Virtual Reality as a Distraction Intervention for Women Receiving Chemotherapy
Purpose/Objectives: To explore the use of virtual reality as a distraction intervention to relieve symptom distress in women receiving chemotherapy for breast cancer.
Design: Crossover study.
Setting: The outpatient clinic of a midwestern comprehensive cancer center.
Sample: 20 women 18-55 years of age.
Methods: Using a crossover design, 20 subjects served as their own controls. For two matched chemotherapy treatments, one pretest and two post-test measures were employed. Participants were assigned randomly to receive the virtual reality distraction intervention during one chemotherapy treatment and received no distraction intervention (control condition) during an alternate chemotherapy treatment. An open-ended questionnaire elicited each subject's evaluation of the intervention.
Main Research Variables: Symptom distress, fatigue, anxiety.
Findings: Significant decreases in symptom distress and fatigue occurred immediately following chemotherapy treatments when women used the virtual reality intervention.
Conclusions: The distraction intervention decreased symptom distress, was well received, and was easy to implement in the clinical setting.
Implications for Nursing: Nursing interventions to manage chemotherapy-related symptom distress can improve patient quality of life and increase chances for survival by reducing treatment-related symptom distress and enhancing patients' ability to adhere to treatment regimens and cope with their disease.
Jump to a section
References
Ali, N.S., & Khalil, H.Z. (1991). Identification of stressors, level of stress, coping strategies, and coping effectiveness among Egyptian mastectomy patients. Cancer Nursing, 14, 232-239.
Arthur, C. (1992). Did reality move for you? New Scientist, 134, 22-27.
Bender, C.M., McDaniel, R.W., Murphy-Ende, K., Pickett, M., Rittenberg, C.N., Rogers, M.P., et al. (2002). Chemotherapy-induced nausea and vomiting. Clinical Journal of Oncology Nursing, 6, 94-102.
Bonadonna, G., Valagussa, P., Moliterni, A., Zambetti, M., & Brambilla, C. (1995). Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node positive breast cancer: The results of 20 years of follow-up. New England Journal of Medicine, 332, 901-906.
Coons, H.L., Leventhal, H., Nerenz, D.R., Love, R.R., & Larson, S. (1987). Anticipatory nausea and emotional distress in patients receiving cisplatinbased chemotherapy. Oncology Nursing Forum, 14(3), 31-35.
Dodd, M.J., Miaskowski, C., & Paul, S.M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28, 465-470.
Ehlke, G. (1988). Symptom distress in breast cancer patients receiving chemotherapy in the outpatient setting. Oncology Nursing Forum, 15, 343-346.
Ezzone, S., Baker, C., Rosselet, R., & Terepka, E. (1998). Music as an adjunct to antiemetic therapy. Oncology Nursing Forum, 25, 1551-1556.
Girden, E.R. (1992). ANOVA: Repeated measures. Newbury Park, CA: Sage.
Good, M., Stanton-Hicks, M., Grass, J.A., Cranston Anderson, G., Choi, C., Schoolmeesters, L.J., et al. (1999). Relief of postoperative pain with jaw relaxation, music and their combination. Pain, 81, 163-172.
Grant, M. (1997). Introduction: Nausea and vomiting, quality of life, and the oncology nurse. Oncology Nursing Forum, 24(7 Suppl.), 5-7.
Gross, S.W. (1995). The impact of a nursing intervention of relaxation with guided imagery on breast cancer patients' stress and health as expanded consciousness. Doctoral dissertation, University of Texas at Austin.
Hinds, P., Quargnenti, A.G., & Wentz, T.J. (1992). Measuring symptom distress in adolescents with cancer. Journal of Pediatric Oncology Nursing, 9, 84-86.
Hinds, P.S., & Martin, J. (1988). Hopefulness and the self-sustaining process in adolescents with cancer. Nursing Research, 37, 336-340.
Hoffman, H.G., Garcia-Palacios, A., Patterson, D.R., Jensen, M., Furness, T., & Ammons, W.F. (2001). The effectiveness of virtual reality for dental pain control: A case study. CyberPsychology and Behavior, 4, 527-535.
Hoffman, H.G., Patterson, D.R., & Carrougher, G.J. (2000). Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: A controlled study. Clinical Journal of Pain, 16, 244-250.
Hoffman, H.G., Patterson, D.R., Carrougher, G.J. & Sharar, S.R. (2001). Effectiveness of virtual reality-based pain control with multiple treatments. Clinical Journal of Pain, 17, 229-235.
Jemal, A., Murray, T., Samuels, A., Ghafoor, A., Ward, E., & Thun, M. (2003). Cancer statistics, 2003. CA: A Cancer Journal for Clinicians, 53, 5-26.
Kolcaba, K., & Fox, C. (1999). The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy. Oncology Nursing Forum, 26, 67-72.
Kozarek, R.A., Raltz, S.L., Neal, L., Wilbur, P., Stewart, S., & Ragsdale, J. (1997). Prospective trial using virtual vision as a distraction technique in patients undergoing gastric laboratory procedures. Gastroenterology Nursing, 20, 12-14.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
Lyman, G.H., Lyman, S., Bakducci, L., Kuderer, N., Reintgen, D., Cox, C., et al. (1996). Age and the risk of breast cancer recurrence. Cancer Control, 3, 421-427.
McCorkle, R. (1987). The measurement of symptom distress. Seminars in Oncology Nursing, 3, 248-256.
McCorkle, R., & Quint-Benoliel, J. (1983). Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease. Social Science and Medicine, 17, 431-438.
McCorkle, R., & Young, K. (1978). Development of a symptom distress scale. Cancer Nursing, 1, 373-378.
McNair, D.M., Lorr, M., & Droppleman, L.F. (1971). POMS: Manual for Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.
Munkres, A., Oberst, M.T., & Hughes, S.H. (1992). Appraisal of illness, symptom distress, self-care burden, and moods states in patients receiving chemotherapy for initial and recurrent cancer. Oncology Nursing Forum, 19, 1201-1209.
Oshuga, M., Tatsuno, Y., Shimono, F., Hirasawa, K., Oyama, H., & Okamura, H. (1998). Development of a bedside wellness system. CyberPsychology and Behavior, 1, 105-112.
Pickett, M. (1991). Determinants of anticipatory nausea and anticipatory vomiting in adults receiving cancer chemotherapy. Cancer Nursing, 14, 334-343.
Piper, B.F., Dibble, S.L., Dodd, M.J., Weiss, M.C., Slaughter, R.E., & Paul, S.M. (1998). The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. Oncology Nursing Forum, 25, 677-684.
Pratt, D.R., Zyda, M., & Kelleher, K. (1995). Virtual reality: In the mind of the beholder. Computer, 7, 17-19.
Rhodes, V.A., Watson, P.M., Johnson, M.H., Madsen, R.W., & Beck, N.C. (1987). Patterns of nausea, vomiting, and distress in patients receiving an-tineoplastic protocols. Oncology Nursing Forum, 14(4), 35-44.
Rizzo, A.A., Buckwalter, J.G., Neumann, U., Kesselman, C., & Thiebaux, M. (1998). Basic issues in the application of virtual reality for the assessment and rehabilitation of cognitive impairment and functional disabilities. CyberPsychology and Behavior, 1, 59-78.
Rothbaum, B.O., Hodges, L.F., Kooper, R., Opdyke, D., Williford, J.S., & North, M. (1995). Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. American Journal of Psychiatry, 152, 626-628.
Sarna, L., Lindsey, A.M., Dean, H., Brecht, M., & McCorkle, R. (1993). Nutritional intake, weight change, symptom distress, and functional status over time in adults with lung cancer. Oncology Nursing Forum, 20, 481-489.
Schneider, S.M. (1999). I look funny and I feel bad: Measurement of symptom distress. Journal of Child and Family Nursing, 2, 380-384.
Schneider, S.M., & Workman, M.L. (1999). Effects of virtual reality on symptom distress in children receiving cancer chemotherapy. CyberPsychology and Behavior, 2, 125-134.
Schneider, S.M., & Workman, M.L. (2000). Virtual reality as a distraction intervention for children receiving chemotherapy. Pediatric Nursing, 26, 593-597.
Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologist Press.
Steuer, J. (1992). Defining virtual reality: Dimensions determining telepresence. Journal of Communication, 42(4), 73-93.
Vasterling, J., Jenkins, R.A., Tope, D.M., & Burish, T.G. (1993). Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. Journal of Behavioral Medicine, 16(1), 65-80.
Watson, M., & Marvell, C. (1992). Anticipatory nausea and vomiting among cancer patients: A review. Psychology and Health, 6, 97-106.
Wiederhold, B., Gevirtz, R., & Wiederhold, M. (1998). Fear of flying: A case report using virtual reality therapy with physiological monitoring. CyberPsychology and Behavior, 1, 97-103.
Winningham, M., Nail, L., Burke, M., Brophy, L., Cimprich, B., Jones, L., et al. (1994). Fatigue and the cancer experience: The state of the knowledge. Oncology Nursing Forum, 21, 23-36.
Wint, S.S., Eshelman, D., Steele, J., & Guzzetta, C.E. (2002). Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer [Online exclusive]. Oncology Nursing Forum,29,E8-E15.RetrievedNovember10,2003,fromhttp://www.ons.org/images/Library/ons_publications/onf/2002/January_Feb…
Witmer, E.G., & Singer, M.J. (1998). Measuring presence in virtual environments: A presence questionnaire. Presence: Teleoperators and Virtual Environments, 7, 225-240.
Wyatt, G.K., & Friedman, L.L. (1998). Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer. Oncology Nursing Forum, 25, 761-768.
Yoshitake, H. (1978). Three characteristic patterns of subjective fatigue symptoms. Ergonomics, 21, 213-233.