Deming James R, Dunbar Kassie J, Lueck Joshua F, Oh Yoonsin
Home Health and Hospice, Mayo Clinic Health System - Northwest Wisconsin region, Eau Claire, WI.
Department of Kinesiology, University of Wisconsin - Eau Claire, Eau Claire, WI.
Mayo Clin Proc Digit Health. 2024 Sep;2(3):477-485. doi: 10.1016/j.mcpdig.2024.08.002. Epub 2024 Aug 10.
To learn more about the effect of virtual reality videos on patients' symptoms near the end of life, including which are most effective, how long the effect lasts, and which patients benefit the most.
We conducted a prospective study of 30 patients in a regional hospice and palliative care program from March 11, 2022, through July 14, 2023. Using a head-mounted display virtual reality, all participants viewed a 15-minute video of serene nature scenes with ambient sounds. Fifteen patients also participated in a second session of viewing bucket-list video clips they selected. Symptoms were measured with the revised Edmonton Symptom Assessment Scale before, immediately after, and 2 days after each experience. Participants rated their bucket-list selections by level of previous experience, strength of connection, and overall video quality. Functional status was also recorded.
Nature scenes significantly improved total symptom scores (30% decrease, <.001), as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved (31% decrease, .03). Patients with lower functional status tended to have more symptoms beforehand and improve the most.
Serene nature head-mounted display virtual reality scenes safely reduce symptoms at the end of life. Bucket-list experiences may be effective if they are high-quality. More infirm patients may benefit the most.
进一步了解虚拟现实视频对临终患者症状的影响，包括哪些视频最有效、效果持续时间以及哪些患者受益最大。
我们对2022年3月11日至2023年7月14日期间在某地区临终关怀与姑息治疗项目中的30名患者进行了一项前瞻性研究。所有参与者使用头戴式虚拟现实设备观看了一段15分钟的配有环境声音的宁静自然场景视频。15名患者还参加了第二阶段，观看他们自己选择的愿望清单视频片段。在每次体验前、体验后立即以及体验后2天，使用修订后的埃德蒙顿症状评估量表测量症状。参与者根据以往体验程度、关联强度和整体视频质量对他们选择的愿望清单视频进行评分。还记录了功能状态。
自然场景显著改善了总症状评分（降低30%，<.001），以及嗜睡、疲劳、抑郁、焦虑、幸福感和呼吸困难的评分。2天后这些改善的评分没有持续。总体而言，愿望清单视频没有显著改善症状。以往对某项活动的体验或强烈的关联与显著改善均无相关性；然而，当患者将视频质量评为优秀时，评分有所改善（降低31%，.03）。功能状态较低的患者事先往往症状更多，改善也最大。
头戴式设备播放的宁静自然虚拟现实场景可安全减轻临终患者的症状。高质量的愿望清单体验可能有效。身体更虚弱的患者可能受益最大。
