How effective is virtual reality technology in palliative care? A systematic review and meta-analysis

Abstract

Background: The efficacy of virtual reality for people living with a terminal illness is unclear. Aim: To determine the feasibility and effectiveness of virtual reality use within a palliative care setting. Design: Systematic review and meta-analysis. PROSPERO (CRD42021240395). Data sources: Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included ‘virtual reality’ and ‘palliative care’. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges’s g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted. Results: Eight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain ( p = 0.0363), tiredness ( p = 0.0030), drowsiness ( p = 0.0051), shortness of breath ( p = 0.0284), depression ( p = 0.0091) and psychological well-being ( p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm. Conclusions: Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.

Virtual Reality for Anxiety Reduction in Women Undergoing Colposcopy: A Randomized Controlled Trial

“…satisfaction in women undergoing colposcopy and colposcopically guided biopsies. Because controversial evidence has been reported regarding the therapeutic value of VR when used as an anxiety-reducing intervention during medical procedures, 17,18,29 we conclude that VR is not a clinically useful intervention to reduce patients' fear and anxiety before and during colposcopy.…”

A Rapid Review of the Role of Virtual Reality in Care Delivery of Palliative Care and Hospice

“…Safety and efficacy were predominant themes in all the studies reviewed with no serious issues identified. The systematic reviews reported promising results regarding safety and efficacy of VR use in palliative care and hospice services 15-17 . Acceptability of VR by providers and patients was consistent across the studies reviewed.…”

“…Virtual reality included computer-simulated environments 9,15,21 with an overarching immersive component 16,17,20,22-25 . Computer-generated imagery, 22,26 a 360° aspect ratio and 3-dimensional, 16-18,20 and virtual worlds 20,23 detailed the experience for the participant. Head-mounted displays were used in nearly all of the studies 16-20,22,24-28 .…”

“…Computer-generated imagery, 22,26 a 360° aspect ratio and 3-dimensional, 16-18,20 and virtual worlds 20,23 detailed the experience for the participant. Head-mounted displays were used in nearly all of the studies 16-20,22,24-28 . Hand controllers, 17,22 joy sticks, 18 screens, 20,22 and a VR facilitator 23 were also integrated as part of the experience.…”

“…The scenes generated by the software included nature-based immersion, such as underwater ocean experiences from VR Blue 22 . In 1 systematic review, 8 different types of VR experiences, such as travel destinations, guided imagery, and personalized experiences, were described 17 . Participants could select a specific destination, such as the beach 19 or forest, 26 or could have an experience personalized to their wishes 28 .…”