School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wuxing Street, Taipei City, 11031, Taiwan.
Department of Nursing, Faculty of Medicine, Universitas Pendidikan Ganesha, Bali, Indonesia.
Support Care Cancer. 2024 Nov 26;32(12):824. doi: 10.1007/s00520-024-09036-7.
Comfort, anxiety, and pain significantly impact the quality of life and treatment adherence in cancer patients undergoing chemotherapy. Virtual reality (VR) technology offers a novel non-pharmacological intervention to address these primary concerns. While vital signs provide objective physiological data, they are considered secondary outcomes that may reflect changes in patients' subjective experiences.
This study aims to evaluate the effectiveness of smartphone-based virtual reality relaxation (SVR) interventions on improving comfort and reducing anxiety and pain (primary outcomes) in patients with cancer undergoing chemotherapy. Additionally, it assesses the impact on blood pressure and pulse rate (secondary outcomes).
This prospective, two-arm, randomized controlled trial involved 99 cancer patients undergoing chemotherapy who were randomized into the SVR group (n = 50) and control group (n = 49) from March to May 2023. The SVR group received a 10-min immersive VR experience featuring 360-degree natural scenery videos with relaxing sounds, while participants in the control group received standard care and guided imagery leaflets. The primary outcomes-comfort, anxiety, and pain-were evaluated at various time points: comfort was assessed at baseline and post-chemotherapy, while anxiety and pain were assessed at four stages (pre-chemotherapy, pre-VR, immediate post-intervention, and post-chemotherapy). Secondary outcomes included vital signs (blood pressure and pulse rate), which were assessed at the same four stages. Cybersickness symptoms were examined post-chemotherapy. Data analysis involved independent t tests, linear regression, and Generalized Estimating Equations (GEE).
Among 99 randomized patients, the SVR group reported significantly higher comfort levels (p = 0.01; Cohen's d = 0.4), reduced anxiety (p = 0.01; Cohen's d = 0.50), and pain (p = 0.015; Cohen's d = 0.35) compared to the control group. No significant differences were found in heart rate (p = 0.92), systolic blood pressure (p = 0.36), or diastolic blood pressure (p = 0.95). The majority of participants (66-96%) in the SVR group did not report cybersickness symptoms.
SVR shows promise as an intervention for improving comfort and reducing anxiety and pain in cancer patients undergoing chemotherapy. Healthcare providers at chemotherapy centers should consider incorporating VR devices and curated content into patient care routines.
ClinicalTrials.gov: NCT05756465, registered on January 22, 2023.
在接受化疗的癌症患者中，舒适度、焦虑和疼痛显著影响生活质量和治疗依从性。虚拟现实 (VR) 技术为解决这些主要问题提供了一种新颖的非药物干预方法。虽然生命体征提供了客观的生理数据，但它们被认为是次要结果，可能反映了患者主观体验的变化。
本研究旨在评估基于智能手机的虚拟现实放松 (SVR) 干预对改善接受化疗的癌症患者舒适度以及减轻焦虑和疼痛（主要结果）的有效性。此外，还评估了对血压和脉搏率（次要结果）的影响。
这是一项前瞻性、双臂、随机对照试验，纳入了 2023 年 3 月至 5 月期间 99 名接受化疗的癌症患者，将其随机分为 SVR 组（n=50）和对照组（n=49）。SVR 组接受了 10 分钟的沉浸式 VR 体验，其中包括带有放松声音的 360 度自然风景视频，而对照组的参与者则接受了标准护理和指导意象手册。主要结果包括舒适度、焦虑和疼痛，在不同时间点进行评估：舒适度在基线和化疗后评估，焦虑和疼痛在四个阶段（化疗前、VR 前、干预后即刻和化疗后）评估。次要结果包括生命体征（血压和脉搏率），在相同的四个阶段进行评估。化疗后评估了晕动病症状。数据分析包括独立 t 检验、线性回归和广义估计方程 (GEE)。
与对照组相比，SVR 组报告的舒适度水平显著更高（p=0.01；Cohen's d=0.4），焦虑（p=0.01；Cohen's d=0.50）和疼痛（p=0.015；Cohen's d=0.35）显著降低。心率（p=0.92）、收缩压（p=0.36）或舒张压（p=0.95）无显著差异。SVR 组的大多数参与者（66-96%）没有报告晕动病症状。
SVR 有望成为改善接受化疗的癌症患者舒适度以及减轻焦虑和疼痛的干预措施。化疗中心的医疗保健提供者应考虑将 VR 设备和精选内容纳入患者护理常规。
ClinicalTrials.gov：NCT05756465，于 2023 年 1 月 22 日注册。
