虚拟现实干预对癌症患者针头相关操作的影响：一项系统评价和荟萃分析

Effects of Virtual Reality Interventions for Needle-Related Procedures in Patients with Cancer: A Systematic Review and Meta-Analysis.

作者信息

Dong Jie, Wang Wenru, Khoo Kennis Yu Jie, Zeng Yingchun

机构信息

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.

出版信息

Cancers (Basel). 2025 Jun 12;17(12):1954. doi: 10.3390/cancers17121954.

DOI:10.3390/cancers17121954

PMID:40563604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12191400/

Abstract

BACKGROUND

Needle-related procedures (NRPs) in cancer care are often associated with significant pain and anxiety, contributing to psychological and physiological distress. This study aimed to assess the effectiveness of virtual reality (VR)-based interventions in reducing anxiety, pain, depression, fear, and physiological parameters (pulse rate and respiratory rate) in patients with cancer undergoing NRPs.

METHODS

A systematic search of 11 databases (CINAHL, Cochrane Library, Embase, IEEE Xplore, Medline, ProQuest, PsycINFO, PubMed, Scopus, Web of Science, and CNKI) was conducted from inception to 15 May 2025. Two independent reviewers selected and extracted studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using Cochrane RevMan 2024 software. Heterogeneity was assessed using Higgins' statistics and Cochran's Q test. The GRADE framework was applied to evaluate the quality of evidence.

RESULTS

Fourteen randomized controlled trials (RCTs) with 1089 participants were included. VR interventions showed significant benefits compared to controls in reducing anxiety (standard mean difference [SMD] = -1.74, 95% confidence interval [CI]: -2.47 to -1.01, < 0.001), pain (SMD = -1.30, 95% CI: -1.93 to -0.67, < 0.001), depression (SMD = -0.73, 95% CI: -0.96 to -0.50, < 0.001), fear (mean difference [MD] = -1.31, 95% CI: -1.56 to -1.06, < 0.001), and respiratory rate (MD = -3.85, 95% CI: -6.18 to -1.52, = 0.001). However, no significant difference was found in pulse rate (MD = 0.25, 95% CI: -14.32 to 14.81, = 0.97).

CONCLUSIONS

VR-based interventions are effective in alleviating psychological symptoms (anxiety, depression, fear) and physiological distress (pain, respiratory rate) in patients with cancer undergoing NRPs. However, they do not significantly impact pulse rate. Interpretation of findings should consider limitations such as the small number of studies, limited sample sizes, and high heterogeneity. Further high-quality RCTs with follow-up assessments are warranted. Customizing VR interventions to address demographic and procedural needs may further enhance their effectiveness.

摘要

背景

癌症护理中的与针相关操作（NRPs）通常会带来显著的疼痛和焦虑，导致心理和生理困扰。本研究旨在评估基于虚拟现实（VR）的干预措施对接受NRPs的癌症患者减轻焦虑、疼痛、抑郁、恐惧及生理参数（心率和呼吸频率）的效果。

方法

对11个数据库（CINAHL、Cochrane图书馆、Embase、IEEE Xplore、Medline、ProQuest、PsycINFO、PubMed、Scopus、科学网和中国知网）进行了从建库至2025年5月15日的系统检索。两名独立评审员根据预先定义的纳入和排除标准选择并提取研究。使用Cochrane RevMan 2024软件进行荟萃分析。使用希金斯统计量和 Cochr an Q检验评估异质性。应用GRADE框架评估证据质量。

结果

纳入了14项随机对照试验（RCT），共1089名参与者。与对照组相比，VR干预在减轻焦虑（标准化均数差[SMD]=-1.74，95%置信区间[CI]：-2.47至-1.01，P<0.001）、疼痛（SMD=-1.30，95%CI：-1.93至-0.67，P<0.001）、抑郁（SMD=-0.73，95%CI：-0.96至-0.50，P<0.001）、恐惧（均数差[MD]=-1.31，95%CI：-1.56至-1.06，P<0.001）和呼吸频率（MD=-3.85，95%CI：-6.18至-1.52，P=0.001）方面显示出显著益处。然而，在心率方面未发现显著差异（MD=0.25，95%CI：-14.32至14.81，P=0.97）。

结论

基于VR的干预措施对减轻接受NRPs的癌症患者的心理症状（焦虑、抑郁、恐惧）和生理困扰（疼痛、呼吸频率）有效。然而，它们对心率没有显著影响。研究结果的解释应考虑研究数量少、样本量有限和异质性高的局限性。有必要开展进一步的高质量RCT并进行随访评估。根据人口统计学和操作需求定制VR干预措施可能会进一步提高其有效性。