A study conducted by Stansel et al, which was published in the journal Clinical Journal of Oncology Nursing, highlighted the potential of virtual reality therapy to reduce patient stress, pain, and negative affect during chemotherapy sessions. The findings also appeared to support its delivery and monitoring by nurses as part of comprehensive care.
“Commercially available [virtual reality] headsets are widely accessible, relatively affordable, and simple to use, making virtual reality a feasible nursing intervention,” the investigators commented. “Patient needs in different care areas may be unique, and nursing is positioned to consider the various conditions for which virtual reality may be useful.”
Study Details
In this single-site study, patients were randomly assigned to receive standard care with (n = 45) or without (n = 45) a 12-minute virtual reality session during chemotherapy. The virtual reality therapy session consisted of three narrated video tours of Venice, Italy; Agra, India; and the Ecuadorian Amazon. Patients who were not randomly assigned to receive this intervention continued their previous activities during chemotherapy (eg, reading, watching television, visiting with guests).
Patients in both groups rated their stress, pain, and affect levels before and immediately after the intervention period. Stress and pain were measured using the validated Likert-type Stress Numerical Rating Scale–11 and the numeric pain rating scale (0 = no stress/pain, 10 = highest stress/pain possible). The investigators assessed affect with the validated Likert-type Positive and Negative Affect Schedule (1 = very slightly or not at all, 5 = extremely). Half of the 20 questions assessed positive affect and the other half assessed negative affect; total scores ranged from 10 to 50 for both, with higher positive affect scores representing higher levels of positive affect and lower negative affect scores representing lower levels of negative affect.
Heart rate was recorded via pulse oximeter for both patients in the virtual reality and control groups before and halfway through the intervention period. Using the validated Likert-type Fast Motion Sickness Scale (0 = no sickness, 20 = frank sickness), the investigators evaluated cybersickness in the virtual reality group. Patient satisfaction with the virtual reality experience was rated on a numeric scale from 0 to 10, with 0 being “least satisfied” and 10 being “most satisfied.”
Key Findings
Among patients receiving virtual reality therapy vs standard care, there appeared to be statistically significant decreases in stress (by 1.5 points; P < .001) and pain (by 0.7 points; P = .02). Positive affect seemed to be significantly elevated (by 3.5 points; P < .001), and negative affect appeared to be significantly reduced (by 4.9 points; P < .001). Heart rate measurements were found to decrease by an average of 6.6 beats per minute from baseline to midway through the intervention period with virtual reality vs standard care (P < .001), indicating reduced psychologic stress. According to the investigators, most patients reported high satisfaction with virtual reality (score ≥ 9: n = 26; score ≤ 6: n = 5) and experienced no feelings of cybersickness (n = 35).
The investigators concluded: “More investigation is needed into the effects of different types of [virtual reality] content and durations of various virtual reality interventions. Future research is also needed to establish long-term outcomes of virtual reality usage in oncologic care and to assess the effect of virtual reality on treatment adherence, pain trajectory, and quality of life. Additional research might intentionally include a broader range of demographic groups, aiming for the participants to reflect the diversity of the U.S. population.”
Cody C. Stansel, MSN, RN, NE-BC, OCN, CMSRN, of Vanderbilt University Medical Center, Nashville, is the corresponding author of the Clinical Journal of Oncology Nursing article.
Disclosure: For full disclosures of the study authors, visit ons.org.
