The Impact of VR-CALM Intervention Based on VR on Psychological Distress and Symptom Management in Breast Cancer Survivors

Abstract

Objective. To evaluate the effectiveness and feasibility of Managing Cancer and Living Meaningfully based on VR (VR-CALM), which is used to manage expected symptoms of cancer itself, relieve psychological distress, and improve quality of life (QOL) in the Chinese breast cancer survivors (BCs). Methods. Ninety-eight patients with breast cancer were recruited in this study. These patients were randomly assigned to the VR-CALM group or the care as usual (CAU) group. All patients were evaluated by the Functional Assessment of Cancer Therapy-Breast cancer patient (FACT-B), Distress Thermometer (DT), Concerns About Recurrence Scale (CARS), Piper Fatigue Scale (PFS), Pittsburgh Sleep Quality Index (PSQI), The Self-Rating Anxiety Scale (SAS), and The Self-Rating Depression Scale (SDS) before and after VR-CALM or CAU application to BCs. We compared the differences in all these scores between the VR-CALM group and the control group. Results. Patients in the VR-CALM group showed a significant decrease in levels of distress, anxiety, depression, sleep disorders, and fatigue (t = −6.829, t = −5.819, t = −2.094, t = −3.031, t = −10.082, P ≤ 0.001 , 0.001, 0.05, 0.01, 0.001, respectively) and had higher level of quality of life (t = 8.216, P ≤ 0.001 ) compared with the CAU group after intervention. And postintervention patients in VR-CALM group compared with preintervention showed lower level of distress and remarkable improvement of QOL (t = 11.521, t = −10.379, P ≤ 0.001 , 0.001). The preintervention questionnaire revealed no significant between-group differences regarding distress, anxiety, depression, sleep disorders, fatigue, and quality of life. Conclusion. VR-CALM is a psychotherapy tailored to the needs of patients with breast cancer. This research innovatively used VR-based CALM intervention to improve psychological and chronic symptoms in BCs. The results of the present study indicate that VR-CALM has salutary effects on the improvement of QOL and relieves psychological distress, anxiety, depression, sleep disorders, and fatigue in BCs.

Effects of Managing Cancer and Living Meaningfully on Cancer-Related Fatigue and Cytokine Levels in Gastrointestinal Cancer Patients

“…13,18 The possible benefits of CALM for cancer patients have attracted the attention of researchers, as studies have reported that CALM can alleviate cognitive impairment, anxiety, fatigue, etc., in cancer patients. 26,29,34,35 In a large randomized controlled trial, Rodin et al 28 reported the effectiveness of CALM on depressive symptoms in etiology of CRF is unclear, but some possible biological mechanisms have been hypothesized, with proinflammatory cytokines receiving the most empirical attention and garnering the most supporting evidence. 13,36,37 CRF, a symptom of cancer cachexia, has been reported to be induced by a variety of mediators, and its prevalence and severity correlate with serum inflammatory cytokine levels, such as IL-6 and TNF-α.…”

“…10 Our study provides further evidence to support the relationship between exhaustion level, quality of life, and sleep quality. Based on the WHO definition of quality of life as "the overall satisfaction of individuals from different cultures," 35 we consider quality of life to be a composite measure of the physical, psychological and social adaptability of an individual or group. We employ CALM as a systematic approach to reducing the negative emotions of cancer patients by addressing the practical and existential issues faced by cancer patients, restoring their hope in life, increasing their meaning and purpose to improve quality of life and improve fatigue symptoms.…”

“…13,18 The possible benefits of CALM for cancer patients have attracted the attention of researchers, as studies have reported that CALM can alleviate cognitive impairment, anxiety, fatigue, etc., in cancer patients. 26,29,34,35 In a large randomized controlled trial, Rodin et al 28 reported the effectiveness of CALM on depressive symptoms in patients with advanced cancer. However, there are limited studies on CALM, and our findings provide further evidence supporting the positive benefits of utilizing CALM interventions for cancer patients.…”