Table 3.
Studies included
| Author Year | Objective | Design | Sample | Results |
|---|---|---|---|---|
| Rutkowski 2021 [9] | To assess the effectiveness of a VR intervention in alleviating treatment-related anxiety and fatigue among cancer patients undergoing chemotherapy. | Descriptive observational | 453 patients receiving virtual reality and chemotherapy infusion | Drawing conclusions about the effectiveness of a virtual reality distractor for cancer patients is challenging due to the overall lack of methodological quality and statistical power observed in the current literature. |
| Schneider 2003 [16] | VR proves to be an effective distraction intervention in reducing pain levels associated with chemotherapy-related symptoms in older women with breast cancer. | Observational, pre-post | The implementation of a virtual reality distraction intervention was examined for its impact on the levels of suffering related to chemotherapy symptoms in a group of 16 women aged 50 and over. | There was a notable reduction in State Anxiety Inventory (SAI) scores immediately after chemotherapy treatments when participants engaged in VR (P = 0.10). |
| Ashley Verzwyvelt. 2021 [23] | VR has the potential to alleviate both the pain and distress experienced by cancer patients undergoing chemotherapy. | Observational, case-crossover | The study involved 33 participants diagnosed with breast, gynecological, gastrointestinal, pancreatic, and prostate cancers. | A significant majority, specifically 90.63% of the patients, expressed interest in understanding how nature could influence their health through the use of VR. |
| Wong 2021 [17] | The study aimed to evaluate the feasibility and acceptability of IVR as an intervention for relaxation and distraction, with the goal of reducing anxiety. | Observational, qualitative | Participants for the study will include both patients and their parents, as well as cancer nurses. Recruitment will take place at the oncology unit of a children’s hospital. | IVR enables patients to be completely engaged in an immersive environment, providing a distraction from noxious stimuli during chemotherapy. This engagement has the potential to reduce painful symptoms. |
| Birkhoff 2021 [30] | The study aimed to investigate the influence of a nursing intervention on anxiety levels and perceived self-efficacy. | Observational, descriptive | This study involved 35 cancer patients who were referred for their initial chemotherapy session. The participants were recruited from a large suburban cancer center in Newark, Delaware. | There was a significant decrease in anxiety levels, heart rate, and blood pressure from baseline to post-surgery. Additionally, perceived self-efficacy to cope increased significantly from baseline to the post-surgery assessment. |
| Janssen 2022 [27] | The objective was to investigate the feasibility and acceptability of utilizing VR for adult patients undergoing chemotherapy. | Observational, descriptive | The study included a total of 18 patients, with 5 of them taking part in semi-structured interviews. | Patients expressed that VR was beneficial in breaking up the monotony of their treatment. It offered an additional choice of activities alongside other recreational options. |
| Schneider 2011 [13] | The use of VR during chemotherapy resulted in an elapsed time compression effect. | Observational, descriptive | The study involved a combined sample of n = 137 participants diagnosed with breast, lung, or colon cancer. | In a forward regression model, three predictors - diagnosis, sex, and anxiety - accounted for a significant portion of the variability in the altered perception of time (F = 5.06, P = 0.0008). |
| Chirico 2020 [14] | Interventions that enhance treatment tolerance are pivotal for improving both the quality of life for patients and their adherence to therapies. | Observational, descriptive | Thirty patients were included in the VR group, 30 in the Music Therapy (MT) group, and 34 in the control group. | The VR group reported a mean post-operative anxiety score significantly lower than that of the control group (P = 0.001). The study results indicate that both VR and MT are beneficial interventions for alleviating anxiety. |
| Schneider 2007 [15] | The study aimed to investigate the use of VR as a distraction intervention to alleviate the discomfort of symptoms in adults undergoing chemotherapy treatments for breast, colon, and lung cancer. | Observational, crossover | A total of 123 adults underwent their initial chemotherapy treatments as part of the study. | Patients experienced an altered perception of time (P < 0.001) when using VR, confirming the distraction capacity of the intervention. The evaluation of the intervention revealed that patients found the head-mounted device easy to use, and 82% expressed a willingness to use VR again. |
| Scates. 2020 [31] | The utilization of VR as an alternative stress and pain relief therapy. | Observational, descriptive | The study involved 50 patients attending their regularly scheduled chemotherapy infusion sessions. | During data collection, the principal investigator observed the patients’ body language and facial expressions before, during, and after the VR experience. Although the patients reported feeling significantly less frustrated, the reduction in stress and pain was not statistically significant. |
| Oyama 2000 [26] | BSW has proven to be effective in reducing stress, improving mental well-being, and is suggested to aid in alleviating side effects and mental disorders in patients undergoing cancer chemotherapy. | Observational, case-control | The study included a total of 30 participants, comprising 6 males and 24 females. | Statistically significant reductions were observed in both fatigue and vomiting scores 3-5 days after chemotherapy (both P < 0.05), indicating noteworthy effects. The virtual reality system represents a novel therapeutic method that can be employed in palliative medicine. |
| Ioannou 2020 [19] | In recent years, VR has emerged as an intriguing alternative to traditional exposure-based therapies for various symptoms. | Observational, descriptive | A total of 882 titles and abstracts were reviewed, and 23 studies were included in the review. | This study contributes to the evidence indicating that distraction is an effective mechanism for managing symptoms. |
| Schneider 2004 [18] | The study aimed to explore the use of VR as an intervention through distraction to alleviate the discomfort of symptoms in women undergoing breast cancer chemotherapy. | Observational, cross-over | The study was conducted at the outpatient clinic of a global cancer center in the Midwest. The sample included 20 women aged between 18 and 55. | The primary research variables were symptom distress, fatigue, and anxiety. The results indicated significant decreases in symptom discomfort and fatigue immediately after chemotherapy treatments when women utilized the virtual reality intervention. |
| Bani 2018 [12] | The study aimed to assess the effectiveness of immersive VR as a distraction technology in reducing pain and anxiety among breast cancer patients. | Observational, randomized control | The study included a sample of 80 female patients diagnosed with breast cancer, recruited from a cancer center in Jordan. | The utilization of immersive VR as an adjuvant to surgery has been found to be more effective than morphine alone in alleviating pain and anxiety. Additionally, VR is considered a safe intervention compared to pharmacological treatments. |
| O’Gara 2022 [24] | VR integrates relaxation and compassionate mental health training to assess acceptability and feasibility in an oncological context. It also evaluates the impact on physical and psychological well-being as well as quality of life. | Observational, pre-post | 20 participants | There is a statistically significant difference in mean scores for EDA at mid-session and post-session compared to pre-session (1.658, 4.973) = 13.364, P < 0.05. There has been a statistically significant reduction in stress levels from baseline to the third session. |
| Keener. 2018 [10] | The purpose of this article was to ascertain the effectiveness of standardized and digitally registered education as an alternative teaching method. | Descriptive, observational | Utilizing a pre/post-test design, the study involved 92 patients who received registered instruction. | The digitally recorded educational method has led to a significant decrease in anxiety and an increased retention of knowledge. |
| Garcia 2014 [20] | Anxiety is among the most prevalent symptoms reported by patients undergoing their initial chemotherapy treatment. | Descriptive, observational | Ten articles were identified as pertinent to the clinical question, and they underwent evaluation for quality and methodological rigor. | Educating patients by nurses before their initial chemotherapy infusion in a tranquil environment proves to be the most effective approach. Strengthening the integration of successful patient education programs contributes to holistic care by placing greater emphasis on the psychosocial aspects of oncology. |
| Pourmand 2017 [29] | IVR simulations have the potential to enhance pain management by reducing the patient’s perception of both pain and anxiety. | Descriptive, observational | The search terms used resulted in 97 potential articles, and after screening, 45 articles were identified as meeting the study criteria and were consequently included in this review. | VR is poised to revolutionize the current approach to pain management, medical training, neurocognitive diagnosis, and physical rehabilitation. |
| Zeng 2019 [22] | The use of VR interventions on health-related outcomes in cancer patients. | Descriptive, observational | A total of 6 empirical studies met the eligibility criteria. | The study investigates the effectiveness of virtual reality-based interventions in cancer rehabilitation. |
| Zeng 2018 [21] | While existing evidence supports the use of VR in treating mental disorders, it remains uncertain whether IVR exercises would be beneficial for mental health. | Descriptive, observational | Four studies documented significant improvements in anxiety and depression measures following immersive IVR exercise. | The results indicate a preference for IVR exercise in alleviating symptoms of anxiety and depression. |
| Zasadzka 2021 [11] | IVR can provide women with breast cancer a secure environment for implementing various interventions. | Descriptive, observational | The initial search yielded a total of 144 records, and after applying the review criteria, 11 articles were identified and selected for analysis. | IVR can positively impact both mental and physical functions, such as alleviating anxiety during oncotherapy. |
| Leggiero 2020 [32] | VR has the potential to alleviate some of the negative aspects of the disease by allowing individuals to escape into environments where they can experience more positive thoughts and emotions. | Descriptive, observational | 721 patients across all the literature reviewed, from combined clinical study data. | The results of this review suggest that virtual reality can be used as an innovative delivery system. |
| Burrai 2023 [33] | Review of the literature, aiming to evaluate the effectiveness of VR in reducing anxiety, fatigue, and pain in patients undergoing chemotherapy, providing evidence to inform clinical decision-making. | Descriptive, observational | An overall sample of 459 patients. | The quality of the evidence is very low, and the strength of the recommendation is weak. Additional research holds significant potential to reduce uncertainty regarding the effects of VR during chemotherapy. |
Abbreviations: BC: breast cancer; BSW: wellness system in bed; EDA: electro dermal activity; IVR: virtual reality immersive; MT: music-therapy; SAI: state anxiety Inventory; VR: virtual reality; HDM: head-mounted device.