Sarah Herwest1, Annalisa Bozem1, Deetje Iggena1, Alexander Kowski1, Anna-Christin Willert1, Christoph Ploner1, Carsten Finke1
1Charité Berlin
Objective:
Assessing whether a VR-intervention in patients receiving neuro-palliative care (NPC) (I) is feasible and accepted by patients, (II) without relevant side effects and (III) can alleviate symptom burden.
Background:
Patients in NPC-settings suffer from complex neurological deficits as well as from pain, anxiety, fatigue, and sadness. Immersive virtual reality (VR) is increasingly used as non-pharmacological treatment of these symptoms. However, data on NPC-patients are not available.
Design/Methods:
Our prospective single-arm study recruited patients from the NPC unit at Charité Berlin. In a 15-20 minute VR-intervention (CUREosity Oculus Quest VR-system), patients explored different landscapes and performed activities like directing a butterfly by gaze, catching meteors, or breathing exercises. To assess feasibility and acceptance, a semi-structured interview was conducted, and consent- and dropout-rate were determined. Symptom burden and side effects were assessed using Edmonton Symptom Assessment Scale and Simulator Sickness Questionnaire.
Results:
We recruited 35% of all inward NPC-patients (n=50, mean age 64 years, 62% male) from 09/2022 - 09/2023. Main reasons for exclusion of the remaining 65% were relevant neurological deficits (e.g. aphasia, cognitive deficits). Included patients had neuro-oncological (42%), neurodegenerative (40%), and neurovascular (8%) diseases. Most patients described the VR-intervention as enjoyable, distracting, and relaxing, and 88% wished for another intervention. Three patients (6%) discontinued the VR-intervention (exacerbation of pre-existing dizziness, dislike of the VR-landscapes). Mild side effects (eyestrain, nausea, tiredness, dizziness) occurred in 24%. The VR-intervention was associated with a significant reduction in sadness (p<0.001, d=0.79), pain (p=0.01, d=0.50), fatigue (p=0.01, d=0.47), anxiety (p=0.02, d=0.47), and dyspnea (p=0.049, d=0.43), and well-being improved significantly (p=0.001, d=0.68).
Conclusions:
Immersive VR in NPC-patients is feasible and accepted, and can be performed without relevant side effects. In our cohort, the VR-intervention was associated with reduced levels of sadness, pain, fatigue, anxiety, and dyspnea, and increased well-being. Immersive VR should therefore be further evaluated as non-pharmacological treatment for NPC-patients.