Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy

Chirico, Andrea; Maiorano, Patrizia; Indovina, Paola; Milanese, C.; Giordano, Giovan Giacomo; Alivernini, Fabio; Iodice, Giovanni; Gallo, Luigi; Pietro, Giuseppe De; Lucidi, Fabio; Botti, Gerardo; Laurentiis, Michelino De; Giordano, Antonio

doi:10.1002/jcp.29422

Cited by 131 publications

(185 citation statements)

References 41 publications

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“…While data comparing the efficacy of VR to other pain and anxiety‐reducing interventions is limited, 7 studies have demonstrated that VR is a significantly more effective analgesic and anxiolytic compared to traditional distraction techniques including music therapy and video games. This is likely due to the increased level of multi‐sensory immersion with VR 7,9,57 . One concern about VR is whether its effectiveness decreases over repeated uses once the novelty of the experience wears off 6,8 .…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality as Distraction Analgesia and Anxiolysis for Pediatric Otolaryngology Procedures

et al. 2020

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Objectives/Hypothesis While virtual reality (VR) has been used as analgesia and anxiolysis for invasive procedures, no literature exists on the use of VR in the pediatric otolaryngology setting. The purpose of this study was to determine the efficacy of VR in reducing pain and anxiety for pediatric otolaryngology patients. Study Design Randomized controlled trial. Methods A total of 53 patients aged 7–17 undergoing in‐office nasal endoscopies were included. Patients were randomized to receive VR or standard of care. Procedural pain, anxiety, and satisfaction scores were recorded from patients and caregivers. The physician filled out a childhood emotional manifestation scale (CEMS). Results Patients in VR group reported a significant decrease in pain (0.80 ± 1.06 vs. 2.26 ± 2.38, P = .018) and anxiety (9.50 ± 12.48 vs. 38.48 ± 29.83, P = .0002) and increase in procedural satisfaction (6.40 ± 0.77 vs. 4.74 ± 1.74, P = .0002) compared to patients in control group. CEMS scores were significantly reduced in VR group (5.15 ± 0.46 vs. 9.64 ± 5.66, P = .0001) and caregiver anxiety levels were significantly reduced in VR group (11.50 ± 17.67 vs. 27.39 ± 30.48, P = .041) compared to control group. There were no reported side effects. Procedural time did not significantly differ between groups. Conclusions For pediatric otolaryngology patients undergoing in‐office nasal endoscopies, VR is a safe and effective form of distraction analgesia and anxiolysis, significantly reducing pain and increasing procedural satisfaction for patients. In addition, VR significantly reduces anxiety for both patients and caregivers without disrupting procedural efficiency and workflow. Level of Evidence 2. Laryngoscope, 131:E1714–E1721, 2021

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Section: Discussionmentioning

confidence: 99%

Virtual Reality as Distraction Analgesia and Anxiolysis for Pediatric Otolaryngology Procedures

et al. 2020

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“…This discomfort was only monetary, and at follow up, the participant reported feeling fine. Studies have indicated that cybersickness occurs with low frequency (Shah et al, 2015;Chirico et al, 2020). Some participants reported experiencing headaches and overheating during the VR sessions.…”

Section: Limitationsmentioning

confidence: 99%

“…Moreover, virtual environments have been created for treating post-traumatic stress disorder (Rizzo et al, 2014;Botella et al, 2015;Freeman et al, 2017;Weir, 2018). Other studies have incorporated VR for pain reduction with patients going through treatments such as chemotherapy (Chirico et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Visual Self-Expression in Virtual Reality on Psychosocial Well-Being With the Inclusion of a Fragrance Stimulus: A Pilot Mixed-Methods Study

et al. 2020

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AimsIn this pilot mixed-methods study, we examined the participants experiences of engaging in virtual drawing tasks and the impact of an olfactory stimulus (calming fragrance blend) on outcomes of affect, stress, self-efficacy, anxiety, creative agency, and well-being (satisfaction with life).MethodsThis study used a parallel mixed-methods, simple block randomization design. The study participants included 24 healthy adults aged 18 to 54 years, including 18 women and six men. The participants completed two 1-h immersive virtual art making sessions and were randomly assigned to receive either a fragrance or a non-fragrance condition for the first session. Quantitative (standardized self-report measures) and qualitative (open-ended survey responses and virtual artwork) datasets were collected concurrently and integrated during data analysis.ResultsThe quantitative results indicated that the fragrance condition demonstrated a significant reduction in negative affect (e.g., feeling hostile, jittery, upset, distressed, etc.), namely, reduced feelings of negativity when compared to the non-fragrance condition. A trend toward improvement in self-efficacy was also seen in the fragrance condition. No significant changes were found for fragrance or non-fragrance conditions for positive affect, anxiety, and creative agency. The qualitative findings included five themes related to art making experiences in virtual reality in both conditions: fun and joy; novelty of virtual media, experimentation, and play; relaxation and calm; learning curve; and physical discomfort and disorientation. Four themes were identified for virtual art content and visual qualities: nature imagery, references to memories and personal symbols, fantasy and play within imagery, and depiction of everyday objects.ConclusionsOverall, the participants reported positive responses to the novel virtual art making experiences which were further heightened by the inclusion of the fragrance stimulus for negative affect. These preliminary findings need to be replicated with larger sample sizes to confirm the outcomes and the trends that were seen in this pilot study. Further research is recommended to examine the differences between experiences of virtual and traditional art media and to examine different olfactory stimuli promoting focus and concentration.

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“…The importance of psychological care to relieve cancer patients and, even more, the impact of this care on their compliance with treatment has been widely demonstrated (Lutgendorf et al, 2010). Beyond conventional psychotherapies and psycho-oncology supportive therapies, various stimulations such as music (Gramaglia et al, 2019), Tai Chi (Wayne et al, 2018) or yoga (Lin et al, 2018) have been proposed and found to be effective in reducing the most common side effects (i.e., tiredness, anxiety, depression, sleep disorders; Chirico et al, 2019;Maindet et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Its use can relieve pain and anxiety in hospital patients with breast cancer (Bani Mohammad and Ahmad, 2018) as well as in younger patients hospitalized in oncology (Tennant et al, 2020). Recent studies have extended the benefits of VR to radiation therapy sessions (Marquess et al, 2017;Chirico et al, 2019;Ahmad et al, 2020) and to palliative care (Niki et al, 2019;Johnson et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Contemplating or Acting? Which Immersive Modes Should Be Favored in Virtual Reality During Physiotherapy for Breast Cancer Rehabilitation

et al. 2021

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BackgroundEven though virtual reality (VR) is more and more considered for its power of distraction in different medical contexts, the optimal conditions for its use still have to be determined in order to design interfaces adapted to therapeutic support in oncology.ObjectiveThe objective of this study was to examine the benefits of VR using two immersion methods (i.e., one participatory, one contemplative) and comparing them with each other in a population of women with breast cancer who have undergone breast surgery, during scar massage sessions.MethodsIn a physiotherapy center, each patient participated in four experimental conditions in a random order: two sessions used virtual immersion (i.e., one participatory and one contemplative), one session proposed musical listening and the fourth one was a standard session care. The impact of the level of patient involvement in the virtual world was apprehended through the evaluation of the feeling of presence; the estimation of elapsed time of the physiotherapy sessions and particular attention was paid to the evaluation of patient emotional state.ResultsOur study showed an increase in positive emotions (i.e., joy and happiness) and a decrease in anxiety regardless which support methods were offered. Participatory VR created a feeling of more intense spatial presence.ConclusionOur results highlight the importance of the context in which VR should be offered. The presence of the practitioner and his interactions with the patient can provide a context just as favorable in reducing anxiety as the emotional regulation tools used (VR, music). The use of technological tools should be favored when the practitioner is unavailable during the treatment phase or, even, in order to reduce the monotonous nature of repetitive therapeutic sessions.

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Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy

Cited by 131 publications

References 41 publications

Virtual Reality as Distraction Analgesia and Anxiolysis for Pediatric Otolaryngology Procedures

Virtual Reality as Distraction Analgesia and Anxiolysis for Pediatric Otolaryngology Procedures

Outcomes of Visual Self-Expression in Virtual Reality on Psychosocial Well-Being With the Inclusion of a Fragrance Stimulus: A Pilot Mixed-Methods Study

Contemplating or Acting? Which Immersive Modes Should Be Favored in Virtual Reality During Physiotherapy for Breast Cancer Rehabilitation

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