Accepted for/Published in: JMIR Serious Games
Date Submitted: Oct 24, 2023
Date Accepted: Aug 16, 2024
Effects of virtual reality therapy for breast cancer patients during chemotherapy: A randomized controlled trial
ABSTRACT
Background:
Breast cancer patients suffer high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of cancer patients.
Objective:
We aimed to test the long-term effects of VR on psychological distress, quality of life (QOL), and medication adherence compared with traditional care in Chinese breast cancer patients. We also explored the intervention mechanism and the acceptability of VR.
Methods:
A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer (DT), Quality of Life Questionnaire version 3.0 (QLQ-C30), 8-item Morisky Medication Adherence Scale (MMAS-8), and Virtual Reality Symptom Questionnaire (VRSQ) were assessed at baseline, post-intervention (three months), and follow-up (six months). Analysis followed the intention-to-treat principle. The generalized estimating equations (GEE) model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect.
Results:
Compared with the control group, distress scores decreased significantly (P = .02), and QOL (emotional functioning, cognitive functioning, social functioning) and medication adherence scores improved after three months of VR interventions (P < .05). These effects persisted at follow-up (all P < .05), except for medication adherence (P = .12). Psychological distress had mediating effects on the longitudinal association between VR interventions and the global health status and the five functional subscales (indirect effect = 4.572−6.672, all P < .05).
Conclusions:
This research demonstrated that VR intervention technology may help reduce distress and improve health-related quality of life in all dimensions for breast cancer patients over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR interventions were manifested through positive effects on psychological distress risk factors. Clinical Trial: The study was registered in the Chinese Clinical Trial Registry (Number: ChiCTR2000035049; Date: 2020.7.29).
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