Virtual Reality and Symptoms Management of Anxiety, Depression, Fatigue, and Pain: A Systematic Review

Androniki Ioannou, Evridiki Papastavrou, Marios N Avraamides, Andreas Charalambous, Androniki Ioannou, Evridiki Papastavrou, Marios N Avraamides, Andreas Charalambous

Abstract

In recent years, virtual reality (VR) has become an interesting alternative to traditional exposure-based therapies for many symptoms. VR involves immersion in a computer-generated virtual environment that minimizes avoidance and facilitates emotional processing. The objective of this systematic review is to evaluate evidence on the intervention effect of VR on anxiety, depression, fatigue, and pain. The research strategy of this systematic review included three electronic databases (MEDLINE/PubMed, Cochrane Library, and ScienceDirect) based on predetermined inclusion and exclusion criteria. Published quantitative studies from 2000 to 2020 were identified, which examined the effect of VR intervention on four different symptoms related to symptoms experienced by cancer patients. Quality assessments, data extractions, and analysis were completed on all included studies. A total of 882 titles and abstracts were screened, and 23 studies were included in the review. The studies were grouped according to the symptoms: anxiety and depression, fatigue, and pain. The review showed that VR intervention is more effective compared with the control (i.e., standard care) for anxiety, depression, fatigue, and pain. VR can reduce effectively these symptoms in different contexts and diseases, including cancer. The evidence suggests that there is value in exploring this intervention as a potential crossover treatment for these symptoms in patients. This study contributes to evidence that distraction is an effective symptom management mechanism. The findings are congruent with the theoretical framework, supporting the premise that VR, as an emotion-focused distraction intervention, decreases the severity of these symptoms.

Keywords: anxiety; depression; fatigue; pain; virtual reality.

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2020.

Figures

Figure 1.
Figure 1.
PRISMA 2009 Flow Diagram.

References

    1. Aminabadi N. A., Erfanparast L., Sohrabi A., Ghertasi Oskouei S., Naghili A. (2012). The impact of virtual reality distraction on pain and anxiety during dental treatment in 4-6 year-old children: A randomized controlled clinical trial. Journal of Dental Research, Dental Clinics, Dental Prospects, 6(4), 117–124. 10.5681/joddd.2012.025
    1. Anderson K. O., Cohen M. Z., Mendoza T. R., Guo H., Harle M. T., Cleeland C. S. (2006). Brief cognitive‐behavioral audiotape interventions for cancer related pain: Immediate but not long‐term effectiveness. Cancer: Interdisciplinary International Journal of the American Cancer Society, 107(1), 207–214.
    1. Biocca F. (1992). Virtual reality technology: A tutorial. Journal of Communication, 42(4), 23–72.
    1. Brown L. F., Kroenke K. (2009). Cancer-related fatigue and its associations with depression and anxiety: A systematic review. Psychosomatics, 50(5), 440–447.
    1. Carrougher G. J., Hoffman H. G., Nakamura D., Lezotte D., Soltani M., Leahy L., Engrav L.H., Patterson D. R. (2009). The effect of virtual reality on pain and range of motion in adults with burn injuries. Journal of Burn Care & Research, 30(5), 785–791.
    1. Charalambous A., Kouta C. (2016). Cancer related fatigue and quality of life in patients with advanced prostate cancer undergoing chemotherapy. BioMed Research International, 2016, 1–11.
    1. Chirico A., Lucidi F., De Laurentiis M., Milanese C., Napoli A., Giordano A. (2016). Virtual reality in health system: Beyond entertainment. A mini‐review on the efficacy of VR during cancer treatment. Journal of Cellular Physiology, 231(2), 275–287.
    1. Cho, H., & Sohng, K. (2014). The effect of a virtual reality exercise program on physical fitness, body composition, and fatigue in hemodialysis patients. Journal of Physical Therapy Science, 26(10), 1661–1665.
    1. Das D. A., Grimmer K. A., Sparnon A. L., McRae S. E., Thomas B. H. (2005). The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556]. BMC Pediatrics, 5(1), 1.
    1. Dascal J., Reid M., IsHak W. W., Spiegel B., Recacho J., Rosen B., Danovitch I. (2017). Virtual reality and medical inpatients: A systematic review of randomized, controlled trials. Innovations in Clinical Neuroscience, 14(1–2), 14–21.
    1. Dehghan F., Jalali R., Bashiri H. (2019). The effect of virtual reality technology on preoperative anxiety in children: A Solomon four-group randomized clinical trial. Perioperative Medicine, 8(1), 5.
    1. Ferrer-García M., Gutiérrez-Maldonado J. (2012). The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: A review of the literature. Body Image, 9(1), 1–11.
    1. Gerçeker G. Ö., Binay Ş., Bilsin E., Kahraman A., Yılmaz H. B. (2018). Effects of virtual reality and external cold and vibration on pain in 7-to 12-year-old children during phlebotomy: A randomized controlled trial. Journal of PeriAnesthesia Nursing, 33(6), 981–989.
    1. Gershon J., Zimand E., Pickering M., Rothbaum B. O., Hodges L. (2004). A pilot and feasibility study of virtual reality as a distraction for children with cancer. Journal of the American Academy of Child & Adolescent Psychiatry, 43(10), 1243–1249.
    1. Gold J. I., Kim S. H., Kant A. J., Joseph M. H., Rizzo A. S. (2006). Effectiveness of virtual reality for pediatric pain distraction during IV placement. CyberPsychology & Behavior, 9(2), 207–212.
    1. 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. The Clinical Journal of Pain, 16(3), 244–250.
    1. Humphreys J., Janson S., Donesky D. A., Dracup K., Lee K. A., Puntillo K., Faucett, J. A., Aouizerat, B., Miaskowski, C., Baggott, C., Carrieri-Kohlman, V., Barger, M., Franck, L., Kennedy, C., & University of California, San Francisco, School of Nursing, Symptom Management Faculty Group. (2014). Theory of symptom management. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (pp. 141–164). Springer Publishing Company.
    1. Indovina P., Barone D., Gallo L., Chirico A., De Pietro G., Giordano A. (2018). Virtual reality as a distraction intervention to relieve pain and distress during medical procedures. The Clinical Journal of Pain, 34(9), 858–877.
    1. JahaniShoorab N., Ebrahimzadeh Zagami S., Nahvi A., Mazluom S. R., Golmakani N., Talebi M., Pabarja F. (2015). The effect of virtual reality on pain in primiparity women during episiotomy repair: A randomize clinical trial. Iranian Journal of Medical Sciences, 40(3), 219–224.
    1. Kampmann I. L., Emmelkamp P. M., Hartanto D., Brinkman W., Zijlstra B. J., Morina N. (2016). Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behaviour Research and Therapy, 77, 147–156.
    1. Kipping B., Rodger S., Miller K., Kimble R. M. (2012). Virtual reality for acute pain reduction in adolescents undergoing burn wound care: A prospective randomized controlled trial. Burns, 38(5), 650–657.
    1. Krijn M., Emmelkamp P. M. G., Biemond R., de Wilde de Ligny C., Schuemie M. J., van der Mast C. A. P. G. (2004). Treatment of acrophobia in virtual reality: The role of immersion and presence. Behaviour Research and Therapy, 42(2), 229–239.
    1. Kwekkeboom K. L., Abbott-Anderson K., Wanta B. (2010). Feasibility of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance in cancer. Oncology Nursing Forum, 37(3), E151–E159 10.1188/10.ONF.E151-E159
    1. Kwekkeboom K. L., Kneip J., Pearson L. (2003). A pilot study to predict success with guided imagery for cancer pain. Pain Management Nursing, 4(3), 112–123.
    1. Lee N., Lee D., Song H. (2015). Effect of virtual reality dance exercise on the balance, activities of daily living, and depressive disorder status of Parkinson’s disease patients. Journal of Physical Therapy Science, 27(1), 145–147.
    1. Liszio S., Graf L., Masuch M. (2018). The relaxing effect of virtual nature: Immersive technology provides relief in acute stress situations. Annual Review of Cybertherapy and Telemedicine, 2018, 87.
    1. Llobera J., González-Franco M., Perez-Marcos D., Valls-Solé J., Slater M., Sanchez-Vives M. V. (2013). Virtual reality for assessment of patients suffering chronic pain: A case study. Experimental Brain Research, 225(1), 105–117.
    1. Maani C. V., Hoffman H. G., Morrow M., Maiers A., Gaylord K., McGhee L. L., DeSocio P. A. (2011). Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. The Journal of Trauma, 71(1 Suppl), S125– S130 10.1097/TA.0b013e31822192e2
    1. Malloy K. M., Milling L. S. (2010). The effectiveness of virtual reality distraction for pain reduction: A systematic review. Clinical Psychology Review, 30(8), 1011–1018.
    1. McCann R. A., Armstrong C. M., Skopp N. A., Edwards-Stewart A., Smolenski D. J., June J. D., . . . Reger G. M. (2014). Virtual reality exposure therapy for the treatment of anxiety disorders: An evaluation of research quality. Journal of Anxiety Disorders, 28(6), 625–631.
    1. Medling B. (2005). Virtual reality utilization in health care: It’s virtually done. Biomedical Instrumentation & Technology, 16(8).
    1. Morina N., Ijntema H., Meyerbröker K., Emmelkamp P. M. (2015). Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Behaviour Research and Therapy, 74, 18–24.
    1. Morris L. D., Louw Q. A., Grimmer-Somers K. (2009). The effectiveness of virtual reality on reducing pain and anxiety in burn injury patients: A systematic review. The Clinical Journal of Pain, 25(9), 815–826.
    1. Motl R. W., McAuley E., Snook E. M., Gliottoni R. C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health & Medicine, 14(1), 111–124.
    1. Opriş D., Pintea S., García-Palacios A., Botella C., Szamosközi Ş., David D. (2012). Virtual reality exposure therapy in anxiety disorders: A quantitative meta‐analysis. Depression and Anxiety, 29(2), 85–93.
    1. Parsons T. D., Rizzo A. A. (2008). Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 39(3), 250–261.
    1. Parsons T. D., Rizzo A. A., Rogers S., York P. (2009). Virtual reality in paediatric rehabilitation: A review. Developmental Neurorehabilitation, 12(4), 224–238.
    1. Powers M. B., Emmelkamp P. M. (2008). Virtual reality exposure therapy for anxiety disorders: A meta-analysis. Journal of Anxiety Disorders, 22(3), 561–569.
    1. Riener R., Harders M. (2012). Virtual reality in medicine. Springer Science & Business Media.
    1. Riva G., Bacchetta M., Cesa G., Conti S., Molinari E. (2003). Six-month follow-up of in-patient experiential cognitive therapy for binge eating disorders. Cyberpsychology & Behavior, 6(3), 251–258.
    1. Riva G., Gaggioli A., Villani D., Preziosa A., Morganti F., Corsi R., . . . Vezzadini L. (2007). NeuroVR: An open source virtual reality platform for clinical psychology and behavioral neurosciences. Studies in Health Technology and Informatics, 125, 394–399.
    1. Ryu J., Park J., Nahm F. S., Jeon Y., Oh A., Lee H. J., . . . Han S. (2018). The effect of gamification through a virtual reality on preoperative anxiety in pediatric patients undergoing general anesthesia: A prospective, randomized, and controlled trial. Journal of Clinical Medicine, 7(9), 284.
    1. Schmitt Y. S., Hoffman H. G., Blough D. K., Patterson D. R., Jensen M. P., Soltani M., . . . Sharar S. R. (2011). A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns, 37(1), 61–68.
    1. Schneider S. M., Ellis M., Coombs W. T., Shonkwiler E. L., Folsom L. C. (2003). Virtual reality intervention for older women with breast cancer. CyberPsychology & Behavior, 6(3), 301–307.
    1. Schneider S. M., Hood L. E. (2007). Virtual reality: A distraction intervention for chemotherapy. Oncology Nursing Forum, 34(1), 39–46. 10.1188/07.ONF.39-46
    1. Schneider S. M., Prince-Paul M., Allen M. J., Silverman P., Talaba D. (2004). Virtual reality as a distraction intervention for women receiving chemotherapy. Oncology Nursing Forum, 31(1), 81–88.
    1. Shah L. B. I., Torres S., Kannusamy P., Chng C. M. L., He H., Klainin-Yobas P. (2015). Efficacy of the virtual reality-based stress management program on stress-related variables in people with mood disorders: The feasibility study. Archives of Psychiatric Nursing, 29(1), 6–13.
    1. So W. K., Marsh G., Ling W., Leung F., Lo J. C., Yeung M., Li G. K. (2009). The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: A multicenter study. Oncology Nursing Forum, 36(4), E205–E214.
    1. Song G. B., Park E. C. (2015). Effect of virtual reality games on stroke patients’ balance, gait, depression, and interpersonal relationships. Journal of Physical Therapy Science, 27(7), 2057–2060.
    1. Teeley A. M., Soltani M., Wiechman S. A., Jensen M. P., Sharar S. R., Patterson D. R. (2012). Virtual reality hypnosis pain control in the treatment of multiple fractures: A case series. American Journal of Clinical Hypnosis, 54(3), 184–194.
    1. van Twillert B., Bremer M., Faber A. W. (2007). Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes. Journal of Burn Care & Research, 28(5), 694–702.
    1. Wiederhold B. K. (2006). The potential for virtual reality to improve health care. The Virtual Reality Medical Center.
    1. Wiederhold M. D., Wiederhold B. K. (2007). Virtual reality and interactive simulation for pain distraction Pain Medicine, 8, S182–S188.
    1. 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. Oncology Nursing Forum, 29(1), E8–E15.
    1. Yu C., Lee H., Luo X. (2018). The effect of virtual reality forest and urban environments on physiological and psychological responses. Urban Forestry & Urban Greening, 35, 106–114.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅