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虚拟现实改善癌症患者的心理和身体健康:一项系统综述。

Virtual Reality to Improve the Psychological and Physical Well-Being in Cancer Patients: An Umbrella Review.

作者信息

Bachelard Lucie, Michel Aude, Blanc Nathalie

机构信息

Epsylon Laboratory EA 4556, Paul Valéry University Montpellier 3, 34090 Montpellier, France.

出版信息

Cancers (Basel). 2024 Nov 25;16(23):3943. doi: 10.3390/cancers16233943.

Abstract

BACKGROUND/OBJECTIVES: Cancer patients often experience psychological and physical symptoms that can significantly impact their quality of life and treatment outcomes. Virtual reality (VR) has emerged as a promising complementary approach to standard cancer care. Due to the rapidly evolving nature of VR research in oncology, it seems essential to provide an overview of the current state of knowledge in this field. Therefore, this umbrella review aimed to synthesize evidence from all relevant systematic reviews and meta-analyses on VR-based interventions for improving psychological and physical well-being among cancer patients.

METHODS

A comprehensive search was conducted in four databases (Cochrane Database of Systematic Reviews, Medline, Web of Science, PsycInfo) from inception to August 2023. We included systematic reviews with or without meta-analyses that evaluated the effects of VR-based interventions on any health-related outcomes in cancer patients. The methodological quality of included reviews was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) tool.

RESULTS

Eighteen individual systematic reviews including ten performed meta-analyses were included, with sample sizes ranging from 225 to 842 participants. VR-based interventions were categorized into three main types: distraction, rehabilitation, and education. The interventions varied significantly in terms of content, equipment, setting, and duration. The most frequent use of VR is one-off exposure in hospital settings to distract patients from anticancer treatment and painful procedures, with natural or game-based content. The mechanism most commonly proposed to explain the effectiveness of VR involves attentional redirection.

CONCLUSIONS

This umbrella review suggests that VR-based interventions may be effective in improving psychological outcomes in cancer patients, particularly anxiety, pain, and depression. However, high heterogeneity across studies and mixed results for some outcomes indicate a need for further high-quality research. Moreover, a more refined analysis of VR-based interventions is essential to explore the specific mechanisms of action associated with each type. This approach would enable us to establish the optimal characteristics of each intervention and their long-term effects.

摘要

背景/目的:癌症患者经常经历心理和身体症状,这些症状会对他们的生活质量和治疗结果产生重大影响。虚拟现实(VR)已成为标准癌症护理的一种有前景的辅助方法。由于肿瘤学中VR研究的快速发展,概述该领域的当前知识状态似乎至关重要。因此,本综合性综述旨在综合所有相关系统评价和荟萃分析的证据,以探讨基于VR的干预措施对改善癌症患者心理和身体健康的作用。

方法

从数据库建立至2023年8月,在四个数据库(Cochrane系统评价数据库、Medline、科学引文索引、心理学文摘数据库)中进行了全面检索。我们纳入了评估基于VR的干预措施对癌症患者任何健康相关结局影响的系统评价,无论是否进行了荟萃分析。使用AMSTAR-2(评估系统评价的测量工具)工具评估纳入综述的方法学质量。

结果

纳入了18项单独的系统评价,其中10项进行了荟萃分析,样本量从225至842名参与者不等。基于VR的干预措施主要分为三类:分散注意力、康复和教育。这些干预措施在内容、设备、环境和持续时间方面差异很大。VR最常见的用途是在医院环境中一次性使用,通过自然或基于游戏的内容,让患者从抗癌治疗和痛苦的程序中分心。最常被提出用于解释VR有效性的机制是注意力重新定向。

结论

本综合性综述表明,基于VR的干预措施可能有效改善癌症患者的心理结局,尤其是焦虑、疼痛和抑郁。然而,研究之间的高度异质性以及某些结局的混合结果表明需要进一步开展高质量研究。此外,对基于VR的干预措施进行更精细的分析对于探索与每种类型相关的具体作用机制至关重要。这种方法将使我们能够确定每种干预措施及其长期效果的最佳特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a16/11640359/68becaab1bb5/cancers-16-03943-g001.jpg

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