The Potential of Personalized Virtual Reality in Palliative Care: A Feasibility Trial

Abstract

Background: Virtual Reality can help alleviate symptoms in a non-palliative care population. Personalized therapy can further alleviate these symptoms. There is little evidence in a palliative care population. Aim: To understand the feasibility of repeated personalized virtual reality sessions in a palliative care population. Design: A feasibility randomized control trial. Intervention: personalized virtual reality, Control: non-personalized virtual reality. All participants completed a 4-minute virtual reality session for 4 weeks. At each point, the Edmonton Symptom Assessment System-Revised (scored 0 = none up to 100 = worst) was completed pre- and post- each session. A time-series regression analysis was completed for the overall effect. Setting/Participants: The research took place in one hospice. The main inclusion criteria was: (1) under the care of the hospice (2) advanced disease (3) over 18 years (4) physically able to use virtual reality set (5) capacity (6) proficient English. Results: Twenty-six participants enrolled, of which 20 (77%) completed all sessions. At baseline, the intervention group had a mean pre- score of 26.3 (SD 15.1) which reduced to 11.5 (SD 12.6) after the first session. At the same time point, the control group had a mean pre- score of 37.9 (SD 21.6) which reduced to 25.5 (SD 17.4) post-session. The mean scores dropped following each session, however this was not significant (mean difference = −1.3, 95% CI: −6.4 to 3.7, p = 0.601). Conclusions: It is feasible to complete repeated virtual reality sessions within a palliative care population. Future research should explore the structure and effectiveness of virtual reality in a fully powered trial.

A Rapid Review of the Role of Virtual Reality in Care Delivery of Palliative Care and Hospice

“…Computer-generated imagery, 22,26 a 360° aspect ratio and 3-dimensional, 16-18,20 and virtual worlds 20,23 detailed the experience for the participant. Head-mounted displays were used in nearly all of the studies 16-20,22,24-28 . Hand controllers, 17,22 joy sticks, 18 screens, 20,22 and a VR facilitator 23 were also integrated as part of the experience.…”

“…One study reported connectivity and charging issues with equipment as well as the need for frequent software updates 26 . Training on the use of VR and financial resources for equipment were listed as challenges associated with implementation 16,27 …”

“…Acceptability of VR by providers and patients was consistent across the studies reviewed. Patients reported the ease of use, 22 enjoyment, 17,23,26 and feasibility to implement as a therapy to augment their treatment plan 11,16,17,20,22,23,27 …”

“…Virtual reality can stimulate a user to perceive purposeful or relaxing environments, as if in those places 19 . A sense of being there, or presence, was a comment frequently reported by the participants to describe the VR experience 16-18,24,27 …”

“…The sustained benefit of VR on symptom management was rarely explored, particularly because the VR experience was provided only once (singular dose). One exception, Perna et al 27 (2021) examined the impact of 4-minute VR sessions weekly for 4 weeks. In comparing personalized VR with preselected experiences, participants in both groups demonstrated reductions in tiredness and drowsiness.…”