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. 2024 Jan 17:8:e46367.
doi: 10.2196/46367.

Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study

Jordana L Sommer  1   2 , Kristin Reynolds  2   3 , Pamela Hebbard  4   5 , Michael S D Smith  6 , Natalie Mota  3   7 , W Alan C Mutch  1 , Jessica Maples-Keller  8 , Leslie Roos  2 , Renée El-Gabalawy  1   2   3   5   7
Affiliations

Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study

Jordana L Sommer et al. JMIR Form Res. .

Abstract

Background: Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation.

Objective: This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction.

Methods: Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study.

Results: Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery").

Conclusions: This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention.

Trial registration: ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.

Keywords: anesthesia; breast cancer surgery; feasibility; pilot; preoperative anxiety and distress; virtual reality.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Retrospective reports of distress/anxiety among the control group and intervention group for patients undergoing breast cancer surgery participating in the feasibility and pilot study to evaluate preoperative virtual reality (VR). Blue guidelines outline the period between when the intervention group trialed the VR and participants’ day of surgery.
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References

    1. Aust H, Eberhart L, Sturm T, Schuster M, Nestoriuc Y, Brehm F, Rüsch D. A cross-sectional study on preoperative anxiety in adults. J Psychosom Res. 2018 Aug;111:133–9. doi: 10.1016/j.jpsychores.2018.05.012.S0022-3999(17)31198-4 - DOI - PubMed
    1. Mitchell M. Patient anxiety and modern elective surgery: a literature review. J Clin Nurs. 2003 Nov;12(6):806–15. doi: 10.1046/j.1365-2702.2003.00812.x.812 - DOI - PubMed
    1. Kil H, Kim WO, Chung WY, Kim GH, Seo H, Hong JY. Preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anaesthesia. Br J Anaesth. 2012 Jan;108(1):119–25. doi: 10.1093/bja/aer305. https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)32523-0 S0007-0912(17)32523-0 - DOI - PubMed
    1. McAvay GJ, Van Ness PH, Bogardus Jr ST, Zhang Y, Leslie DL, Leo-Summers LS, Inouye SK. Depressive symptoms and the risk of incident delirium in older hospitalized adults. J Am Geriatr Soc. 2007 May 11;55(5):684–91. doi: 10.1111/j.1532-5415.2007.01150.x.JGS1150 - DOI - PubMed
    1. Skeppholm M, Fransson R, Hammar M, Olerud C. The association between preoperative mental distress and patient-reported outcome measures in patients treated surgically for cervical radiculopathy. Spine J. 2017 Jun;17(6):790–8. doi: 10.1016/j.spinee.2016.02.037.S1529-9430(16)00390-9 - DOI - PubMed

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