Department of Palliative Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany.
Psychological Institute and Network Aging Research, Ruprecht Karls University of Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany.
BMC Palliat Care. 2024 Oct 23;23(1):247. doi: 10.1186/s12904-024-01577-2.
Cancer patients benefit from Virtual Reality (VR) in burdensome situations, but evidence is scarce for palliative situations. Based on earlier work in palliative care, individualized VR interventions like seeing the patient's home may address a patient's wish to be at home and thus have a greater effect compared to standard VR content. Yet, some patients and relatives may be concerned about their privacy. Also, patient stakeholders raised concerns about triggering depressed mood or homesickness.
To test the feasibility and safety of individualized vs. standard 360°video VR interventions in palliative cancer inpatients.
Prospective observational study with patient-reported outcome measurement using validated instruments of well-being (MDBF), symptoms and psychosocial burden (IPOS), cybersickness (SSQ), presence experience (SPES), subjective benefit (2 items), content analysis of interviews, and field notes. Individualized VR content was recorded with action camcorder-technology to protect the patients' privacy.
Seventeen patients participated, median age 65 years (range 20-82), 9 women (53%), 8 single or widowed (47%), 4 childless (23.5%), 4 academics (23.5%), with a median length of stay of 9 days (1-75) in the hematology (10), palliative care (3), or radiotherapy (2) unit of a German university hospital. Eight patients (53.3%) chose their own home environments or family for individualized VR-content. All participants enjoyed the intervention. Compared to standard VR content the individualized VR tended to have a stronger effect on well-being and emotional touch. It was not inferior in terms of psychosocial burden and cybersickness. No subjective and relevant side effects occurred. The patients well tolerated the assessments. However, most patients demanded a lighter headset and a desire for more interactivity.
Individualization of VR content shows potential for enhancement of immersion, which improves the VR experience and does not harm in terms of depressed mood or worsening of symptoms. The patients' and family desire for privacy is feasible with the support of family members who recorded the individualized videos, which is easily manageable today. We suggest a pragmatic randomized clinical trial to compare the effects of individualized vs. standard VR-content.
Registered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11/07/2023.
癌症患者在负担过重的情况下受益于虚拟现实 (VR)，但在姑息治疗情况下的证据有限。基于姑息治疗中的早期工作，像看到患者的家这样的个性化 VR 干预措施可能会满足患者在家的愿望，因此与标准 VR 内容相比效果更大。然而，一些患者和家属可能担心他们的隐私。此外，患者利益相关者对引发抑郁情绪或思乡之情表示担忧。
测试个性化与标准 360°视频 VR 干预措施在姑息治疗癌症住院患者中的可行性和安全性。
前瞻性观察研究，使用经过验证的幸福感量表（MDBF）、症状和心理社会负担量表（IPOS）、晕动症量表（SSQ）、存在体验量表（SPES）、主观受益量表（2 项）进行患者报告的结果测量，进行内容分析访谈和现场记录。个性化 VR 内容使用动作摄像机技术录制，以保护患者的隐私。
17 名患者参与，中位年龄 65 岁（范围 20-82），9 名女性（53%），8 名单身或丧偶（47%），4 名无子女（23.5%），4 名学者（23.5%），在德国一所大学医院的血液科（10 例）、姑息治疗科（3 例）或放射治疗科（2 例）住院中位时间为 9 天（1-75）。8 名患者（53.3%）选择自己的家庭环境或家人作为个性化 VR 内容。所有参与者都喜欢这种干预措施。与标准 VR 内容相比，个性化 VR 更倾向于对幸福感和情感触动产生更强的影响。在心理社会负担和晕动症方面没有劣势。没有出现主观和相关的副作用。患者能够很好地耐受评估。然而，大多数患者要求使用更轻便的耳机，并希望增加互动性。
VR 内容的个性化具有增强沉浸感的潜力，从而改善 VR 体验，并且不会在情绪低落或症状恶化方面造成伤害。在家庭成员的支持下，患者和家属对隐私的需求是可行的，这在今天是很容易管理的。我们建议进行一项实用的随机临床试验，以比较个性化与标准 VR 内容的效果。
在德国临床试验注册处（Deutsches Register Klinischer Studien; DRKS）注册；注册号：DRKS00032172；注册日期：2023 年 7 月 11 日。
