Multimedia Journal of Metaverse in MEDICINE

RESEARCH ARTICLE | JANUARY 2, 2025

The Impact of Virtual Reality Intervention on Postoperative Pain Management and Emotional Well-being in Patients with Non-Small Cell Lung Cancer

Lvjia Song¹, Di Liu¹, Dongshuai Jing¹,Huihui Xu¹,Xiao Zhang¹,Dong Qi¹, Dachun Liu^1*1 Department of Thoracic Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China.
Corresponding Authors: Dachun Liu. E-mail: [email protected]
Address: Department of Thoracic Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China.

Abstract

This study investigated the effect of virtual reality (VR) technology on postoperative pain and anxiety in patients with non-small cell lung cancer (NSCLC). The study included 98 NSCLC patients who underwent surgical treatment, with 49 patients in the control group receiving standard clinical care and 49 in the observation group receiving VR intervention in addition to standard care. The results showed that the VR group had significantly lower pain scores, anxiety and depression levels, and higher quality of life scores compared to the control group. The VR group also had higher satisfaction with their hospital stay. The study concludes that VR technology can effectively reduce postoperative pain, improve negative emotions, and enhance the quality of life and satisfaction in NSCLC patients.

Keywords: Virtual Reality; Non-Small Cell Lung Cancer; Pain Management; Emotional Well-being

Introduction

Lung cancer is a common malignant tumor in China, with non-small cell lung cancer (NSCLC) accounting for 85%. NSCLC is characterized by high morbidity, high disability rate, and high mortality rate. In recent years, the incidence and mortality of NSCLC have been increasing globally, seriously threatening human life safety. Surgery is an important treatment for NSCLC. Pain is a common postoperative complication, and severe postoperative pain will increase the risk of adverse emotions such as anxiety and depression in patients. Analgesic drug intervention is usually given, but with many adverse reactions. Therefore, it is particularly necessary to implement effective pain nursing for NSCLC patients after surgery.
Virtual reality (VR) technology creates a three-dimensional stereoscopic simulation environment through devices such as computers, headphones, haptic controllers, and glasses. VR allows patients to interact with the virtual world through haptic controllers and perceive the virtual environment through multiple senses such as hearing, vision, and touch, achieving an immersive experience. VR can provide patients with a broad imagination space, allowing them to experience the joy of the virtual world, divert their attention, and reduce their focus on pain, thereby reducing the degree of postoperative pain (1,2). VR technology has been widely used in the medical field, realizing functions such as virtual surgery and anatomy, telemedicine, and virtual rehabilitation training(3).
The study aimed to observe the application effect of VR technology in NSCLC postoperative patients, providing a reference for pain relief and improving nursing effectiveness.

Methods

The study included 98 patients with non-small cell lung cancer (NSCLC) who underwent surgical treatment at the hospital from August 2022 to August 2023. The patients were randomly divided into a control group and an observation group, with 49 cases in each group.
The inclusion criteria were: meeting the diagnostic criteria for NSCLC in the “Diagnosis and Treatment Guidelines for Primary Lung Cancer in China” [3]; confirmed as lung cancer by preoperative imaging examination and NSCLC by postoperative clinical pathology; age ≥18 years; and first-time undergoing video-assisted thoracoscopic surgery. 2 The exclusion criteria were: no previous experience with virtual reality (VR); combined with dysfunction of other important organs such as the heart and liver; combined with mental illness; combined with cognitive impairment, hearing or visual impairment; combined with malignant tumors; combined with blood system diseases or immune system diseases; deterioration of the condition after surgery; and unwillingness to cooperate with the study or withdrawal during the study. The study was approved by the hospital’s medical ethics committee, and the patients and their families voluntarily signed the informed consent form.
The control group received routine clinical nursing care, while the observation group received VR intervention based on the control group. The VR intervention used the EPSON MOVERIO BT-300 all-in-one VR glasses, including a movie headset display, glasses, motion control handle, and headphones. Patients were instructed on the purpose, method, and techniques of using the instrument, and were allowed to try it out and adjust the pictures, videos, music, games, and scenes according to their preferences. Patients in the observation group used the VR device for 30-40 minutes per day for 7 days.
The study evaluated the patients’ pain, negative emotions, quality of life, and hospital service satisfaction. 2 The Visual Analogue Scale (VAS) was used to assess pain, the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess negative emotions, the 36-item Short Form Health Survey (SF-36) was used to assess quality of life, and a satisfaction survey was used to assess hospital service satisfaction.
According to the study, the researchers evaluated the patients’ hospital service satisfaction at discharge using a self-designed satisfaction survey with three options: satisfied, relatively satisfied, and dissatisfied. The total satisfaction rate was calculated as the sum of the satisfied and relatively satisfied rates.
The researchers used SPSS 24.0 software to conduct statistical analysis on the study data. For count data, the results were presented as the number of cases (%) and analyzed using the chi-square (χ2) test. For measurement data that followed a normal distribution, the results were presented as the mean ± standard deviation (X±SD) and analyzed using the t-test. A P-value less than 0.05 was considered statistically significant.

Results

1. Virtual reality technology alleviates pain The VAS score of the observation group was 4.02±0.73 on postoperative day 1, 3.11±0.67 on postoperative day 3, and 2.06±0.51 on postoperative day 5, while the VAS score of the control group was 5.49±0.81 on postoperative day 1, 4.18±0.76 on postoperative day 3, and 2.98±0.59 on postoperative day 5. The VAS scores of the observation group were significantly lower than those of the control group (P<0.05).
2. Virtual reality technology alleviates negative emotions After the intervention, the SAS and SDS scores of both groups decreased significantly, and the observation group was significantly lower than the control group (P<0.05).
3. Virtual reality technology improves quality of life After the intervention, the scores of physical pain, mental health, physical function, and emotional function in the SF-36 scale of both groups increased significantly, and the observation group was significantly higher than the control group (P<0.05).
4. Virtual reality technology improves hospital service satisfaction In the observation group, 34 cases were satisfied, 13 cases were relatively satisfied, and 2 cases were dissatisfied, with a total satisfaction rate of 95.92% (47/49); in the control group, 19 cases were satisfied, 21 cases were relatively satisfied, and 9 cases were dissatisfied, with a total satisfaction rate of 77.55% (38/49). The total satisfaction rate of the observation group was significantly higher than that of the control group (P<0.05).

Discussion

The study results suggest that virtual reality technology can effectively reduce the degree of postoperative pain, improve anxiety, depression, and other negative emotions, enhance the quality of life, and increase the satisfaction with hospital stay in NSCLC patients .
The mechanism by which VR technology improves postoperative outcomes in NSCLC patients may be related to its ability to distract patients from pain and negative emotions . During the VR intervention, patients are immersed in a simulated environment, which can divert their attention away from the physical discomfort and unpleasant feelings associated with the surgical procedure . Additionally, the VR experience may help patients gain a better understanding of their disease and treatment, which can increase their confidence and reduce anxiety(4,5) .
The findings of this study are consistent with previous research on the use of VR in pain management and psychological support for cancer patients (6,7) . The results indicate that VR can be a valuable complementary therapy to improve postoperative recovery in NSCLC patients .

Conclusion

In conclusion, virtual reality technology can effectively reduce the degree of postoperative pain, improve anxiety, depression, and other negative emotions, enhance the quality of life, and increase the satisfaction with hospital stay in NSCLC patients . VR can be a valuable complementary therapy to improve postoperative recovery in NSCLC patients .

Author Contributions

Lvjia Song wrote the first draft. Di Liu, Dongshuai Jing, Huihui Xu and Xiao Zhang contributed to the critical revision of the manuscript. Dong Qi and Dachun Liu reviewed and revised the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

None.

Conflicts of Interest

The authors declare no conflict of interest.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Received: 15 October 2024
Accepted: 16 December 2024
Published on line: 2 January 2025

Reference

Rousseaux F, Dardenne N, Massion PB, Ledoux D, Bicego A, Donneau AF, Faymonville ME, Nyssen AS, Vanhaudenhuyse A. Virtual reality and hypnosis for anxiety and pain management in intensive care units: A prospective randomised trial among cardiac surgery patients. Eur J Anaesthesiol. 2022, 39(1):58-66.
Rousseaux F, Faymonville ME, Nyssen AS, Dardenne N, Ledoux D, Massion PB, Vanhaudenhuyse A. Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial. Trials. 2020, 21(1):330.
Wiechman SA, Jensen MP, Sharar SR, Barber JK, Soltani M, Patterson DR. The Impact of Virtual Reality Hypnosis on Pain and Anxiety Caused by Trauma: Lessons Learned from a Clinical Trial. Int J Clin Exp Hypn. 2022, 70(2):156-173.
Rougereau G, Sandiford MH, Lévêque R, Ménigaux C, Bauer T, Hardy A. Management of Anxiety for Ambulatory Hallux Valgus Surgery With a Virtual Reality Hypnosis Mask: Randomized Controlled Trial. Foot Ankle Int. 2023, 44(6):539-544.
Eijlers R, Dierckx B, Staals LM, Berghmans JM, van der Schroeff MP, Strabbing EM, Wijnen RMH, Hillegers MHJ, Legerstee JS, Utens EMWJ. Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: A randomised controlled trial. Eur J Anaesthesiol. 2019, 36(10):728-737.
Deo N, Khan KS, Mak J, Allotey J, Gonzalez Carreras FJ, Fusari G, Benn J. Virtual reality for acute pain in outpatient hysteroscopy: a randomised controlled trial. BJOG. 2021, 128(1):87-95.
Burrai F, Ortu S, Marinucci M, De Marinis MG, Piredda M. Effectiveness of Immersive Virtual Reality in People with Cancer Undergoing Antiblastic Therapy: A Randomized Controlled Trial. Semin Oncol Nurs. 2023, 39(4):151470.