性的证据不足。需要进行更大样本量和高质量研究方法的研究来阐明这个问题。临床护士应注意 VR 的潜在副作用。

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