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Giannelli A, Moscato S, Ostan R, Pannuti R, Chiari L, Biasco G, Varani S. Virtual Reality for advanced cancer patients assisted at home: A randomized controlled interventional study. Psychooncology 2024; 33:e6368. [PMID: 38937094 DOI: 10.1002/pon.6368] [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: 06/30/2023] [Revised: 05/27/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Virtual Reality (VR) has been demonstrated to be an effective option for integrating psychological interventions in different therapeutic settings. This randomized controlled interventional study aims to assess the effects of VR, compared to tablet controlled intervention, on anxiety, depression, pain, and short-term psychophysical symptoms in advanced cancer patients assisted at home. METHODS Participants were provided with a VR headset or a tablet (TAB) for 4 days. On the first and last day, anxiety and depression were measured by Hospital Anxiety and Depression Scale and pain by Brief Pain Inventory. Before and after each VR and tablet session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS). RESULTS Fifty-three patients (27 VR vs. 26 TAB) completed the study. Anxiety significantly decreased in the VR group after the 4-day intervention. The analysis of ESAS showed a significant improvement in pain (p = 0.013), tiredness (p < 0.001), and anxiety (p = 0.013) for TAB group, and a significant reduction in tiredness (p < 0.001) in the VR group. CONCLUSIONS Technological and user-friendly tools, such as VR and tablets, might be integrated with traditional psychological interventions to improve anxiety and cancer-related short-term symptoms. Further studies are needed to better consolidate the possible beneficial effects of VR.
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Affiliation(s)
| | - Serena Moscato
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (DEI), University of Bologna, Bologna, Italy
| | - Rita Ostan
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | | | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (DEI), University of Bologna, Bologna, Italy
- Health Sciences and Technologies - Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
| | - Guido Biasco
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Silvia Varani
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
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Marianti L, Saputra R, Arizona, Arifah S, Fitri HU, Putra BJ. Increasing the scope of virtual reality in palliative care: Insights and future directions. Palliat Support Care 2024:1-2. [PMID: 38826055 DOI: 10.1017/s147895152400097x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Affiliation(s)
- Lena Marianti
- Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Rikas Saputra
- Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
| | - Arizona
- Universitas PGRI Palembang, Palembang, Indonesia
| | - Siti Arifah
- Universitas Darul Ulum Jombang, Jawa Timur, Indonesia
| | | | - Bela Janare Putra
- Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
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Corvin J, Hoskinson Z, Mozolic-Staunton B, Hattingh L, Plumbridge-Jones R. The effects of virtual reality interventions on occupational participation and distress from symptoms in palliative care patients: A pilot study. Palliat Support Care 2024:1-8. [PMID: 38605653 DOI: 10.1017/s1478951524000245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND Virtual reality (VR) offers the prospect of a safe and effective adjunct therapeutic modality to promote mental health and reduce distress from symptoms in palliative care patients. Common physiological and psychological symptoms experienced at the end of life may impact the person's participation in day-to-day activities that bring them meaning. The purpose of this study was to examine the effect of VR interventions on occupational participation and distress from symptoms. OBJECTIVES To describe the stimulus, results, and learnings from a single-site pilot study of virtual reality therapy in a specialist palliative care setting. METHODS Participants engaged in a VR session lasting from 9 to 30 minutes related to coping with pain, inner peace and mindfulness, adventure, and bucket list. METHODS MEASURES The pilot prospective quantitative observational cohort study was conducted from November 2021 through March 2022 using a pre-post VR intervention research design. Quantitative data was collected using patient-rated assessments and a wireless pulse oximeter. Occupational performance, satisfaction, and distress symptoms were measured using the Canadian Occupational Performance Measure and the Palliative Care Outcomes Collaboration Symptom Assessment Scale (PCOC SAS). The intervention and study design adhered to international guidelines. RESULTS Ten participants engaged in the VR interventions. Data showed significantly improved occupational performance and satisfaction scores (p < .001), decreases in PCOC SAS distress from pain (p = .01), fatigue (p < .001), and heart rate (p = .018). No adverse side effects were observed. SIGNIFICANCE OF RESULTS Outcomes included an analysis of virtual reality's effectiveness to alleviate symptom burden and increase occupational participation for palliative care patients. Of specific interest to the research team was the application of virtual reality in a community-based and inpatient palliative care context to supplement allied health services and its feasibility of integration into standard palliative care. CONCLUSION VR therapy showed positive improvements in the participants' occupational performance, satisfaction, and distress from pain and fatigue.
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Affiliation(s)
- Julian Corvin
- Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Zara Hoskinson
- Supportive and Specialist Community Palliative Care Service, Gold Coast Health, Robina, Queensland, Australia
| | - Beth Mozolic-Staunton
- Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Laetitia Hattingh
- Department of Allied Health Research, Allied Health & Rehabilitation Services, Gold Coast Health, Southport, Queensland, Australia
| | - Russell Plumbridge-Jones
- Supportive and Specialist Community Palliative Care Service, Gold Coast Health, Robina, Queensland, Australia
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Yao Z, Ma Z, Zhu Y, Lv X. Music intervention in patients undergoing hematopoietic stem cell transplantation: A systematic review and meta-analysis. Jpn J Nurs Sci 2024; 21:e12586. [PMID: 38258611 DOI: 10.1111/jjns.12586] [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: 09/01/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
AIMS To explore whether music intervention improves the quality of life (QOL) of patients undergoing hematopoietic stem cell transplantation (HSCT) and to evaluate its impact on patients' symptoms of depression/anxiety and fatigue. METHODS This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Cochrane CENTRAL, and EMBASE were searched from inception to September 30, 2022. The search strategy used a combination of the keywords "music" and "hematopoietic stem cell transplantation" or "HSCT." The outcomes assessed were QOL, depression and anxiety, and fatigue. Pooled standardized mean differences with 95% confidence intervals were calculated to compare the outcomes between the music intervention and control groups. Heterogeneity across the studies was assessed using a chi-square-based test, and the I2 and Q statistics. RESULTS Meta-analysis of the included study population showed that music intervention for patients undergoing HSCT was associated with patients' improved QOL, and resulted in reduced depression/anxiety and fatigue compared to patients without music intervention. CONCLUSION Music intervention benefits HSCT outcomes, including better QOL, less depression/anxiety, and less fatigue postoperatively. Future trials with larger samples are still warranted to strengthen the evidence supporting the benefits of music intervention in this patient population.
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Affiliation(s)
- Zijin Yao
- School of Arts, Beijing Language and Culture University, Beijing, China
| | - Zhuolin Ma
- Academy of Music, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Yichen Zhu
- Department of Urology, Capital Medical University Beijing Friendship Hospital, Beijing, China
| | - Xinan Lv
- Department of Urology, Capital Medical University Beijing Friendship Hospital, Beijing, China
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Lee LJ, Son EH, Farmer N, Gerrard C, Tuason RT, Yang L, Kohn-Godbout J, Stephens C, Nahm ES, Smith L, Risch S, Wallen GR. Nature-based virtual reality intervention to manage stress in family caregivers of allogeneic hematopoietic stem cell transplant recipients: a two-phase pilot study protocol. Front Psychiatry 2024; 15:1295097. [PMID: 38516258 PMCID: PMC10954866 DOI: 10.3389/fpsyt.2024.1295097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Millions of family members and/or friends in the U.S. serve as unpaid caregivers for individuals with chronic conditions, such as cancer. Caregiving for someone undergoing an intense allogeneic hematopoietic stem cell transplant (HSCT) is particularly demanding, with accompanying physical and psychological stress. Increased stress and stress-related symptoms could make it difficult for caregivers to fulfill their roles and could negatively impact the health status and quality of life of themselves and the recipients. Virtual reality (VR) is a promising technology increasingly used for treatment and wellness in various medical settings. There is growing evidence that studies have reported the positive effects of the VR intervention in managing and reducing stress among diverse populations in various clinical scenarios; however, no published studies have focused on family caregivers of patients with cancer. The study aims to assess the feasibility and acceptability of a four-week nature-based VR intervention and to examine the effectiveness of the VR intervention on stress in HSCT caregivers. This study comprises two phases. Phase I of the study will be a single-arm pre-post design focused on assessing the feasibility and acceptability of the VR intervention. Phase II of the study will be a prospective randomized controlled group design to examine the effectiveness of the VR intervention on perceived stress. Adults (≥ 18 years) who serve as primary caregivers for a person who will undergo an allogeneic HSCT will be recruited. Fifteen participants will be enrolled for Phase I and 94 participants for Phase II (Active VR arm N=47; Sham VR arm N=47). The nature-based immersive VR program contains 360° high-definition videos of nature scenes along with nature sounds through a head-mounted display (HMD) for 20 minutes every day for four weeks. Primary outcome is perceived stress measured by the Perceived Stress Scale. Secondary/exploratory outcomes are stress-related symptoms (e.g., fatigue, sleep disturbance) and physiological biomarkers (e.g., cortisol, alpha-amylase). The importance and innovativeness of this study consist of using a first-of-its-kind, immersive VR technology to target stress and investigating the health outcomes assessed by validated objective biomarkers as well as self-report measures of the nature-based intervention in the caregiver population. Clinical trial registration ClinicalTrials.gov, identifier NCT05909202.
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Affiliation(s)
- Lena J. Lee
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Elisa H. Son
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Nicole Farmer
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Chantal Gerrard
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Ralph Thadeus Tuason
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Li Yang
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Julie Kohn-Godbout
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
| | - Cory Stephens
- University of Maryland Baltimore, School of Nursing, Baltimore, MD, United States
| | - Eun-Shim Nahm
- University of Maryland Baltimore, School of Nursing, Baltimore, MD, United States
| | - Leslie Smith
- National Institutes of Health, Clinical Center, Nursing Department, Bethesda, MD, United States
| | - Steve Risch
- National Institutes of Health, Clinical Center, Nursing Department, Bethesda, MD, United States
| | - Gwenyth R. Wallen
- National Institutes of Health, Clinical Center, Translational Biobehavioral and Health Disparities (TBHD), Bethesda, MD, United States
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Javvaji CK, Reddy H, Vagha JD, Taksande A, Kommareddy A, Reddy NS. Immersive Innovations: Exploring the Diverse Applications of Virtual Reality (VR) in Healthcare. Cureus 2024; 16:e56137. [PMID: 38618363 PMCID: PMC11016331 DOI: 10.7759/cureus.56137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Virtual reality (VR) has experienced a remarkable evolution over recent decades, evolving from its initial applications in specific military domains to becoming a ubiquitous and easily accessible technology. This thorough review delves into the intricate domain of VR within healthcare, seeking to offer a comprehensive understanding of its historical evolution, theoretical foundations, and current adoption status. The examination explores the advantages of VR in enhancing the educational experience for medical students, with a particular focus on skill acquisition and retention. Within this exploration, the review dissects the applications of VR across diverse medical disciplines, highlighting its role in surgical training and anatomy/physiology education. While navigating the expansive landscape of VR, the review addresses challenges related to technology and pedagogy, providing insights into overcoming technical hurdles and seamlessly integrating VR into healthcare practices. Additionally, the review looks ahead to future directions and emerging trends, examining the potential impact of technological advancements and innovative applications in healthcare. This review illuminates the transformative potential of VR as a tool poised to revolutionize healthcare practices.
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Affiliation(s)
- Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshitha Reddy
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayant D Vagha
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anirudh Kommareddy
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Naramreddy Sudheesh Reddy
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Altman K, Saredakis D, Keage H, Hutchinson A, Corlis M, Smith RT, Crawford GB, Loetscher T. Personalised virtual reality in palliative care: clinically meaningful symptom improvement for some. BMJ Support Palliat Care 2024:spcare-2024-004815. [PMID: 38378242 DOI: 10.1136/spcare-2024-004815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES This study examined the effects of virtual reality (VR) among palliative care patients at an acute ward. Objectives included evaluating VR therapy benefits across three sessions, assessing its differential impact on emotional versus physical symptoms and determining the proportion of patients experiencing clinically meaningful improvements after each session. METHODS A mixed-methods design was employed. Sixteen palliative inpatients completed three personalised 20 min VR sessions. Symptom burden was assessed using the Edmonton Symptom Assessment Scale-Revised and quality of life with the Functional Assessment of Chronic Illness Therapy (FACIT-Pal-14). Standardised criteria assessed clinically meaningful changes. Quantitative data were analysed using linear mixed models. RESULTS Quality of life improved significantly pre-VR to post-VR with a large effect size (Cohen's d: 0.98). Total symptom burden decreased after 20 min VR sessions (Cohen's d: 0.75), with similar effect sizes for emotional (Cohen's d: 0.67) and physical symptoms (Cohen's d: 0.63). Over 50% of patients experienced clinically meaningful improvements per session, though substantial individual variability occurred. CONCLUSIONS This study reveals the nuanced efficacy of personalised VR therapy in palliative care, with over half of the patients experiencing meaningful benefits in emotional and physical symptoms. The marked variability in responses underscores the need for realistic expectations when implementing VR therapy.
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Affiliation(s)
- Kaylin Altman
- Justice & Society, University of South Australia, Adelaide, Australia
| | | | - Hannah Keage
- Justice & Society, University of South Australia, Adelaide, Australia
| | - Amanda Hutchinson
- Justice & Society, University of South Australia, Adelaide, Australia
| | - Megan Corlis
- Australian Nursing and Midwifery Education Centre, Adelaide, Australia
| | - Ross T Smith
- Australian Centre for Interactive and Virtual Environments, University of South Australia, Adelaide, South Australia, Australia
| | - Gregory Brian Crawford
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tobias Loetscher
- Justice & Society, University of South Australia, Adelaide, Australia
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Woo OKL. Integrating knowledge, skills, and attitudes: professional training required for virtual reality therapists in palliative care. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1268662. [PMID: 37849786 PMCID: PMC10577415 DOI: 10.3389/fmedt.2023.1268662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Fully immersive virtual reality (VR) is an advanced technology increasingly studied and used in palliative care for symptom management. While the findings shed a positive light on its therapeutic potential, VR carries adverse effects, leading to ethical concerns. Based on the clinical experiences of a registered clinical psychologist who is also a certified thanatologist, we put forward a perspective on the importance of professional training for VR therapists in view of the possible risks posed by VR in palliative care. We propose professional trainings on knowledge, skills, and attitudes to ensure patients' safety while maximizing the therapeutic benefits of VR. Given the scarcity of reports on such an area, we hope this perspective article opens up discussions and contributes to current understanding and emerging future directions to ensure quality and ethical delivery of VR in palliative care.
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Affiliation(s)
- Olive K. L. Woo
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Woo OKL, Lee AM. Case report: Therapeutic potential of Flourishing-Life-Of-Wish Virtual Reality Therapy on Relaxation (FLOW-VRT-Relaxation)-a novel personalized relaxation in palliative care. Front Digit Health 2023; 5:1228781. [PMID: 37674510 PMCID: PMC10477913 DOI: 10.3389/fdgth.2023.1228781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
In view of the global aging population and growing need of palliative care, innovative intervention for effective symptom management is of urgent need. Flourishing-Life-Of-Wish Virtual Reality Therapy (FLOW-VRT) is a brief, structured, manualized, and personalized psychological intervention with theoretical foundations based on stress coping theory, self-determination theory, flow theory, and attention restoration theory. With a specific focus on relaxation, FLOW-VRT-Relaxation intends to facilitate adaptive end-of-life coping through delivering personalized relaxation. This paper reports a case study of the application of FLOW-VRT-Relaxation, and discusses its therapeutic potential as a cost-effective method for reducing palliative symptoms by addressing patient's unmet needs. The case study is a 51-year-old Chinese female, diagnosed with advanced cervix cancer, and presented with unmet psychological (i.e., unfulfilled wishes) and physical needs (i.e., pain and fatigue) before FLOW-VRT-Relaxation. To address her unmet needs, FLOW-VRT-Relaxation was delivered by a registered clinical psychologist specialized in palliative care. Need assessment was first conducted, followed by a 10-min VR travel of Japan as her own choice. Relaxation was verbally coached during VR. Right after VR, consolidation with psychological components including psychoeducation, cognitive and emotional processing, and reminiscence intervention were delivered. The patient showed improvement in physical and psychological symptoms, lower sense of loneliness and engulfment, as well as enhanced peace after FLOW-VRT-Relaxation. The current findings provide encouraging initial support for the feasibility, acceptability, and therapeutic potential of using FLOW-VRT-Relaxation as a cost-effective, scalable and personalized VR relaxation for patients under palliative care. It is hoped that with its optimal use, FLOW-VRT-Relaxation can serve as an alternative therapeutic tool that effectively improves the end-on-life care.
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Affiliation(s)
- Olive K. L. Woo
- Department of Psychology, The University of Hong Kong, Hong Kong, China
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Moloney M, Doody O, O’Reilly M, Lucey M, Callinan J, Exton C, Colreavy S, O’Mahony F, Meskell P, Coffey A. Virtual reality use and patient outcomes in palliative care: A scoping review. Digit Health 2023; 9:20552076231207574. [PMID: 37928326 PMCID: PMC10621306 DOI: 10.1177/20552076231207574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Virtual reality is increasingly used in healthcare settings. Potentially, it's use in palliative carecould have a positive impact; however, there is limited evidence on the scope, purpose and patient outcomes relating to virtual reality use in this context. The objective of this scoping review is to chart the literature on virtual reality use in palliative care, identifying any evidence relating to biopsychosocial patient outcomes which could support its use in practice. Methods A scoping review of the literature, involving . a systematic search across 10 electronic bibliographic databases in December 2021, . Eligibility criteria were primary research studies, of any research designwithin a 10-year timeframe, which reported on virtual reality use and patient outcomes in palliative care. A total of 993 papers were identified, andcomprehensive screening resulted in 10 papers for inclusion. Results This scoping review identified 10 papers addressing virtual reality in palliative care, published within a three-year timeframe 2019-2021. Research methodologies included mixed methods, quantitative and qualitative. The evidence highlightsvirtual reality use with patients receiving palliative care in a variety of settings, and data around useability, feasibility and acceptability is positive. However, the evidence regarding biopsychosocial patient outcomes linked to virtual reality use is limited. Conclusion Virtual reality is gathering momentum in palliative care and is potentially a helpful intervention; however more research is needed to underpin the evidence base supporting its application, particularly in understanding the impact on biopsychosocial patient outcomes and ascertaining the best approach for measuring intervention effectiveness.
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Affiliation(s)
- Mairead Moloney
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | | | - Chris Exton
- Department of Computer Science and Information Systems, University of Limerick, Limerick, Ireland
| | - Simon Colreavy
- Department of Computer Science and Information Systems, University of Limerick, Limerick, Ireland
| | | | - Pauline Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alice Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Alexanian S, Foxman M, Pimentel D. Virtual reality and music's impact on psychological well-being. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:864990. [PMID: 36188907 PMCID: PMC9397989 DOI: 10.3389/fresc.2022.864990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022]
Abstract
Quality of life is bound to psychological well-being, which in turn is affected by the frequency and magnitude of negative mood states. To regulate mood states, humans often consume media such as music and movies, with varied degrees of effectiveness. The current investigation examined the effectiveness of virtual reality (VR) vs. two-dimensional (2D) online interventions with various stimuli (audiovisual vs. visual only vs. audio only) to assess which interventions were most effective for improved well-being. Additionally, this study examined which groups displayed the highest amount of perceived presence to understand what components are essential when maximizing a person's subjective feeling of being “in” a new place and if this translated toward therapeutic results. Our data suggests that even though VR participants generally experienced more presence and had similar benefits as 2D groups for increasing positive mood, only participants in the 2D groups had a reduction in negative mood overall with 2D audiovisual participants experiencing the best results. These results contradict past studies which indicate that there could be other psychological and theoretical considerations that may play a role in determining what online experiences are more effective than just examining presence and immersive stimuli. Further research and development into using VR as a tool for improved well-being is needed to understand its efficacy in remote and in-person setting.
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Affiliation(s)
- Stephen Alexanian
- School of Journalism and Communication, University of Oregon, Eugene, ORUnited States
- Correspondence: Stephen Alexanian
| | - Maxwell Foxman
- School of Journalism and Communication, University of Oregon, Eugene, ORUnited States
| | - Danny Pimentel
- University of Oregon, Oregon Reality Labs, School of Journalism and Communication, Portland, OR, United States
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Application of Virtual Reality Technology in Clinical Practice, Teaching, and Research in Complementary and Alternative Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1373170. [PMID: 35990836 PMCID: PMC9388243 DOI: 10.1155/2022/1373170] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
Background The application of virtual reality (VR) in clinical settings is growing rapidly, with encouraging results. As VR has been introduced into complementary and alternative medicine (CAM), a systematic review must be undertaken to understand its current status. Aim This review aims to evaluate and summarize the current applications of VR in CAM, as well as to explore potential directions for future research and development. Methods After a brief description of VR technology, we discuss the past 20 years of clinical VR applications in the medical field. Then, we discuss the theoretical basis of the combination of VR technology and CAM, the research thus far, and practical factors regarding usability, etc., from the following three main aspects: clinical application, teaching, and scientific research. Finally, we summarize and propose hypotheses on the application of VR in CAM and its limitations. Results Our review of the theoretical underpinnings and research findings to date leads to the prediction that VR and CAM will have a significant impact on future research and practice. Conclusion Although there is still much research needed to advance the science in this area, we strongly believe that VR applications will become indispensable tools in the toolbox of CAM researchers and practitioners and will only grow in relevance and popularity in the era of digital health.
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Mo J, Vickerstaff V, Minton O, Tavabie S, Taubert M, Stone P, White N. How effective is virtual reality technology in palliative care? A systematic review and meta-analysis. Palliat Med 2022; 36:1047-1058. [PMID: 35635018 PMCID: PMC9248003 DOI: 10.1177/02692163221099584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The efficacy of virtual reality for people living with a terminal illness is unclear. AIM To determine the feasibility and effectiveness of virtual reality use within a palliative care setting. DESIGN Systematic review and meta-analysis. PROSPERO (CRD42021240395). DATA SOURCES Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included 'virtual reality' and 'palliative care'. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges's g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted. RESULTS Eight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain (p = 0.0363), tiredness (p = 0.0030), drowsiness (p = 0.0051), shortness of breath (p = 0.0284), depression (p = 0.0091) and psychological well-being (p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm. CONCLUSIONS Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.
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Affiliation(s)
- Jiping Mo
- UCL Division of Psychiatry, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK.,Priment Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London (UCL), London, UK
| | - Ollie Minton
- Sussex Cancer Centre University Hospitals, Sussex, UK
| | | | - Mark Taubert
- Palliative Medicine, Velindre Cancer Centre, Cardiff, UK.,Palliative Care, Cardiff University School of Medicine, Cardiff, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Nicola White
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
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Martin JL, Saredakis D, Hutchinson AD, Crawford GB, Loetscher T. Virtual Reality in Palliative Care: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071222. [PMID: 35885749 PMCID: PMC9319274 DOI: 10.3390/healthcare10071222] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Virtual reality (VR) using head-mounted displays (HMDs) has demonstrated to be an effective tool for treating various somatic and psychological symptoms. Technological advances and increased affordability of VR technology provide an interesting option for delivering psychological interventions to patients in palliative care. The primary aim of this systematic review was to synthesise the available research on the use of VR for enhancing psychological and somatic outcomes for palliative care patients. Secondary aims included assessing general satisfaction and overall usability. Method: A pre-registered systematic literature search was conducted according to PRISMA guidelines using OVID Emcare, Cochrane Library, Embase, Medline, PsycINFO, and PubMed Care Search: Palliative Care Knowledge Network. Peer-reviewed experimental, quasi-experimental, observational, case, and feasibility studies consisting of single or multiple VR sessions using HMDs that reported psychological and/or somatic outcomes were included. Results: Eight studies published between 2019 and 2021 were included, representing 138 patients. While the reported quantitative psychological and somatic outcomes were ambiguous, the qualitative outcomes were largely positive. Participants were generally satisfied with VR, and most studies reported the VR interventions as usable, feasible, and acceptable. Conclusions: VR shows promise in palliative care and generally addresses a range of symptoms with few adverse effects. Future research should consist of adequately powered RCTs evaluating dosage and focusing on providing meaningful activities to enhance outcomes further.
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Affiliation(s)
- Jessica L. Martin
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
| | - Dimitrios Saredakis
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
- Correspondence:
| | - Amanda D. Hutchinson
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
| | - Gregory B. Crawford
- Northern Adelaide Local Health Network, Adelaide 5092, Australia;
- Discipline of Medicine, University of Adelaide, Adelaide 5005, Australia
| | - Tobias Loetscher
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
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15
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Moscato S, Sichi V, Giannelli A, Palumbo P, Ostan R, Varani S, Pannuti R, Chiari L. Virtual Reality in Home Palliative Care: Brief Report on the Effect on Cancer-Related Symptomatology. Front Psychol 2021; 12:709154. [PMID: 34630217 PMCID: PMC8497744 DOI: 10.3389/fpsyg.2021.709154] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
Virtual reality (VR) has been used as a complementary therapy for managing psychological and physical symptoms in cancer patients. In palliative care, the evidence about the use of VR is still inadequate. This study aims to assess the effect of an immersive VR-based intervention conducted at home on anxiety, depression, and pain over 4days and to evaluate the short-term effect of VR sessions on cancer-related symptomatology. Participants were advanced cancer patients assisted at home who were provided with a VR headset for 4days. On days one and four, anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS) and pain by the Brief Pain Inventory (BPI). Before and after each VR session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS). Participants wore a smart wristband measuring physiological signals associated with pain, anxiety, and depression. Fourteen patients (mean age 47.2±14.2years) were recruited. Anxiety, depression (HADS), and pain (BPI) did not change significantly between days one and four. However, the ESAS items related to pain, depression, anxiety, well-being, and shortness of breath collected immediately after the VR sessions showed a significant improvement (p<0.01). A progressive reduction in electrodermal activity has been observed comparing the recordings before, during, and after the VR sessions, although these changes were not statistically significant. This brief research report supports the idea that VR could represent a suitable complementary tool for psychological treatment in advanced cancer patients assisted at home.
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Affiliation(s)
- Serena Moscato
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
| | - Vittoria Sichi
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | | | - Pierpaolo Palumbo
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
| | - Rita Ostan
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | - Silvia Varani
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | | | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
- Health Sciences and Technologies - Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
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Wakiguchi Y, Kiyohara H, Kako J, Kajiwara K, Kobayashi M. Response to Brungardt et al.: Virtual Reality-Based Music Therapy in Palliative Care: A Pilot Implementation Trial (DOI: 10.1089/jpm.2020.0403). J Palliat Med 2021; 24:653. [PMID: 33945323 DOI: 10.1089/jpm.2021.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yuki Wakiguchi
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Hana Kiyohara
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Kohei Kajiwara
- Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
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