Effects of virtual reality on symptom distress in children receiving cancer chemotherapy

Abstract

<p>The objective of this study was to test the premise that virtual reality, as a developmentally appropriate distraction intervention, mitigates chemotherapy related symptom distress in older children with cancer aged 10-17. For this study the subjects wore a commercially available head set which projected an image with corresponding sounds. The sense of touch was involved through use of a computer mouse. A synthesis of Lazarus and Folkman's (1984) stress and coping theoretical framework and a model of the self-sustaining process in adolescents (Hinds &amp; Martin, 1988) was used to guide the study. An interrupted time series design with removed treatment was used to answer the following research questions: (1) Is virtual reality an effective distraction intervention for reducing chemotherapy related symptom distress in children? and (2) Does virtual reality have a lasting effect? Hypotheses: (1) There will be differences in measures of symptom distress in a single group of children with cancer who receive a virtual reality distraction intervention during the second chemotherapy treatment and who receive no virtual reality intervention during the first and third chemotherapy treatments, and (2) There will be differences in measures of symptom distress two days following chemotherapy treatments, over three time measures in a single group of children with cancer who receive a virtual reality distraction intervention during the second chemotherapy treatment and who receive no virtual reality intervention during the first and third chemotherapy treatments. The convenience sample consisted of 11 children receiving outpatient chemotherapy at a clinical cancer center. Measures of symptoms distress were obtained at nine time points during three consecutive chemotherapy treatments. Four indicators were used to measure the dependent variable of symptom distress. The Symptom Distress Scale (SDS) (McCorkle, R. &amp; Young, K., 1978) was considered a general indicator. Specific indicators of symptom distress included the State-Trait Anxiety Inventory for Children (STAIC C-1) (Speilberger, 1970) and single item indicators for nausea and vomiting. Data analysis of the SDS suggested that the virtual reality intervention was effective at reducing the level of symptom distress immediately following the chemotherapy treatment (p $&lt;$.10), but did not have a lasting effect. Analysis of the STAIC C-1 demonstrated high levels of anxiety during the initial chemotherapy treatment which decreased during the two subsequent treatments. State anxiety levels were not influenced by the virtual reality intervention. A qualitative evaluation of the virtual reality intervention was completed by all subjects. The responses suggested that the virtual reality experience provided an effective distraction that was easy to use. Eighty two percent of subjects indicated the chemotherapy treatment with the virtual reality equipment was better than previous treatments and none of the subjects indicated that the virtual reality made them feel worse. All subjects responded that they liked the virtual reality intervention and that they would like to use the equipment again during chemotherapy treatments. Findings support the theoretical premise that distraction mitigates perceptions of symptom distress. This was the first study to suggest that virtual reality as a distraction intervention has positive clinical outcomes.</p>