A Virtual Smash Room for Venting Frustration or Just Having Fun: Participatory Design of Virtual Environments in Digitally Reinforced Cancer Rehabilitation

Abstract

Background Cancer rehabilitation is central for helping patients and relatives create a functional everyday life based on the changes in life conditions. The needs are highly individual and include physical, mental, and social challenges. Cancer rehabilitation programs offer coping strategies, including guidelines on how to handle emotions. Objective This paper presents a participatory design activity where patients in cancer rehabilitation use a virtual smash room, which is a virtual environment where the user can break things, mainly porcelain or glass items such as vases or plates. The objective is to understand attitudes to, and some effects of, using this application, as well as eliciting ideas of other virtual environments that would be desired. Methods The virtual environment presented here, the virtual smash room, was designed at the request of a patient with cancer who wanted a tool for venting frustration. In this virtual environment, the user can break porcelain, vases, and plates. Patients participating in a week-long cancer rehabilitation program tested the virtual smash room and reported their experiences through a questionnaire. The questionnaire comprised three sections: (1) a subset of the Intrinsic Motivation Inventory (IMI), (2) a subset of the Virtual Reality Symptoms Questionnaire (VRSQ), and (3) a free-text response section. Results A total of 101 responses were gathered. The results from the IMI questions showed that the participants found the virtual experience enjoyable (mean 4.52, maximum 5, SD 0.73), and it helped them retain their focus (mean 4.44, maximum 5, SD 0.74). The VRSQ revealed that there were only minor symptoms related to general discomfort (5.9%, n=6), fatigue (5.9%, n=6), nausea (3.0%, n=3), and tired eyes (8.9%, n=9), while several participants experienced dizziness (22.8%, n=23). Since only postmeasurements were gathered, nothing could be concluded about the prevalence of these symptoms before testing. The free-text responses indicated that the user group had many ideas for other virtual environments to use in cancer rehabilitation. Conclusions This study presents a concept of using virtual reality in the cancer rehabilitation process and exemplifies activities of patient participation in the design process. Virtual reality has potential in being both distracting and enjoyable, while certain aspects of cybersickness might be especially important to consider for a user group already experiencing physical and mental issues. The results will act as input in the process of further designing virtual applications in digitally reinforced cancer rehabilitation.

SafeVRwards: Designing a complementary virtual reality module to the Safewards framework intended to relax and manage conflict in mental health wards

“…Employing participatory design allowed end-users to collaborate with researchers in defining, creating and iterating on the potential VR intervention to ensure alignment with patient needs, unit workflow and ethical application principles. [34][35][36][37][38][39][40][41][42][43][44][45][46] Addressing clinical staff's concerns and perceived barriers to implementation is crucial to prevent biases against VR adoption. 33 Continuous exposure to VR through research collaboration can improve staff comfort with the technology and align their Open access perspectives to recent literature, demonstrating its promising clinical application.…”

Psychometric Parameters of the Intrinsic Motivation Inventory Adapted to Physical Education in a Sample of Active Adults from Austria

“…The IMI in competitive sports [8] is composed by 18 items divided into four factors as follows [4]: Interest-Enjoyment (IENJ), i.e., how interested is a person in carrying out the given activity, and how they enjoy participating in it ("doing this activity was fun"); Competence (COMP), i.e., whether a person feels competent and skilled at carrying out the given activity ("I am pretty skilled at this activity"); Effort-Importance (EIMP), i.e., how much effort has the person put into carrying out the given activity, and therefore, how important they consider it ("it was important to me to do well at this activity"); and Tension-Pressure (TENP), which is negatively associated with intrinsic motivation and describes whether a person feels tense or pressured at participating in the given activity ("I felt tense while doing this activity") [4]. The IMI has been widely used in research to assess intrinsic motivation in different scientific fields, such as the academic [30,31] or the medical [32,33]. The instrument's validity and reliability has been demonstrated in a prior study [8].…”