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护理学报 ›› 2024, Vol. 31 ›› Issue (11): 58-62.doi: 10.16460/j.issn1008-9969.2024.11.058

• 临床护理: 内科护理 • 上一篇    下一篇

虚拟现实在癌症晚期患者安宁疗护中的应用

郭颖英1, 俞新燕2, 谢淑萍3   

  1. 1.浙江省肿瘤医院 肿瘤内科,浙江 杭州 310022;
    2.浙江省肿瘤医院 护理部,浙江 杭州 310022;
    3.浙江省肿瘤医院 质改部,浙江 杭州 310022
  • 收稿日期:2024-01-24 出版日期:2024-06-10 发布日期:2024-07-10
  • 通讯作者: 俞新燕（1972-）,女,绍兴新昌人,本科学历,主任护师。E-mail：yuxinyansafe@163.com
  • 作者简介:郭颖英（1980-）,女,浙江东阳人,本科学历,主管护师。
  • 基金资助:
    浙江省医药卫生科技计划项目（2022KY089）

Virtual reality in symptom management in hospice care for patients with advanced cancer

GUO Ying-yinga, YU Xin-yanb, XIE Shu-pingc   

  1. a. Dept. of Oncology; b. Dept. of Nursing Administration; c. Dept. of Quality Improvement, Zhejiang Cancer Hospital, Hangzhou 310022, China
  • Received:2024-01-24 Online:2024-06-10 Published:2024-07-10

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摘要： 目的 探讨虚拟现实（VR）技术在晚期癌症患者安宁疗护症状管理中的应用效果。方法 选取2022年7月到2024年1月在浙江省某肿瘤专科医院接受治疗的61例复发/转移的晚期癌症住院患者为研究对象,给予1次30 min的VR放松体验。运用埃德蒙顿症状评估系统（ESAS）中文版对患者的躯体及情绪症状在干预前后即时进行多维度评估,以评价有效性。并使用11点数字评价量表（NRS）即时评估患者在干预前后头晕变化,以观察不良反应发生情况。结果 61例入组患者经VR放松干预后,ESAS评分明显低于干预前,且差异具有统计学意义（P<0.05）。头晕NRS评分高于干预前,差异具有统计学意义（P<0.05）。干预后9例患者出现轻度头晕或头晕稍微加重现象,发生率为15%。头晕NRS评分波动在1~2分之间,均可自行缓解。结论 虚拟现实技术在晚期癌症患者安宁疗护中的应用,可有效改善晚期癌症患者即时的疼痛、疲乏、恶心、厌食,焦虑和抑郁等症状,且安全可靠,VR技术有望成为晚期癌症患者安宁疗护症状管理中的一种辅助治疗技术。

关键词: 虚拟现实技术, 症状管理, 晚期癌症患者, 安宁疗护

Abstract: Objective To explore the application effect of virtual reality (VR) technology in symptom management of hospice care for patients with advanced cancer. Methods Sixty-one advanced cancer patients with recurrence/metastasis who received treatment at a specialized cancer hospital in Zhejiang Province from July 2022 to January 2024 were selected for the study and provided one 30-minute VR relaxation experience. The Edmonton Symptom Assessment System (ESAS)---Chinese version was used to conduct multidimensional evaluations of the physical and emotional symptoms of patients before and after intervention to evaluate the effectiveness, and the 11 point Numeric Rating Scale (NRS) to immediately evaluate the changes in dizziness of patients before and after intervention to observe the occurrence of adverse reactions. Results After the VR relaxation intervention, the ESAS score of 61 enrolled patients were significantly lower than that before the intervention, and the difference was statistically significant (P<0.05). The NRS score for dizziness was higher than that before intervention, and the difference was statistically significant (P<0.05). After intervention, 9 patients experienced mild dizziness or slightly aggravated dizziness, with an incidence rate of 15%. NRS score of dizziness fluctuated between 1 and 2 points, and all the symptoms can be alleviated on their own. Conclusion The application of VR technology in the hospice care of patients with advanced cancer can effectively improve their immediate symptoms such as pain, fatigue, nausea, anorexia, anxiety, and depression. It is safe and reliable. VR technology is expected to become an auxiliary treatment technology in the symptom management of hospice care for patients with advanced cancer.

Key words: virtual reality technology, symptom management, patients with advanced cancer, hospice care

中图分类号: 

  • R473
[1] 田继红, 蒋岱. 从虚拟现实(VR)发展看未来医学教育的变革[J].中国管理信息化, 2017, 20(6):209-210.DOI:10.3969/j.issn.1673-0194.2017.06.142.
[2] Seiler A, Schettle M, Amann M, et al.Virtual reality therapy in palliative care: a case series[J]. J Palliat Care, 2022: 8258597221086767.DOI: 10.1177/08258597221086767.
[3] 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.
[4] 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.
[5] 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.
[6] 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/s00520-012-152-x.
[7] 肖倩,余赛英,孙沛.虚拟现实技术在医疗护理领域中的应用与研究进展[J].中国护理管理,2020,20(2):165-170.
[8] 杨秋,刘美连,邰明霞,等.虚拟现实技术在国内外护理领域中应用的研究进展[J].护士进修杂志,2023,38(7):620-623.DOI:10.16821/j.cnki.hsjx.2023.07.008.
[9] 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.
[10] 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.
[11] 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.
[12] Dong Y, Chen H, Zheng Y, et al. Psychometric validation of the edmonton symptom assessment system in chinese patients[J]. J Pain Symptom Manage, 2015, 50(5):712-717.e2. DOI:10.1016/j.jpainsymman.2015.05.018.
[13] 郑立萍,张淑香,何瑞仙,等.埃德蒙顿量表在癌症患者症状评估中的应用进展[J].中华现代护理杂志, 2017,23(4):578-581.DOI:10.3760/cma.j.issn.1674-2907.2017.04.035.
[14] 彭晓喻. 穴位按摩联合情志护理对肺癌患者疼痛及情绪状态的影响[J]. 中医外治杂志, 2022, 31(1):102-103.
[15] Zeng Y, Zhang JE, Cheng ASK, et al.Meta-analysis of the efficacy of virtual reality-based interventions in cancer-related symptom management[J]. Integr Cancer Ther,2019,18:1534735419871108.DOI:10.1177/1534735419871108.
[16] Chirico A, Maiorano P, Indovina P, et al.Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy[J]. J Cell Physiol, 2020, 235(6): 5353-5362.DOI:10.1002/jcp.29422.
[17] 陈静文, 裴菱花, 陆丽兰, 等. 虚拟现实技术对急性冠状动脉综合征患者心率变异性及儿茶酚胺水平的影响[J]. 江苏医药, 2021, 47(11):1156-1159.DOI:10.19460/j.cnki.0253-3685.2021.11.020.
[18] Michel A, Brigaud E, Cousson-Gélie F, et al.Virtual reality for elderly with breast cancer: usefulness and acceptance[J]. Geriatr Psychol Neuropsychiatr Vieil,2019,17(4):415-422. DOI: 10.1684/pnv.2019.0832.
[19] Kaufeld M, Bourdeinik J, Prinz LM, et al.Emotions are associated with the genesis of visually induced motion sickness in virtual reality[J]. Exp Brain Res, 2022, 240(10): 2757-2771. DOI: 10.1007/s00221-022-06454-z.
[20] Tanaka N, Takagi H.Virtual reality environment design of managing both presence and virtual reality sickness[J].J Physiol Anthropol Appl Human Sci, 2004,23(6):313-317. DOI: 10.2114/jpa.23.313.
[21] Spiegel B, Fuller G, Lopez M, et al.Virtual reality for management of pain in hospitalized patients:a randomized comparative effectiveness trial[J]. PLoS One, 2019, 14(8): e0219115.DOI: 10.1371/journal.pone.0219115.
[22] Park JH, Liao Y, Kim DR, et al.Feasibility and tolerability of a culture-based virtual reality (VR) training program in patients with mild cognitive impairment: a randomized controlled pilot study[J]. Int J Environ Res Public Health, 2020,17(9):3030. DOI:10.3390/ijerph17093030.
[23] Peck K, Russo F, Campos JL, et al.Examining potential effects of arousal, valence, and likability of music on visually induced motion sickness[J]. Exp Brain Res, 2020, 238(10):2347-2358.DOI:10.1007/s00221-020-05871-2.
[24] Keshavarz B, Stelzmann D, Paillard A, et al.Visually induced motion sickness can be alleviated by pleasant odors[J]. Exp Brain Res, 2015, 233(5):1353-1364.DOI:10.1007/s00221-015-4209-9.
[25] Dyer E, Swartzlander BJ, Gugliucci MR.Using virtual reality in medical education to teach empathy[J]. J Med Libr Assoc, 2018, 106(4):498-500. DOI:10.5195/jmla.2018.518.
[26] Park S, Lee G.Full-immersion virtual reality: adverse effects related to static balance[J]. Neurosci Lett, 2020, 733: 134974.DOI:10.1016/j.neulet.2020.134974.
[27] Benelli A, Neri F, Cinti A, et al.Frequency-dependent reduction of cybersickness in virtual reality by transcranial oscillatory stimulation of the vestibular cortex[J]. Neurotherapeutics, 2023, 20(6):1796-1807.DOI:10.1007/s13311
-023-01437-6.
[28] D’amour S, Bos JE, Keshavarz B.The efficacy of airflow and seat vibration on reducing visually induced motion sickness[J]. Exp Brain Res, 2017, 235(9): 2811-2820.DOI: 10.1007/s00221-017-5009-1.
[29] Yang AHX, Kasabov N, Cakmak YO.Machine learning methods for the study of cybersickness: a systematic review[J]. Brain Inform, 2022,9(1):24.DOI:10.1186/s40708-022-00172-6.
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