Feasibility, acceptability, and preliminary efficacy of smartphone-based virtual reality relaxation in chemotherapy patients: A pilot study
-
Made Satya Nugraha Gautama
,
Haryani Haryani
,
Tsai Wei Huang
,
Ariani Arista Putri Pertiwi
,
Devi Rohmah Sholihatun
,
Uki Noviana
Abstract
Background & Aim: While virtual reality holds promise for enhancing patient management and experience during chemotherapy, its use remains limited. The present study aimed to test the feasibility, acceptability, and preliminary efficacy of smartphone-based virtual reality relaxation (SVR) in chemotherapy patients.
Methods & Materials: In this pilot study, 29 participants were divided into two groups. The SVR group (n=14) experienced a 10-minute virtual reality intervention, while the control group (n=15) received standard care and guided imagery leaflets. Outcomes such as comfort, anxiety, pain, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate were evaluated at baseline and post-chemotherapy. The Technology Acceptance Model (TAM) questionnaire and open-ended questions evaluated SVR’s acceptability. Data was analyzed using descriptive statistics, non-parametric t-tests, and thematic analysis.
Results: The SVR intervention appears feasible, as evidenced by a high recruitment rate of 93.75% (30 out of 32 eligible patients) and a retention rate of 96.67% (29 out of 30 participants), despite one withdrawal. The SVR group showed significant comfort improvement (P=0.002), significant changes in pulse rate (P=0.047), and SBP (P=0.023) compared to the control group. Anxiety, pain, pulse rate, and DBP showed no significant differences. A significant TAM variable (P<0.001) confirmed the intervention's acceptability. Qualitative feedback showed no serious side effects and patients reported positive experiences.
Conclusion: The SVR intervention, feasible and acceptable, significantly improved comfort and altered pulse rate and SBP in chemotherapy patients. It shows potential as an oncology care strategy. Further validation is needed through large-scale trials.
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25. Gautama MSN, Huang T-W, Haryani H. A systematic review and meta-analysis of randomized controlled trials on the effectiveness of immersive virtual reality in cancer patients receiving chemotherapy. European Journal of Oncology Nursing. 2023;102424. https://www.sciencedirect.com/science/article/pii/S1462388923001588
26. Jadmiko AW, Kristina TN, Sujianto U, Prajoko YW, Dwiantoro L, Widodo AP. A Quasi-experimental of a Virtual Reality Content Intervention for Level of Comfort of Indonesian Cancer Patients. CIN: Computers, Informatics, Nursing. 2022;40(12). https://journals.lww.com/cinjournal/Fulltext/2022/12000/A_Quasi_experimental_of_a_Virtual_Reality_Content.7.aspx
27. Lewandowska A, Rudzki G, Lewandowski T, Próchnicki M, Rudzki S, Laskowska B, et al. Quality of Life of Cancer Patients Treated with Chemotherapy. International Journal of Environmental Research and Public Health. 2020;17(19).
28. Gautama MSN, Haryani H, Huang T-W. Efficacy of smartphone-based virtual reality relaxation in providing comfort to patients with cancer undergoing chemotherapy in oncology outpatient setting in Indonesia: protocol for a randomised controlled trial. BMJ Open. 2023 Jul 1;13(7):e074506. http://bmjopen.bmj.com/content/13/7/e074506.abstract
29. Ökten Çiğdem, Bedük T. The problems faced by outpatients after gastrointestinal cancer chemotherapy and the methods they use to cope with these problems. Nursing Practice Today. 2017;4(3):125-133.
30. Mahdavi M, Ghafourifard M, Rahmani A. Nursing presence from the perspective of cancer patients: A cross-sectional study. Nursing Practice Today. 2020;8(2):139-145.
2. Mattiuzzi C, Lippi G. Current Cancer Epidemiology. Journal of Epidemiology Global Health. 2019 Dec;9(4):217–22.
3. Abbas Z, Rehman S. An overview of cancer treatment modalities. Neoplasm. 2018;1:139–57.
4. Behranvand N, Nasri F, Zolfaghari Emameh R, Khani P, Hosseini A, Garssen J, et al. Chemotherapy: a double-edged sword in cancer treatment. Cancer Immunology Immunotherapy. 2022;71(3):507–26. https://doi.org/10.1007/s00262-021-03013-3
5. Amjad MT, Chidharla A, Kasi A. Cancer Chemotherapy. Central Harnett Hospital: StatPearls Publishing, Treasure Island (FL); 2022. http://europepmc.org/abstract/MED/33232037
6. Nurgali K, Jagoe RT, Abalo R. Editorial: Adverse Effects of Cancer Chemotherapy: Anything New to Improve Tolerance and Reduce Sequelae? Frontiers in Pharmacology. 2018;9. https://www.frontiersin.org/articles/10.3389/fphar.2018.00245
7. Berntzen H, Bjørk IT, Storsveen A-M, Wøien H. “Please mind the gap”: A secondary analysis of discomfort and comfort in intensive care. Journal of Clinical Nursing. 2020 Jul 1;29(13–14):2441–54. https://doi.org/10.1111/jocn.15260
8. Miao J, Liu M, Ma J, Wang H. Effectiveness of Comfort Nursing Combined with Continuous Nursing on Patients with Colorectal Cancer Chemotherapy. Wu X, editor. Evidence-Based Complementary and Alternative Medicine. 2022;2022:9647325. https://doi.org/10.1155/2022/9647325
9. Kolcaba K, Tilton C, Drouin C. Comfort Theory: A Unifying Framework to Enhance the Practice Environment. JONA: The Journal of Nursing Administration. 2006;36(11). https://journals.lww.com/jonajournal/Fulltext/2006/11000/Comfort_Theory__A_Unifying_Framework_to_Enhance.10.aspx
10. Can A, Hintistan S. An Assessment of the Comfort Level of Cancer Patients with Receiving Chemotheraphy. Bezmialem Science. 2021;9(3):310-6.
11. Chirico A, Maiorano P, Indovina P, Milanese C, Giordano GG, Alivernini F, et al. Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy. Journal of Cellular Physiology. 2020 Jun 1;235(6):5353–62. https://doi.org/10.1002/jcp.29422
12. Huang Q, Lin J, Han R, Peng C, Huang A. Using Virtual Reality Exposure Therapy in Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Value in Health. 2022;25(2):288–301. https://www.sciencedirect.com/science/article/pii/S1098301521015400
13. Rutkowski S, Czech O, Wrzeciono A, Kiper P, Szczepańska-Gieracha J, Malicka I. Virtual reality as a chemotherapy support in treatment of anxiety and fatigue in patients with cancer: A systematic review and meta-analysis and future research directions. Complementary Therapies in Medicine. 2021;61:102767. https://www.sciencedirect.com/science/article/pii/S0965229921001084
14. Blomain E, Capaldi DP, Panjwani N, Skinner L, Loo Jr BW. Development of a Smartphone-Based Virtual Reality Platform for Radiation Oncology Patient Education. International Journal of Radiation Oncology, Biology, Physics. 2021 Nov 1;111(3):e156. https://doi.org/10.1016/j.ijrobp.2021.07.621
15. Chow H, Hon J, Chua W, Chuan A. Effect of Virtual Reality Therapy in Reducing Pain and Anxiety for Cancer-Related Medical Procedures: A Systematic Narrative Review. Journal of Pain and Symptom Management. 2021;61(2):384–94. https://www.sciencedirect.com/science/article/pii/S0885392420306953
16. Ahmad M, Bani Mohammad E, Anshasi HA. Virtual Reality Technology for Pain and Anxiety Management among Patients with Cancer: A Systematic Review. Pain Management Nursing. 2020;21(6):601–7. https://www.sciencedirect.com/science/article/pii/S1524904220301168
17. chulz KF, Altman DG, Moher D, Group the C. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine. 2010;8(1):18. https://doi.org/10.1186/1741-7015-8-18
18. Fabi A, Fotia L, Giuseppini F, Gaeta A, Falcicchio C, Giuliani G, et al. The immersive experience of virtual reality during chemotherapy in patients with early breast and ovarian cancers: the Patient’s Dream study. Frontiers in Oncology. 2022;4271.
19. rtanti ER, Nurjannah I, Subroto S. Validity and reliability of shortened general Comfort questionnaire in indonesian version. Belitung Nursing Journal. 2018 Jun 29;4(4 SE-Original Research Article):366–72. https://www.belitungraya.org/BRP/index.php/bnj/article/view/437
20. Abend R, Dan O, Maoz K, Raz S, Bar-Haim Y. Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety. Journal of Behavior Therapy and Experimental Psychiatry. 2014;45(4):447–53.
21. Frampton CL, Hughes-Webb P. The Measurement of Pain. Clinical Oncology. 2011;23(6):381–6. https://www.sciencedirect.com/science/article/pii/S0936655511006674
22. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology. 2013;4. https://www.frontiersin.org/articles/10.3389/fpsyg.2013.00863
23. Tsuda K, Sudo K, Goto G, Takai M, Itokawa T, Isshiki T, et al. A Feasibility Study of Virtual Reality Exercise in Elderly Patients with Hematologic Malignancies Receiving Chemotherapy. Internal Medicine. 2016;55(4):347–52.
24. Verzwyvelt L, McNamara A, Xu X, Stubbins R. Effects of virtual reality v. biophilic environments on pain and distress in oncology patients: a case-crossover pilot study. Scientific Reports. 2021;11(1):20196. https://doi.org/10.1038/s41598-021-99763-2
25. Gautama MSN, Huang T-W, Haryani H. A systematic review and meta-analysis of randomized controlled trials on the effectiveness of immersive virtual reality in cancer patients receiving chemotherapy. European Journal of Oncology Nursing. 2023;102424. https://www.sciencedirect.com/science/article/pii/S1462388923001588
26. Jadmiko AW, Kristina TN, Sujianto U, Prajoko YW, Dwiantoro L, Widodo AP. A Quasi-experimental of a Virtual Reality Content Intervention for Level of Comfort of Indonesian Cancer Patients. CIN: Computers, Informatics, Nursing. 2022;40(12). https://journals.lww.com/cinjournal/Fulltext/2022/12000/A_Quasi_experimental_of_a_Virtual_Reality_Content.7.aspx
27. Lewandowska A, Rudzki G, Lewandowski T, Próchnicki M, Rudzki S, Laskowska B, et al. Quality of Life of Cancer Patients Treated with Chemotherapy. International Journal of Environmental Research and Public Health. 2020;17(19).
28. Gautama MSN, Haryani H, Huang T-W. Efficacy of smartphone-based virtual reality relaxation in providing comfort to patients with cancer undergoing chemotherapy in oncology outpatient setting in Indonesia: protocol for a randomised controlled trial. BMJ Open. 2023 Jul 1;13(7):e074506. http://bmjopen.bmj.com/content/13/7/e074506.abstract
29. Ökten Çiğdem, Bedük T. The problems faced by outpatients after gastrointestinal cancer chemotherapy and the methods they use to cope with these problems. Nursing Practice Today. 2017;4(3):125-133.
30. Mahdavi M, Ghafourifard M, Rahmani A. Nursing presence from the perspective of cancer patients: A cross-sectional study. Nursing Practice Today. 2020;8(2):139-145.
| Files | ||
| Issue | Vol 11 No 2 (2024): Spring | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v11i2.15408 | |
| Keywords | ||
| smartphone virtual reality cancer chemotherapy | ||
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How to Cite
1.
Gautama MSN, Haryani H, Huang TW, Pertiwi AAP, Sholihatun DR, Noviana U. Feasibility, acceptability, and preliminary efficacy of smartphone-based virtual reality relaxation in chemotherapy patients: A pilot study. NPT. 2024;11(2):158-171.
