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Li H, Wong CL, Jin X, Wang N, Shi Z. Effects of acceptance and commitment therapy on fatigue interference in patients with advanced lung cancer and caregiving burden: protocol for a pilot randomised controlled trial. BMJ Open 2024; 14:e082090. [PMID: 39043593 PMCID: PMC11268034 DOI: 10.1136/bmjopen-2023-082090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/25/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Cancer-related fatigue is common in patients with advanced lung cancer. It not only interferes with patients' health-related quality of life, but also increases the caregiving burden of their caregivers. Acceptance and commitment therapy is emerging as a novel way to advocate accepting negative experiences and taking effective actions based on their own values to help patients commit meaningful actions in the course of cancer diseases. This trial aims to test the feasibility, acceptability and preliminary effects of acceptance and commitment therapy for fatigue interference in patients with advanced lung cancer and the caregiver burden. METHOD AND ANALYSIS A two-arm, assessor-blind pilot randomised controlled trial will be conducted. A total of 40 advanced lung cancer patient-caregiver dyads, who live in rural areas, will be recruited from a university-affiliated hospital in central China. The participants will be randomised to receive an online six-session acceptance and commitment therapy (i.e. involving metaphors, experiential exercises and mindfulness exercises facilitated by virtual reality technology) plus health education (intervention group, n=20) or health education (control group, n=20). Outcomes will be measured at baseline and 1 week postintervention. The primary outcomes are study feasibility (i.e. eligibility rate, recruitment rate, attrition rate and adherence rate), fatigue interference and caregiver burden. The secondary outcomes are health-related quality of life, meaning in life, psychological flexibility and mindful attention. Semistructured interviews will be conducted to explore the feasibility and experiences of the intervention in a subsample of 10 participants from the intervention group. ETHICS AND DISSEMINATION This study has been approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No. 2023.030) and the Medical Ethics Committee of Xiangya Hospital Central South University (No. 202305336). The findings will be disseminated in peer-reviewed journals and through local or international conference presentations. TRIAL REGISTRATION NUMBER NCT05885984.
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Affiliation(s)
- Huiyuan Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, China
| | - Xiaohuan Jin
- The School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Nina Wang
- Respiratory Department, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Zhengkun Shi
- Respiratory Department, Xiangya Hospital Central South University, Changsha, Hunan, China
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Kahlon S, Gjestad R, Lindner P, Nordgreen T. Perfectionism as a predictor of change in digital self-guided interventions for public speaking anxiety in adolescents: A secondary analysis of a four-armed randomized controlled trial. Cogn Behav Ther 2024; 53:152-170. [PMID: 37991001 DOI: 10.1080/16506073.2023.2281243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
Public Speaking Anxiety (PSA) interventions targeting adolescents exist; however, not all gain improvement. This exploratory study investigated whether PSA interventions resulted in a decrease in perfectionism and whether pre-treatment level and changes in perfectionism moderated the effects on PSA and social anxiety. The sample consisted of 100 adolescents from junior high schools randomized to four groups: 1) VR only (n = 20), 2) VR + online exposure program (n = 20), 3) online psychoeducation and online exposure program (n = 40), 4) waitlist and online psychoeducation program (n = 20). Self-reported symptoms of PSA, social anxiety, and perfectionism were measured at pre, week 3, post, and 3-months follow-up. Level and change in outcome variables were analyzed using latent growth curve modeling. Results revealed that the interventions did not lead to a reduction in perfectionism. Reduction in perfectionism was associated with a larger reduction in all outcome measures from post to follow-up. No interaction was found between pre-treatment perfectionism and PSA symptoms. High pre-treatment levels of perfectionism were associated with poorer outcomes on social anxiety symptoms from post to follow-up for online exposure groups. The results indicate that one should assess and address high pre-treatment levels of perfectionism during PSA interventions.
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Affiliation(s)
- Smiti Kahlon
- Research Centre for Digital Mental Health Services, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Rolf Gjestad
- Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tine Nordgreen
- Research Centre for Digital Mental Health Services, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Shahid S, Kelson J, Saliba A. Effectiveness and User Experience of Virtual Reality for Social Anxiety Disorder: Systematic Review. JMIR Ment Health 2024; 11:e48916. [PMID: 38329804 PMCID: PMC10884902 DOI: 10.2196/48916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) is a debilitating psychiatric disorder that affects occupational and social functioning. Virtual reality (VR) therapies can provide effective treatment for people with SAD. However, with rapid innovations in immersive VR technology, more contemporary research is required to examine the effectiveness and concomitant user experience outcomes (ie, safety, usability, acceptability, and attrition) of emerging VR interventions for SAD. OBJECTIVE The aim of this systematic review was to examine the effectiveness and user experience of contemporary VR interventions among people with SAD. METHODS The Cochrane Library, Emcare, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science databases were searched between January 1, 2012, and April 26, 2022. Deduplicated search results were screened based on title and abstract information. Full-text examination was conducted on 71 articles. Studies of all designs and comparator groups were included if they appraised the effectiveness and user experience outcomes of any immersive VR intervention among people with SAD. A standardized coding sheet was used to extract data on key participant, intervention, comparator, outcome, and study design items. RESULTS The findings were tabulated and discussed using a narrative synthesis. A total of 18 studies met the inclusion criteria. CONCLUSIONS The findings showed that VR exposure therapy-based interventions can generally provide effective, safe, usable, and acceptable treatments for adults with SAD. The average attrition rate from VR treatment was low (11.36%) despite some reported user experience difficulties, including potential simulator sickness, exposure-based emotional distress, and problems with managing treatment delivered in a synchronous group setting. This review also revealed several research gaps, including a lack of VR treatment studies on children and adolescents with SAD as well as a paucity of standardized assessments of VR user experience interactions. More studies are required to address these issues. TRIAL REGISTRATION PROSPERO CRD42022353891; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353891.
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Affiliation(s)
- Simon Shahid
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
| | - Joshua Kelson
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
| | - Anthony Saliba
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
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Limoncin E, Gaudio B, Sansone A, Jannini TB, Ciocca G, Mollaioli D, Jannini EA. The role of metaverse on sexual health of people with disabilities: narrative review. Int J Impot Res 2023:10.1038/s41443-023-00807-0. [PMID: 38129693 DOI: 10.1038/s41443-023-00807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
Metaverse is the implementation of an Internet-based hypothetical meta-universe, which should facilitate an immersive experience in meeting people, working, shopping and other leisure activities. Immersive reality makes it possible to feel involved in a virtual environment using the mechanism of the "embodied simulations", i.e., the capacity to evoke a sense of presence in a specific reality, whether real or imagined. The growing interest in the metaverse suggests exploring how this new kind of communicative space could be used to provide and guarantee sexual entertainment and/or education for people with disabilities. Through a thematic analysis, we aimed to define the theoretical framework and analyze scientific literature on this subject. Our purpose is to provide a comprehensive picture of the use of metaverse as a tool for sexuality, and of the possible benefits of such technologies for people with disabilities. To this end, we have also discussed a major topic, related to the Sexual Assistants, examining how their possible application can be implemented within the context of augmented reality. Our study further explores the importance of the metaverse in sexual education. Finally, we addressed the issue of cyber security as well as possible threats and negative consequences linked to metaverse misuse.
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Affiliation(s)
- Erika Limoncin
- Dept. of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.
| | - Benedetta Gaudio
- Dept. of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Andrea Sansone
- Section of Endocrinology and Medical Sexology (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| | - Tommaso B Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Dept. of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Daniele Mollaioli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Emmanuele A Jannini
- Section of Endocrinology and Medical Sexology (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
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Zolfaghari E, Ridout B, Medlow S, Campbell A, Coggins A, Murphy M, Jani S, Thosar D, Wiederhold BK, Wiederhold M, Steinbeck K. Exploring the use of virtual reality to manage distress in adolescent patients in emergency departments: A feasibility study. Emerg Med Australas 2022; 34:687-693. [PMID: 35238143 PMCID: PMC9790434 DOI: 10.1111/1742-6723.13945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The present study aimed to explore the feasibility and potential benefits of deploying virtual reality (VR) for adolescents in the ED. METHODS This multi-centre study was undertaken in paediatric and adult EDs in two university teaching hospitals. Twenty-six participants who had voluntarily attended the ED received the VR intervention. Pre- and post-measures assessing changes in state anxiety, stress and affect, and physical biomarkers were obtained. RESULTS The use of VR intervention was associated with significant reductions in distress (Short State Stress Questionnaire - Distress Subscale; t = 4.55, P < 0.001) and negative affect (the International Positive and Negative Affect Scale - Short Form version; t = 4.99, P < 0.001). Most participants chose 'Netflix' as their content of choice. The technology was well received by the participants with subjective reports indicating that receiving VR intervention was 'insanely cool', 'takes you away from what's actually happening' and some participants felt 'privileged to get this experience in a hospital'. CONCLUSIONS VR technology can effectively be used in EDs to assist adolescents and young adults better manage their distress and take steps towards activating more self-control mechanisms that will in turn allow for more meaningful engagements to be established with health clinicians. This technology has broad implications for reducing distress in adolescents in a variety of clinical contexts.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brad Ridout
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Sharon Medlow
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Andrew Campbell
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Andrew Coggins
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Margaret Murphy
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Shefali Jani
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Deepali Thosar
- Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brenda K Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Mark Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Katharine Steinbeck
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Leung WK, Chang MK, Cheung ML, Shi S. VR tourism experiences and tourist behavior intention in COVID-19: an experience economy and mood management perspective. INFORMATION TECHNOLOGY & PEOPLE 2022. [DOI: 10.1108/itp-06-2021-0423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PurposeVirtual reality (VR) technology is a potential tool for tourism marketers to maintain the attractiveness of their destinations and recover from the COVID-19 pandemic. However, the effectiveness of VR technology in motivating potential tourists' visit intention under lockdown conditions remains unknown. An integrated model based on the experience economy framework and mood management theory was, therefore, used to explain how tourists' VR experiences affect their mood management processes and subsequent behaviors. This research also examined how perceived travel risk influenced the relationship between mood management processes and future decisions.Design/methodology/approachThis study used a cross-sectional design based on a sample collected from a Chinese survey company, Sojump. The author surveyed 285 respondents who had experienced VR tourism activities during the COVID-19 pandemic. The research model was tested using partial least squares–structural equation modeling.FindingsThe results demonstrated that the four dimensions of VR experiences differently affected mood management processes, while perceived travel risk differently moderated the influence of mood management processes on visit intention and VR stickiness. This provides insights for tourism marketers to adapt to the current tourism environment and develop recovery strategies.Originality/valueIn response to gaps in the literature, this research examined the effectiveness of VR technology in driving tourists' visit intention during the COVID-19 pandemic, providing insights for tourism marketers to successfully implement VR tourism and plan timely recovery strategies.
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Caponnetto P, Triscari S, Maglia M, Quattropani MC. The Simulation Game-Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413209. [PMID: 34948817 PMCID: PMC8701873 DOI: 10.3390/ijerph182413209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: With the term Virtual reality (VR) we refer to a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) which make it possible to achieve what theorists define "direct mediated action". The aim of our systematic review is specifically to investigate the applications of virtual reality therapy for the treatment of social anxiety disorder, also known as social phobia. The most common treatment for social anxiety disorder is represented by "in vivo exposure therapy" (iVET). This method consists of exposing the participant, in a gradual and controlled way, to anxious stimuli, with the goal to change the subject's response to the object or situation that is causing the fear. However, the main flaw of "in Vivo therapies" is represented by both the huge costs involved and the possible disturbance variables that can hinder the execution of the therapeutic treatment. Virtual reality exposure therapy could therefore, if confirmed in its effectiveness, constitute a solution to eliminate these two defects demonstrated by "in vivo exposure therapy". The goal is to use VR as a means for the clinician to build a tailor-made path for the participant in order to make him acquire "in virtual" those skills necessary for a good adaptation in the "real" world. (2) Methods: From February 2021 until the date of submission of the article (September 2021), we conducted a systematic review aiming to verify the effectiveness of virtual reality exposure therapy (VRET) for the treatment of SAD. (3) Results: We identified a total of 205 unique articles. Among these, 20 full-text articles were assessed for eligibility and 5 of these met the eligibility criteria and were, therefore, included in the final systematic review. (4) Conclusions: Virtual reality therapies proved to be a valid alternative to the acquisition of social skills suitable for improving the symptoms of SAD. Although there has not been a significant difference between VRET and iVET, the low costs and flexibility of VRET open up new scenarios for achieving greater psychophysical well-being.
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Affiliation(s)
- Pasquale Caponnetto
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95123 Catania, Italy
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, 95030 Mascalucia, Italy
- Correspondence: (P.C.); (M.M.)
| | - Sergio Triscari
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
| | - Marilena Maglia
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95123 Catania, Italy
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, 95030 Mascalucia, Italy
- Correspondence: (P.C.); (M.M.)
| | - Maria C. Quattropani
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
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Pallavicini F, Pepe A, Clerici M, Mantovani F. Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint). JMIR Serious Games 2021; 10:e35000. [PMID: 36282554 PMCID: PMC9605086 DOI: 10.2196/35000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/18/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. Objective This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis. Methods We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. Conclusions Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. Trial Registration International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/
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Affiliation(s)
- Federica Pallavicini
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
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