Abstract
The use of virtual reality (VR) shows promising results in improving the emotional wellbeing of cancer patients, reducing anxiety, depression, and pain symptoms. No data exist concerning the use of VR in cancer patients assisted at home. The ANT Foundation decided to conduct a pilot study to test the use of VR in cancer patients assisted at home. Fifty-eight ANT patients were randomized and assigned to a control group that didn't use VR devices and to an experimental group that used them. The primary objective of the pilot study was to determine whether VR device could be a viable instrument in homecare patients. Furthermore, the aim of the study was to discover if VR could have beneficial effects on patients' quality of life as well as discover which kind of videos were more effective. The innovative aspect of this study was to test the use of VR directly at home of patients, proposing a use of VR that is compatible with the needs and the daily rhythms of families, and investigating its effectiveness through appropriate validated psychometric questionnaires and semi-structured interviews.
TopIntroduction
The experience of a cancer diagnosis and progression of the disease in its different phases can lead to psychological distress, relationship problems, cognitive limitations and numerous physical symptoms of a strong emotional impact. Besides compromising the physical health of the patient, cancer often causes psychological discomfort characterized by anxious and depressive symptoms that may be clinically significant in some cases. These factors can seriously affect the quality of life of the person and his family environment, hampering the adherence to treatment, the efficacy of therapies and deteriorating the clinical prognosis. Cancer greatly interferes with all aspects of daily life of the person affected, from family and personal relationships to business and financial areas. Numerous studies confirm that a high number of cancer patients experience severe levels of psychological distress such as depression and anxiety, with a percentage people affected respectively of 20% and 10% (Pitman et al., 2018). Contrary to expectations, percentages of people suffering of depression and anxiety in end-of-life phase do not differ significantly from those of patients in non-palliative care settings (Mitchell et al., 2011). In addition to the emotional distress related to the anguish of confronting death, advanced stages of the disease very often imply a progressive loss of functional autonomy. This puts the patient in a state of deprivation and forced isolation from a relational and social aspect that was hitherto part of their life. This state of psychological distress naturally adds to the burden of the physical symptoms caused by the disease and/or invasive therapies, above pain. The reduction of the opportunities in which it is possible to experience positive emotions and meaningful social interactions often corresponds to an intensification of the concerns and the obsessive thoughts, which in turn increase stress and connect to further negative emotional experiences. This vicious circle, in absence of rapid and effective intervention, risks to worsen patients’ quality of life. Beyond pharmacological approach, complementary psychological techniques aiming to deflect patient’s attention from unpleasant symptoms have been employed (e.g. muscular progressive relaxation, mindfulness, guided imagery). By moving attention towards neutral or positive emotions and sensations, these techniques may help patients to manage distress and pain.
Key Terms in this Chapter
Palliative Care (PC): Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by identification, assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.
Breakthrough Cancer Pain (BTcP): Transient exacerbation of pain occurring in a patient with otherwise stable, persistent pain. Breakthrough pain is relatively common among cancer patients, particularly those with moderate to severe background pain, and is one of the most difficult pain syndromes to treat.
Virtual Reality (VR): The possibility to immerse in a completely virtual world using a device to visualize computer graphics or computer sound.
Home Oncological Clinic: ANT oncological home care service.
Psychological Distress (Distress): Is a general term used to describe unpleasant feelings or emotions that impact your level of functioning. Sadness, anxiety, distraction, and symptoms of mental illness are manifestations of psychological distress.
Mindfulness: The psychological process of bringing one’s attention to the internal and external experiences occurring in the present moment, which can be developed through the practice of meditation and other training.
End-of-Life Care: Care given to people who are near the end of life and have stopped treatment to cure or control their disease. End-of-life care includes physical, emotional, social, and spiritual support for patients and their families.