Gaina Alexandra-Maria, Stefanescu Cristinel, Szalontay Andreea-Silvana, Gaina Marcel-Alexandru, Poroch Vladimir, Mosoiu Daniela Viorica, Stefanescu Bogdan-Victor, Axinte Magdalena, Tofan Cristina-Maria, Magurianu Liviu Adrian
Department of Medicine III, Faculty of Medicine"Grigore T. Popa", University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania.
Romanian Academy, Carol I Boulevard 8, 700506 Iași, Romania.
Healthcare (Basel). 2024 Dec 12;12(24):2517. doi: 10.3390/healthcare12242517.
Virtual Reality (VR) is an emerging non-pharmacological treatment for anxiety in palliative care patients. Anxiety, a common symptom in this population, has a significant effect on living standards. The aim of this systematic review is to evaluate the effectiveness of VR interventions in reducing anxiety and improving quality of life in palliative care.
The systematic review protocol was registered in PROSPERO (CRD42024517914). The comprehensive search was performed in nine databases, including PubMed, PsycINFO, and EMBASE, and included studies published up to 15 November 2024. RCTs, pilot studies, and feasibility trials involving adult palliative care patients in which VR interventions were used, were compared with standard care. Two reviewers independently extracted and assessed the quality of the data using the RoB 2 tool.
A total of 13 studies were considered eligible, with 333 participants aged 15 to 85 years old. In these experiments, anxiety decreased steadily, and in some cases mood and quality of life were improved significantly. The VR interventions ranged from guided nature walks to memory-training sessions. Sessions lasted between 5 and 30 min and ranged in duration from single sessions to daily use. Personalized and participatory VR-based content was particularly effective in alleviating anxiety. The heterogeneity of the study designs and VR protocols hampered meta-analysis, despite promising findings.
VR has considerable potential as an adjunctive anxiety therapy for palliative care. The personalization and immersion that VR provides are psychologically unique and have the potential to lower anxiety and improve well-being. But standardizing intervention protocols and more studies are required to define the best VR strategies and evaluate outcomes over the long term. The article highlights the promise of VR as part of palliative care as a viable bio-psycho-socio-spiritual approach.
虚拟现实（VR）是一种新兴的用于缓解姑息治疗患者焦虑的非药物治疗方法。焦虑是该人群的常见症状，对生活质量有重大影响。本系统评价的目的是评估VR干预措施在减轻姑息治疗患者焦虑和改善生活质量方面的有效性。
本系统评价方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42024517914）登记。在包括PubMed、PsycINFO和EMBASE在内的9个数据库中进行了全面检索，纳入截至2024年11月15日发表的研究。将使用VR干预措施的涉及成年姑息治疗患者的随机对照试验、试点研究和可行性试验与标准护理进行比较。两名评价员使用RoB 2工具独立提取并评估数据质量。
共纳入13项符合条件的研究，333名参与者年龄在15至85岁之间。在这些实验中，焦虑水平稳步下降，在某些情况下，情绪和生活质量得到显著改善。VR干预措施包括引导式自然漫步和记忆训练课程。课程时长为5至30分钟，从单次课程到每日使用不等。基于VR的个性化和参与性内容在缓解焦虑方面特别有效。尽管研究结果很有前景，但研究设计和VR方案的异质性阻碍了荟萃分析。
VR作为姑息治疗的辅助焦虑治疗方法具有相当大的潜力。VR提供的个性化和沉浸感在心理上是独特的，有可能降低焦虑并改善幸福感。但需要规范干预方案并开展更多研究，以确定最佳的VR策略并长期评估结果。本文强调了VR作为姑息治疗一部分的前景，是一种可行的生物-心理-社会-精神方法。
