目的 对虚拟现实技术在生命末期患者中应用的相关研究进行范围综述,为我国医护人员在生命末期照护领域深入开发和运用虚拟现实技术提供参考。方法 以澳大利亚JBI循证卫生保健中心提出的范围综述指南为方法学指导,计算机检索PubMed、Web of Science、Embase、Cochrane library、CINAHL、中国生物医学文献数据库、中国知网、万方数据服务平台和维普数据库,检索时限为建库至2023年8月。由 2 名研究人员独立筛选并提取资料。结果 共纳入 13篇文献,均为英文文献,虚拟现实技术干预类型主要为基于沉浸式的观影或游戏体验等,干预总时长为1 d至4周不等,4~60 min/次;结局指标主要包括对生命末期患者疼痛水平、症状困扰、心理或精神健康水平、生活质量、生理参数的影响,以及可行性与可接受性等指标。结论 虚拟现实技术在生命末期患者中应用具有较强的可行性与较高的可接受度,未来仍需要开展大样本、高质量的研究来验证虚拟现实技术在生命末期患者中的应用效果,为制订符合我国生命末期群体特点的最佳虚拟现实技术干预方案提供循证依据。
Abstract
Objective To conduct a scoping review on researches on the application of virtual reality (VR) technology in patients at the end of life, and to provide reference for healthcare professionals to further develop and apply VR technology in the field of end-life care. Methods Using the scoping review guidelines developed by the Joanna Briggs Institute (JBI) as methodological guidance, PubMed, Web of Science, Embase, Cochrane library, CINAHL, CBM, CNKI, Wanfang Data and VIP were searched with a retrieval period spanning from the inception to August 2023. Data were screened and extracted independently by two researchers. Results A total of 13 studies were included, all of which were in English. The intervention types of VR technology were mainly based on immersive movie watching or game experience, etc. The total intervention course ranged from 1 day to 4 weeks, and the duration of a single intervention was 4 to 60 minutes per session. The outcome indicators mainly included the impact on pain, symptom distress, mental or mental health, quality of life, physiological parameters, and feasibility and acceptability. Conclusion VR technology intervention has a positive impact on end-of-life patients, with strong feasibility and high acceptability. In the future, large-scale and high-quality studies are still needed to verify the application effect of VR technology in end-of-life patients, so as to provide an evidence-based basis for the development of an optimal VR technology intervention program that meets the characteristics of end-of-life population in China.
关键词
虚拟现实技术 /
生命末期 /
安宁疗护 /
范围综述
Key words
virtual reality /
end of life /
palliative care /
scoping review
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参考文献
[1] World Health Organization.Strengthening of palliative care as a component of integrated treatment throughout the life course[J]. J Pain Palliat Care Pharmacother, 2014, 28(2): 130-134. DOI:10.3109/15360288.2014.911801.
[2] 国家卫生计生委.《全国护理事业发展规划(2021-2025年)》[EB/OL].(2022-05-07) [2023-09-01]. http://www.nhc.gov.cn/yzygj/s7653pd/202205/441f75ad347b4ed68a7d2f2972f78e67.Shtml.
[3] 郭颖英,谢淑萍,傅晓炜.虚拟现实技术在安宁疗护中的应用进展[J].护理学报,2021, 28(10):32-34. DOI:10.16460/j.issn1008-9969.2021.10.032.
[4] 玄令美,颛孙雯,陈梦婷,等.虚拟现实技术在老年痴呆患者中的研究进展[J].护理学报,2019,26(3):17-19. DOI:10.16460/j.issn1008-9969.2019.03.017.
[5] Mo J, Vickerstaff V, Minton O, et al.How effective is virtual reality technology in palliative care? A systematic review and Meta-analysis[J]. Palliat Med, 2022, 36(7):1047-1058. DOI:10.1177/02692163221099584.
[6] Martin JL, Saredakis D, Hutchinson AD, et al.Virtual reality in palliative care: a systematic review[J].Healthcare (Basel), 2022,10(7):1222. DOI:10.3390/healthcare10071222.
[7] Lockwood C, Dos santos KB, Pap R. Practical guidance for knowledge synthesis: scoping review methods[J].Asian Nurs Res, 2019,13(5):287-294. DOI:10.1016/j.anr.2019.11.002.
[8] Perna MSc Msw L, Lund S, et al. The potential of personalized virtual reality in palliative care: a feasibility trial[J]. Am J Hosp Palliat Care, 2021,38(12):1488-1494. DOI:10.1177/1049909121994299.
[9] Groninger H, Stewart D, Fisher JM, et al.Virtual reality for pain management in advanced heart failure: a randomized controlled study[J]. Palliat Med, 2021,35(10):2008-2016. DOI:10.1177/02692163211041273.
[10] Austin PD, Siddall PJ, Lovell MR.Feasibility and acceptability of virtual reality for cancer pain in people receiving palliative care: a randomised cross-over study[J]. Support Care Cancer, 2022,30(5):3995-4005.DOI:10.1007/s00520-022-06824-x.
[11] Baños RM, Espinoza M, García-palacios A,et al. A positive psychological intervention using virtual reality for patients with advanced cancer in a hospital setting: a pilot study to assess feasibility[J]. Support Care Cancer, 2013,21(1):263-270. DOI:10.1007/s00520-012-1520-x.
[12] Niki K, Okamoto Y, Maeda I, et al.A novel palliative care approach using virtual reality for improving various symptoms of terminal cancer patients: a preliminary prospective, multicenter study[J]. J Palliat Med, 2019,22(6):702-707.DOI:10.1089/jpm.2018.0527.
[13] Johnson T, Bauler L, Vos D, et al.Virtual reality use for symptom management in palliative care: a pilot study to assess user perceptions[J].J Palliat Med, 2020,23(9):1233-1238.DOI:10.1089/jpm.2019.0411.
[14] Ferguson C, Shade MY, Blaskewicz BJ, et al.Virtual reality for therapeutic recreation in dementia hospice care: a feasibility study[J]. Am J Hosp Palliat Care, 2020, 37(10):809-815. DOI:10.1177/1049909120901525.
[15] Moscato S, Sichi V, Giannelli A, et al.Virtual reality in home palliative care: brief report on the effect on cancer-related symptomatology[J]. Front Psychol,2021(12):709154.DOI:10.3389/fpsyg.2021.709154.
[16] Brungardt A, Wibben A,Tompkins AF, et al.Virtual reality-based music therapy in palliative care: a pilot implementation trial[J]. J Palliat Med, 2021,24(5):736-742. DOI:10.1089/jpm.2020.0403.
[17] Dang M, Noreika D, Ryu S, et al.Feasibility of delivering an avatar-facilitated life review intervention for patients with cancer[J]. J Palliat Med, 2021, 24(4):520-526. DOI:10.1089/jpm.2020.0020.
[18] Seiler A, Schettle M, Amann M, et al. Virtual reality therapy in palliative care: a case series[J]. J Palliat Care, 2022,8258597221086767. Advance Online Publication. DOI:10.1177/08258597221086767.
[19] Guenther M, Görlich D, Bernhardt F, et al.Virtual reality reduces pain in palliative care-a feasibility trial[J]. BMC Palliat Care, 2022,21(1):169. DOI:10.1186/s12904-022-01058-4.
[20] Kabir M, Rice JL, Bush SH, et al.A mixed-methods pilot study of ‘LIFEView' audiovisual technology: virtual travel to support well-being and quality of life in palliative and end-of-life care patients[J]. Palliat Med, 2020, 34(7):954-965. DOI:10.1177/0269216320918514.
[21] Yang J, Wahner-roedler DL, Zhou X, et al. Acupuncture for palliative cancer pain management: systematic review[J]. BMJ Support Palliat Care, 2021,11(3):264-270. DOI:10.1136/bmjspcare-2020-002638.
[22] Smith AK, Cenzer IS, Knight SJ, et al.The epidemiology of pain during the last 2 years of life[J].Ann Intern Med, 2010,153(9):563-569.DOI:10.7326/0003-4819-153-9-201011020-00005.
[23] 夏婉婷,谌永毅,刘翔宇, 等.虚拟现实技术在安宁疗护症状管理中的应用进展[J].中华现代护理杂志,2023,29(6):717-722. DOI:10.3760/cma.j.cn115682-20220307-01037.
[24] He M, Li X, Zhang T, et al.The fifth generation mobile communication technology plus virtual reality system for intensive care unit visits during COVID-19 pandemic: keep the delirium away[J].J Nurs Manag,2022,30(8):3885-3887.DOI:10.1111/jonm.13450.
[25] Anwar N, Karimi H, Ahmad A, et al.A novel virtual reality training strategy for poststroke patients: a randomized clinical trial[J]. J Healthc Eng, 2021,2021:6598726. DOI:10.1155/2021/6598726.
基金
湖南省科技厅重点领域研发计划项目（2020SK2121）; 中国卫生人才培养项目护理研究子项目（RCLX2220034）; 湖南省卫生健康委员会一般指导项目（D202314058838）
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