journal article Open Access Apr 02, 2022

The benefits and acceptability of virtual reality interventions for women with metastatic breast cancer in their homes; a pilot randomised trial

View at Publisher Save 10.1186/s12885-021-09081-z
Abstract
Abstract
Background
Women with metastatic breast cancer (MBC) report debilitating physical and psychological symptoms, including fatigue, anxiety, and pain, that greatly impact their quality of life. Immersive virtual reality (VR) has been proposed as an adjunctive pain therapy for patients with cancer, and evidence suggests it may also decrease symptoms of anxiety and depression. The purpose of this pilot study was to assess whether VR should be pursued as a feasible and acceptable adjunctive therapy to alleviate physical and psychological symptoms in women with MBC.

Methods
We conducted a pilot study testing the acceptability and efficacy of VR interventions with MBC patients to improve quality of life and to produce enduring decreases in fatigue, pain, depression, anxiety, and stress. Participants completed two different week-long VR experiences, reporting the prevalence of symptoms immediately before and after each study week, and 48 h later. Linear mixed models including fixed effects (VR intervention, counterbalancing order, and study week) and random effects (participant) were used to assess the effect of immersive VR on all outcome measures.

Results
Thirty-eight women with MBC completed the VR interventions and were included in analyses. Significant improvements post-intervention and/or 48 h later were demonstrated for quality of life, fatigue, pain, depression, anxiety, and stress. Across the entire study period, these differences met the criteria of a clinically important difference for quality of life, fatigue, depression, and stress. Participants reported feelings of relaxation and enjoyment and were highly likely to use the interventions gain.

Conclusions
Our results demonstrate that VR experiences offer enduring benefits to the physical and psychological well-being of women with MBC. VR interventions are a feasible and acceptable intervention that can be conducted in a patient’s own home. Such interventions are worthy of future investigation as a novel approach to improving quality of life in a patient population that have often been overlooked.

Trial registration

Prospectively registered on 25th October 2019 with Australian New Zealand Clinical Trials Registry (ref: ACTRN12619001480178).
Topics

No keywords indexed for this article. Browse by subject →

References
44
[1]
Seneviratne S, Lawrenson R, Harvey V, Ramsaroop R, Elwood M, Scott N, et al. Stage of breast cancer at diagnosis in New Zealand: impacts of socio-demographic factors, breast cancer screening and biology. BMC Cancer. 2016;16(1):1–9. 10.1186/s12885-016-2177-5
[2]
Mosher CE, Daily S, Tometich D, Matthias MS, Outcalt SD, Hirsh A, et al. Factors underlying metastatic breast cancer patients’ perceptions of symptom importance: a qualitative analysis. Eur J Cancer Care. 2018;27(1):e12540. 10.1111/ecc.12540
[3]
Niklasson A, Paty J, Rydén A. Talking about breast Cancer: which symptoms and treatment side effects are important to patients with advanced disease? Patient - Patient-Centered Outcomes Res. 2017;10(6):719–27.
[4]
Cleeland C, von Moos R, Walker MS, Wang Y, Gao J, Chavez-MacGregor M, et al. Burden of symptoms associated with development of metastatic bone disease in patients with breast cancer. Support Care Cancer. 2016;24(8):3557–65. 10.1007/s00520-016-3154-x
[5]
Park EM, Gelber S, Rosenberg SM, Seah DSE, Schapira L, Come SE, et al. Anxiety and depression in young women with metastatic breast Cancer: a cross-sectional study. Psychosomatics. 2018;59(3):251–8. 10.1016/j.psym.2018.01.007
[6]
Paolucci T, Saggino A, Agostini F, Paoloni M, Bernetti A, Mangone M, et al. The influence of rehabilitation on quality of life in breast cancer survivors: a clinical study. Int J Environ Res Public Health. 2021;18(16):8585. 10.3390/ijerph18168585
[7]
Teo I, Krishnan A, Lee GL. Psychosocial interventions for advanced cancer patients: a systematic review. Psycho-Oncology. 2019;28(7):1394–407. 10.1002/pon.5103
[8]
Chirico A, Lucidi F, De Laurentiis M, Milanese C, Napoli A, Giordano A. Virtual reality in health system: beyond entertainment. A Mini-review on the efficacy of VR during Cancer treatment. J Cell Physiol. 2016;231(2):275–87. 10.1002/jcp.25117
[9]
Ventura S, Baños RM, Botella C. Virtual and augmented reality: new Frontiers for clinical psychology. In: State of the Art Virtual Reality and Augmented Reality Knowhow . InTech; 2018 [cited 2019 May 23]. Available from: http://www.intechopen.com/books/state-of-the-art-virtual-reality-and-augmented-reality-knowhow/virtual-and-augmented-reality-new-frontiers-for-clinical-psychology 10.5772/intechopen.74344
[10]
Hoffman HG, Patterson DR, Seibel E, Soltani M, Jewett-Leahy L, Sharar SR. Virtual reality pain control during burn wound debridement in the hydrotank. Clin J Pain. 2008;24(4):299–304. 10.1097/ajp.0b013e318164d2cc
[11]
Schneider SM, Prince-Paul M, Allen MJ, Silverman P, Talaba D. Virtual reality as a distraction intervention for women receiving chemotherapy. Oncol Nurs Forum. 2004;31(1):81–8. 10.1188/04.onf.81-88
[12]
Schneider SM, Kisby CK, Flint EP. Effect of virtual reality on time perception in patients receiving chemotherapy. Support Care Cancer. 2011;19(4):555–64. 10.1007/s00520-010-0852-7
[13]
Baños RM, Espinoza M, García-Palacios A, Cervera JM, Esquerdo G, Barrajón E, et al. A positive psychological intervention using virtual reality for patients with advanced cancer in a hospital setting: a pilot study to assess feasibility. Support Care Cancer. 2013;21(1):263–70. 10.1007/s00520-012-1520-x
[14]
Gerçeker GÖ, Bektaş M, Aydınok Y, Ören H, Ellidokuz H, Olgun N. The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: randomized controlled trial. Eur J Oncol Nurs. 2021;50:101886. 10.1016/j.ejon.2020.101886
[15]
Hoffman H., Patterson D., Carrougher G., Sharar S. Effectiveness of virtual reality–based pain control With multiple treatments . Vol. 17, The Clinical Journal of Pain. 2001. p. 229–35. 10.1097/00002508-200109000-00007
[16]
Reed E, Simmonds P, Haviland J, Corner J. Quality of life and experience of Care in Women with Metastatic Breast Cancer: a cross-sectional survey. J Pain Symptom Manag. 2012;43(4):747–58. 10.1016/j.jpainsymman.2011.05.005
[17]
Bardwell WA, Ancoli-Israel S. Breast Cancer and fatigue. Sleep Med Clin. 2008;3(1):61–71. 10.1016/j.jsmc.2007.10.011
[18]
Butt Z, Rosenbloom SK, Abernethy AP, Beaumont JL, Paul D, Hampton D, et al. Fatigue is the Most important symptom for advanced Cancer patients who have had chemotherapy. J Natl Compr Cancer Netw. 2008;6(5):448–55. 10.6004/jnccn.2008.0036
[19]
Oyama H, Kaneda M, Katsumata N, Akechi T, Ohsuga M. Using the bedside wellness system during chemotherapy decreases fatigue and emesis in cancer patients. J Med Syst. 2000;24(3):173–82. 10.1023/a:1005591626518
[20]
Melville NA. Virtual reality ventures into real world of chronic pain. Medscape. 2016.
[21]
Hjärtat A. Happy Place VR . Wenderfalck. 2016 [cited 2021 Aug 24]. Available from: https://wenderfalck.com/projects/happy-place-vr
[22]
Mixt Studio. Ripple VR Experience . 2016 [cited 2021 Aug 24]. Available from: https://mixtstudio.co.nz/work/ripple-vr-experience
[23]
Pickard AS, Neary MP, Cella D. Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health Qual Life Outcomes. 2007;5(1):1–8. 10.1186/1477-7525-5-70
[24]
Yost KJ, Eton DT. Combining Distribution- and Anchor-Based Approaches to Determine Minimally Important Differences: The FACIT Experience. http://dx.doi.org.ezproxy.auckland.ac.nz/101177/0163278705275340 . 2016;28(2):172–91. 10.1177/0163278705275340
[25]
Wong K, Zeng L, Zhang L, Bedard G, Wong E, Tsao M, et al. Minimal clinically important differences in the brief pain inventory in patients with bone metastases. Support Care Cancer. 2013;21(7):1893–9. 10.1007/s00520-013-1731-9
[26]
Ronk FR, Korman JR, Hooke GR, Page AC. Assessing clinical significance of treatment outcomes using the dass-21. Psychol Assess. 2013;25(4):1103–10. 10.1037/a0033100
[27]
Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727–36. 10.1007/s11136-011-9903-x
[28]
Cella DF, Lai JS, Chang CH, Peterman A, Slavin M. Fatigue in cancer patients compared with fatigue in the general United States population. Cancer. 2002;94(2):528–38. 10.1002/cncr.10245
[29]
Eden MM, Kunkel K. Psychometric properties of the modified brief fatigue inventory and FACIT-fatigue in individuals with cancer of the head and neck. Rehabil Oncol. 2016;34(3):97–103. 10.1097/01.reo.0000000000000024
[30]
Shin H, Kim K. Young Hee Kim, Chee W, Im EO. A comparison of two pain measures for Asian American cancer patients. West J Nurs Res. 2008;30:181–96. 10.1177/0193945907303062
[32]
Fox RS, Lillis TA, Gerhart J, Hoerger M, Duberstein P. Multiple group confirmatory factor analysis of the DASS-21 depression and anxiety scales: how do they perform in a cancer sample? Psychol Rep. 2018;121(3):548–65. 10.1177/0033294117727747
[33]
Swallow WH, Monahan JF. Monte carlo comparison of ANOVA, MIVQUE, REML, and ML estimators of variance components. Technometrics. 1984;26(1):47–57. 10.1080/00401706.1984.10487921
[34]
Harville DA. Maximum likelihood approaches to variance component estimation and to related problems. J Am Stat Assoc. 1977;72(358):320–38. 10.1080/01621459.1977.10480998
[35]
Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997;53(3):983. 10.2307/2533558
[36]
Gautier A. “I’m still here”: insights into living - and dying - with advanced breast cancer in New Zealand. Breast. 2019;48:S69–70. 10.1016/s0960-9776(19)30739-8
[37]
Arciero V, Santos SD, Koshy L, Rahmadian A, Saluja R, Everest L, et al. Assessment of Food and Drug Administration– and European medicines agency–approved systemic oncology therapies and clinically meaningful improvements in quality of life: a systematic review. JAMA Netw Open. 2021;4(2):e2033004–4. 10.1001/jamanetworkopen.2020.33004
[38]
Tanja-Dijkstra K, Pahl S, White MP, Andrade J, Qian C, Bruce M, et al. Improving dental experiences by using virtual reality distraction: a simulation study. PLoS One. 2014;9(3):e91276. 10.1371/journal.pone.0091276
[39]
Wender R, Hoffman HG, Hunner HH, Seibel EJ, Patterson DR, Sharar SR. Interactivity influences the magnitude of virtual reality analgesia. J Cyber Ther Rehabil. 2009;2(1):27–33.
[40]
Bower JE, Ganz PA, Aziz N, Fahey JL. Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosom Med. 2002;64(4):604–11. 10.1097/00006842-200207000-00010
[41]
Bower JE, Ganz PA, Aziz N, Fahey JL, Cole SW. T-cell homeostasis in breast Cancer survivors with persistent fatigue. JNCI J Natl Cancer Inst. 2003;95(15):1165–8. 10.1093/jnci/djg0019
[42]
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and Cancer. Cell. 2010;140(6):883–99. 10.1016/j.cell.2010.01.025
[43]
Jones T, Moore T, Choo J. The impact of virtual reality on chronic pain. PLoS One. 2016;11(12):e0167523. 10.1371/journal.pone.0167523
[44]
Ganry L, Hersant B, Sidahmed-Mezi M, Dhonneur G, Meningaud JP. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: a pilot study in maxillofacial and plastic surgery. J Stomatol Oral Maxillofac Surg. 2018;119(4):257–61. 10.1016/j.jormas.2017.12.010
Metrics
62
Citations
44
References
Details
Published
Apr 02, 2022
Vol/Issue
22(1)
License
View
Cite This Article
Lisa M. Reynolds, Alana Cavadino, Stanley Chin, et al. (2022). The benefits and acceptability of virtual reality interventions for women with metastatic breast cancer in their homes; a pilot randomised trial. BMC Cancer, 22(1). https://doi.org/10.1186/s12885-021-09081-z