Virtual Reality Can Ease Pre-Chemotherapy Anxiety

For patients receiving chemotherapy, using a virtual reality headset may help patients alleviate pretreatment anxiety, said an oncology nurse.

Virtual reality (VR), which typically uses a headset to simulate experiences, can play a role in alleviating pretreatment anxiety in patients with cancer or help provide comfort to patients on palliative care and serve as an educational tool for both patients and providers.

In a recent interview with CURE®’s sister publication, Oncology Nursing News, Emery Bergey, a clinical nurse specialist at Moffitt Cancer Center in Tampa, Florida, discussed how her center uses VR in patient care.

How is VR currently being used at Moffitt?

VR is currently being used as a way to relieve patients’ anxiety and stress, in particular, during procedures [and] during chemotherapy to reduce anxiety. We actually did a project here at Moffitt, where we provided the patients with VR headsets on their first day of chemotherapy treatment, when everything's very overwhelming, when they're very scared. And when we put that headset on, we noticed patients immediately calmed down.

There was one patient [who] stated that she was feeling tremors. When she put the headset on, her tremors ceased, and then they didn't come back after the activity was completed. That was very rewarding.

It's also being used in palliative care settings. It’s associated a lot with that concept of a “good death.” Sometimes patients are hospitalized and providing them the opportunity to be on a beach or somewhere that brings them joy, that can really help with that peaceful passing. In addition, there's a program that allows family members the opportunity to record their voices or to be present through an avatar or their photos, so the patient can actually see that on the VR headset. So that's been really, really peaceful.

It has also been used for patient education, specifically in radiation oncology. It is a really cool system, where they can upload the patient's scan — so a CT, MRI — and they can see a four-dimensional visualization of their tumor. Especially if it's a complex tumor, like if it's around the carotid artery or the spine, they can see where exactly the treatment beams are going to come in, where they might see side effects, and conceptualize that a little bit easier.

Going back to what you mentioned, how patients can use VR to pretend they’re on a beach or somewhere peaceful. What do you think it is about that approach that decreases stress in patients?

A lot of it is our brain being able to focus on one source of stimuli at a time. When we're directly visualizing that particular scene, when we're immersed in the sight and sounds, it takes that attention off of anything that might be causing us pain and anxiety, anything that's distressing in the environment. It's taking us away and putting our focus elsewhere.

Can this technology be used for all patients, or are there certain patients who may not be suited for this?

It can be implemented with pediatric and adult patients across the spectrum of oncology care. There are a couple of considerations. For example, if a patient is experiencing a mental health condition that causes them to have visual and auditory hallucinations, or they may be sensitive to visual and auditory stimuli, if they have vertigo or balance issues, moving around, just everything follows them. It might be a little bit inappropriate if they're having acute episodes of nausea and vomiting, where that motion can irritate them, or if they have any sort of visual difficulties.

Our biggest concern with VR is patient safety. A lot of those headsets have a lockout feature, where the nurse can establish a boundary. And if the patient moves or tries to ambulate and steps outside of that boundary, the simulation goes away, and all they can see is the floor. That is meant to discourage patients from ambulating while all of that stuff is going on and potentially putting them at risk for injury.

Is VR being used in many institutions or are we just scratching the surface?

I know a lot of nursing schools have implemented it for clinical skills-based things. A lot of oncology centers have used it with their pediatric population undergoing radiation therapy, because sometimes children struggle to stay still on the table, as well as adults undergoing procedures in an interventional radiology setting, and in pre-op before they're going into their surgical procedure.

With the palliative care aspect, it's being used there quite a bit. Especially with our geriatric patients, they do a lot of remembrance therapy. And then putting those VR headsets on them before sleep can also help increase their sleep quality.

This transcript has been edited for clarity and conciseness.

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