Virtual Reality in Palliative Care: A Systematic Review

Abstract

Background: Virtual reality (VR) using head-mounted displays (HMDs) has demonstrated to be an effective tool for treating various somatic and psychological symptoms. Technological advances and increased affordability of VR technology provide an interesting option for delivering psychological interventions to patients in palliative care. The primary aim of this systematic review was to synthesise the available research on the use of VR for enhancing psychological and somatic outcomes for palliative care patients. Secondary aims included assessing general satisfaction and overall usability. Method: A pre-registered systematic literature search was conducted according to PRISMA guidelines using OVID Emcare, Cochrane Library, Embase, Medline, PsycINFO, and PubMed Care Search: Palliative Care Knowledge Network. Peer-reviewed experimental, quasi-experimental, observational, case, and feasibility studies consisting of single or multiple VR sessions using HMDs that reported psychological and/or somatic outcomes were included. Results: Eight studies published between 2019 and 2021 were included, representing 138 patients. While the reported quantitative psychological and somatic outcomes were ambiguous, the qualitative outcomes were largely positive. Participants were generally satisfied with VR, and most studies reported the VR interventions as usable, feasible, and acceptable. Conclusions: VR shows promise in palliative care and generally addresses a range of symptoms with few adverse effects. Future research should consist of adequately powered RCTs evaluating dosage and focusing on providing meaningful activities to enhance outcomes further.

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

“…One study explored the use of VR as a modality for therapeutic recreation in patients living with dementia enrolled in hospice 19 . Three systematic reviews have been conducted to address specific areas of interest with VR, such as determining the feasibility and effectiveness in palliative care 17 and as a platform for enhancing psychological and somatic outcomes 16 . Only 1 study explored the role of VR in pediatric palliative care 28 …”

“…Virtual reality included computer-simulated environments 9,15,21 with an overarching immersive component 16,17,20,22-25 . 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 .…”

“…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.…”

“…Hand controllers, 17,22 joy sticks, 18 screens, 20,22 and a VR facilitator 23 were also integrated as part of the experience. Reports of sore shoulders, improper sizing, and heaviness of the HMDs were reported by patients 16,20,21,26 . Conversely, HMDs were more flexible devices compared with stereoscopic displays and also allowed for mobility 21 …”

“…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 …”