Authors (including presenting author) :
Martin CHAN(1), Jackson WONG(1), Peggy HUI(1), PT LAM(2), SY Ma(2)
Affiliation :
(1) Department of Occupational Therapy and (2) Department of Medicine & Geriatrics, United Christian Hospital, HA.
Introduction :
Virtual Reality (VR) technology enables patients to become immersed in a computer-simulated, three-dimensional environment, through Head-Mounted Display (HMD), audio feedback and motion tracking to produce an immersive experience. Recent studies and systematic review have shown that VR can be an effective technology in pain management of cancer patients in clinical settings [1,2,3]. VR application can offer an advance, non-pharmacological and adjunctive therapy to distract cancer patients from the painfully sensory signals and to draw their attention to the virtual experience with cognitive engagement and mindfulness relaxation.
Since 2019, Occupational Therapy department applied Fully-Immersive Virtual Reality (FI-VR) for cancer patient under palliative care (PC) as an advanced alternative modality of cancer pain management in United Christian Hospital.
Objectives :
A pilot study to evaluate effectiveness of FI-VR system on pain management for advanced cancer patients under PC.
Methodology :
Cancer patients under PC in UCH, who had met the inclusion criteria, (1) diagnosis of advanced cancer; (2) suffering from cancer-related pain; (3) medically stable without history of seizure, epilepsy, nausea, vomiting or motion sickness; (4) satisfactory head & neck control; and (5) no significant cognitive and visual impairment, were recruited for the pilot study (from 2/2019 to 11/2021). Recruited cancer patients attended sessions of FI-VR application on pain management provided by Occupational Therapist. Each FI-VR session was up to 30 minutes (subject to patient’s need and tolerance). During each FI-VR session, patient was wearing a HMD FI-VR system and/or headphones, and could choose their desired VR environment, such as deep sea diving, or through Google Earth VR to travel to either “their memorable places” or “return their home”.
A pretest-posttest design was adopted. Outcome measures were measured before and after the FI-VR session, including pain score (Numeric Rating Scale - NRS), heart-rate, blood-pressure, respiration rate and patient satisfaction survey.
Result & Outcome :
A total of 28 (61% male and 39% female) cancer patients were recruited in the pilot study and their mean age was 70.8 (±11.6). Diagnosis of patients includes Ca lung (45%), Ca colon (22%), Ca breast (11%), Ca renal pelvis (11%) and Ca cholangio (11%). Results showed statistically significant differences over pain scores (Pre-test 4.3 SD 1.6 vs Post-test 2.8 SD 1.6; p<0.001), heart rate (Pre-test 81.7 SD 17.2 vs Post-test 77.9 SD 17.3; p<0.001), and respiration rate (Pre-test 21.9 SD 2.6 vs Post-test 18.7 SD 2.8; p<0.001) of recruited patients. Most of participants (95%) perceived a satisfying, relaxing and non-frustrating experience by using the VR system. All of them reported that Virtual Reality was effective to distract their pain feeling when being immersed in the desired and relaxing VR environment.
