مجله زنان، مامایی و نازایی ایران

مجله زنان، مامایی و نازایی ایران

تأثیر بکارگیری واقعیت مجازی حین شیمی‌درمانی بر دیسترس و خستگی زنان مبتلا به سرطان پستان: یک مطالعه مداخله‌ای متقاطع

نوع مقاله : اصیل پژوهشی

نویسندگان
صبا قوامی 1
دکتر فرزانه ظاهری 2
دکتر بایزید قادری 3
دکتر بیژن نوری 4
دکتر روناک شاهوی 5
1 دانشجوی کارشناسی ارشد آموزش مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.
2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.
3 دانشیار خون و سرطان بالغین، مرکز تحقیقات سرطان و ایمونولوژی، مرکز تحقیقات توسعه بهداشت، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.
4 دانشیار گروه آمار و اپیدمیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.
5 استاد گروه مامایی، مرکز تحقیقات مراقبت بالینی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.
10.22038/ijogi.2025.81699.6171
چکیده
مقدمه: سرطان پستان، دومین علت مرگ ناشی از سرطان در زنان در سراسر جهان است. مطالعه حاضر با هدف تعیین تأثیر بکارگیری واقعیت مجازی حین شیمی‌درمانی بر دیسترس و خستگی زنان مبتلا به سرطان پستان انجام شد.
روش‌کار: این مطالعه مداخله‌ای متقاطع در سال 1400 بر روی 50 نفر از زنان مبتلا به سرطان پستان تحت شیمی‌درمانی بستری در بخش انکولوژی مرکز آموزشی درمانی توحید شهر سنندج انجام شد. افراد با تخصیص تصادفی ساده به دو گروه 25 نفره مداخله-کنترل (B) و کنترل- مداخله (A) تقسیم شدند. در جلسه سوم شیمی‌درمانی جهت افراد گروه B، علاوه بر مراقبت‌های معمول، مداخله و افراد گروه A مراقبت‌های معمول به‌عمل آمد، در جلسه چهارم شیمی‌درمانی جهت افراد گروه A، علاوه بر مراقبت‌های معمول مداخله مذکور و گروه B مراقبت‌های معمول انجام شد. مداخله شامل پخش ویدئوهای قدم زدن در جنگل در تمام طول مدت شیمی‌درمانی بود. ابزار گردآوری اطلاعات شامل اطلاعات دموگرافیک و بالینی، پرسشنامه‌های مقیاس دیسترس علائم مک کارکل و یانگ و مقیاس خستگی پایپر، قبل، بلافاصله، 24 و 48 ساعت بعد از شیمی‌درمانی بود. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار STATA (نسخه 17) و آزمون‌های تحلیل واریانس، شاپیرو-ویلک، تی‌مستقل و مدل اثر رگرسیون خطی مرکب انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ ها: مداخله تأثیر معنی‌داری بر روی نمرات دیسترس و خستگی بلافاصله، 24 و 48 ساعت بعد از شیمی‌درمانی در هر دو گروه داشت. میانگین نمرات دیسترس بین دو گروه از نظر ترتیب انجام مداخله تفاوت آماری معنی‌داری نداشت (057/0=p). مداخله تأثیر معنی‌داری بر کاهش میانگین نمرات دیسترس و نمرات خستگی در هر دو گروه داشت (001/0>p). میانگین نمرات خستگی بین دو گروه از نظر ترتیب انجام مداخله تفاوت آماری معنی‌داری داشت (043/0=p)؛ بدین‌صورت که نمرات گروه مداخله-کنترل (B) کمتر از گروه کنترل- مداخله (B) بود.
نتیجه ­گیری: تکنیک واقعیت مجازی در کاهش دیسترس و خستگی ناشی از شیمی‌درمانی در بیماران مبتلا به سرطان پستان مؤثر است، بنابراین توصیه می‌شود از این روش در بالین استفاده شود.
کلیدواژه‌ها
خستگی
دیسترس
سرطان پستان
شیمی‌درمانی
واقعیت مجازی
موضوعات

عنوان مقاله English

The Effect of Applying Virtual Reality during Chemotherapy on Distress and Fatigue of Women with Breast Cancer: A Cross-Over Interventional Study

نویسندگان English

Saba Ghavami 1
Farzaneh Zaheri 2
Bayazid Ghaderi 3
Bijan Nouri 4
Roonak Shahoei 5
1 M.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3 Associate Professor, Department of Hematology & Oncology, Cancer and Immunology Research Center, Research Institute for Health Development, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
4 Associate Professor, Department of Statistics and Epidemiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
5 Professor, Department of Midwifery, Clinical Care Research Center, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
چکیده English

Introduction: Breast cancer is the second leading cause of cancer-related death in women worldwide. The present study was conducted with aim to determine the effect of using virtual reality during chemotherapy on distress and fatigue of women with breast.
Methods: This crossover interventional study was conducted in 2021 on 50 women with breast cancer undergoing chemotherapy in the oncology ward of Tohid hospital in Sanandaj. Using simple random allocation, women were divided into two groups of intervention-control (B) and control-intervention (A) (n=25 per group). In the third session of chemotherapy for the intervention-control group (B), in addition to the usual care, intervention was carried out and the control-intervention group (A) received the usual care, and in the fourth session of chemotherapy for the control-intervention group (A), in addition to the usual care, the mentioned intervention was done, and the control-intervention group (B) received the usual care. The intervention includes playing videos of walking in the forest throughout the chemotherapy period. Data collection tools included demographic and clinical information, McCorkle and Young's Symptom Distress Scale questionnaires, and Piper's Fatigue Scale, before, immediately, 24, and 48 hours after chemotherapy. Data were to analyse using STATA software (version 17) and variance analysis, Shapiro-Wilk, independent t and mixed linear regression effect models. P<0.05 was considered significant.
Results: The intervention had a significant effect on distress and fatigue scores immediately, 24 and 48 hours after chemotherapy in both groups. There was no statistically significant difference between the two groups in terms of the order of the intervention (P=0.057). The intervention had a significant effect on reducing the mean distress scores and fatigue scores in both groups (P<0.001). There was no statistically significant difference between the two groups in the mean fatigue scores in terms of the order of the intervention (P=0.043); so that the scores of the intervention-control group (B) were lower than the control-intervention group (A).
Conclusion: The virtual reality technique was effective in reducing distress and fatigue caused by chemotherapy in breast cancer patients, so it is recommended to use this method in the hospital.

کلیدواژه‌ها English

Breast Cancer
Chemotherapy
Distress
Fatigue
Virtual Reality
  1. Ashkhaneh Y, Mollazadeh J, Aflakseir A, Goudarzi MA, Homaei Shandiz F. Study of difficulty in emotion regulation as a predictor of incidence and severity of nausea and vomiting in breast cancer patients. Journal of Fundamentals of Mental Health 2015; 17(3):123-8.
  2. Baghaei R, Sharifi M, Mohammadpour Y, Sheykhi N. Evaluation of the effects of educational package on controlling the complications of chemotherapeutic agents on symptom scales of quality of life in patients with breast cancer undergoing chemotherapy. Nursing and Midwifery Journal 2013; 11(9).
  3. World Health Organization. WHO report on cancer: setting priorities, investing wisely and providing care for all. World Health Organization; 2020.
  4. Rastad H, Khanjani N, Khandani BK. Causes of delay in seeking treatment in patients with breast cancer in Iran: a qualitative content analysis study. Asian Pacific Journal of Cancer Prevention 2012; 13(9):4511-5.
  5. Abachizadeh K, Moradi-Kouchi A, Ghanbari-Motlagh A, Kousha A, Shekarriz-Foumani R, Erfani A. Breast cancer in Iran: Levels, variations and correlates. Community Health (Salamat ijtimai) 2018; 5(1):11-21.
  6. Kolden GG, Strauman TJ, Ward A, Kuta J, Woods TE, Schneider KL, et al. A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer 2002; 11(5):447-56.
  7. Yap KY, Low XH, Chan A. Exploring chemotherapy-induced toxicities through multivariate projection of risk factors: prediction of nausea and vomiting. Toxicological research 2012; 28(2):81-91.
  8. Gholamy R, Dehghan M, Vanaki Z, Ghaedi F, Soheili M, Mosarezaee A. Efficacy of complementary therapies in reduction of chemotherapy induced nausea and vomiting in breast cancer patients: Systematic review. Complementary Medicine Journal 2014; 4(2):831-44.
  9. Barthakur MS, Sharma MP, Chaturvedi SK, Manjunath SK. Body image and sexuality in women survivors of breast cancer in India: Qualitative findings. Indian journal of palliative care 2017; 23(1):13.
  10. Sharma N, Purkayastha A. Impact of radiotherapy on psychological, financial, and sexual aspects in postmastectomy carcinoma breast patients: a prospective study and management. Asia-Pacific Journal of Oncology Nursing 2017; 4(1):69-76.
  11. Sreerekha K, Pandey M, Thomas A. Psychosexual problems of cancer patients and their spouses Results of an open ended survey. World Journal of Psycho-Social Oncology 2012; 1(1).
  12. Chaturvedi SK. Psycho-oncology: Indian experiences and research. InDevelopments in Psychiatry in India: Clinical, Research and Policy Perspectives 2015:451-461.
  13. Kornblith AB, Ligibel J. Psychosocial and sexual functioning of survivors of breast cancer. InSeminars in oncology 2003; 30(6):799-813.
  14. Holland J, Jacobsen P, Andersen B. NCCN clinical practice guidelines in oncology: distress management, v2. 2016. National Comprehensive Cancer Network, Inc. 2016.
  15. Holland JC, Andersen B, Breitbart WS, Compas B, Dudley M, Fleishman S. NCCN clinical practice guidelines in oncology: distress management. J Natl Compr Canc Netw 2010; 8(3):448-85.
  16. Adler NE, Page AE. Committee on psychosocial services to cancer patients/families in a community setting. InCancer care for the whole patient: meeting psychosocial health needs 2008.
  17. Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecologic oncology 2015; 136(3):446-52.
  18. Bardwell WA, Ancoli-Israel S. Breast cancer and fatigue. Sleep medicine clinics 2008; 3(1):61-71.
  19. Schjolberg TK, Dodd M, Henriksen N, Asplund K, Småstuen MC, Rustoen T. Effects of an educational intervention for managing fatigue in women with early stage breast cancer. European Journal of Oncology Nursing 2014; 18(3):286-94.
  20. Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. Journal of clinical oncology 2000; 18(4):743-.
  21. Curt GA, Breitbart W, Cella D, Groopman JE, Horning SJ, Itri LM, et al. Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. The oncologist 2000; 5(5):353-60.
  22. Akin S, Can G, Aydiner A, Ozdilli K, Durna Z. Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. European journal of oncology nursing 2010; 14(5):400-9.
  23. Mikaeili N, Fathi A, Kanani S, Samadifard HR. A comparison of distraction techniques (bubble and cartoon) on reducing chemotherapy induced pain in children with cancer. Iranian Journal of Cancer Care (ijca) 2022; 1(1):15-23.
  24. Jensen SB, Mouridsen HT, Bergmann OJ, Reibel J, Brünner N, Nauntofte B. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontology 2008; 106(2):217-26.
  25. Gazendam-Donofrio SM, Hoekstra HJ, van der Graaf WT, van de Wiel HB, Visser A, Huizinga GA, et al. Adolescents’ emotional reactions to parental cancer: effect on emotional and behavioral problems. Journal of pediatric psychology 2011; 36(3):346-59.
  26. King AL, Roche KN, Leeper HE, Vera E, Mendoza T, Mentges K, et al. Feasibility of a virtual reality intervention targeting distress and anxiety symptoms in patients with primary brain tumors: Interim analysis of a phase 2 clinical trial. Journal of neuro-oncology 2023; 162(1):137-45.
  27. van Bennekom MJ, de Koning PP, Denys D. Virtual reality objectifies the diagnosis of psychiatric disorders: a literature review. Frontiers in Psychiatry 2017; 8:163.
  28. Sharifpour S, Manshaee GR, Sajjadian I. Effects of virtual reality therapy on perceived pain intensity, anxiety, catastrophising and self‐efficacy among adolescents with cancer. Counselling and Psychotherapy Research 2021; 21(1):218-26.
  29. Schneider SM, Ellis M, Coombs WT, Shonkwiler EL, Folsom LC. Virtual reality intervention for older women with breast cancer. CyberPsychology & Behavior 2003; 6(3):301-7.
  30. Chirico A, Maiorano P, Indovina P, Milanese C, Giordano GG, Alivernini F, et al. Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy. Journal of cellular physiology 2020; 235(6):5353-62.
  31. Nematollahzade M, Maasoumi R, Lamyian M, ASGHARI JM. Study of women's attitude and sexual function during pregnancy. Journal of Ardabil University of Medical Sciences 2010; 10(3):241-249.
  32. Shobeyri F, Nikravesh A, Masoumi SZ, Heydarimoghadam R, Karami M, Badafreh M. Effect of exercise counseling on functional scales quality of life in women with breast cancer. Journal of Education and Community Health 2015; 2(1):1-9.
  33. Rezaei M, Elyasi F, Janbabai G, Moosazadeh M, Hamzehgardeshi Z. Factor’s influencing body image in women with breast cancer: A comprehensive literature review. Iranian Red Crescent Medical Journal 2016; 18(10):e39465.
  34. Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. Randomized controlled trial of abdominal binders for postoperative pain, distress, and blood loss after cesarean delivery. International Journal of Gynecology & Obstetrics 2017; 137(3):271-6.
  35. Fazel Asgarpoor A, Amini Z, Zeraati A, Esmaeli H. The effect of a care plan based on the Roy Adaptation Model on level of Fatigue in hemodialysis patients. Evidence Based Care 2011; 1(1):77-90.
  36. Zhang X, Yao S, Wang M, Yin X, Bi Z, Jing Y, et al. The impact of VR‐CALM intervention based on VR on psychological distress and symptom management in breast cancer survivors. Journal of Oncology 2022; 2022(1):1012813.
  37. Nilsson S, Finnström B, Kokinsky E, Enskär K. The use of virtual reality for needle-related procedural pain and distress in children and adolescents in a paediatric oncology unit. European Journal of Oncology Nursing 2009; 13(2):102-9.
  38. Fabi A, Fotia L, Giuseppini F, Gaeta A, Falcicchio C, Giuliani G, et al. The immersive experience of virtual reality during chemotherapy in patients with early breast and ovarian cancers: The patient’s dream study. Frontiers in Oncology 2022; 12:960387.
  39. 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. InSeminars in Oncology Nursing 2023; 39(4):151470.
  40. Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. InOncology nursing forum 2001; 28(3):465-470.
  41. Aghabarari M, Ahmadi F, Mohammadi I, Hajizadeh E, Varvani FA. Physical, emotional and social dimension of quality of life among breast cancer women under chemotherapy. Iranian Journal of Nursing Research 2007; 1(3):55-65.
  42. Reynolds LM, Cavadino A, Chin S, Little Z, Akroyd A, Tennant G, et al. The benefits and acceptability of virtual reality interventions for women with metastatic breast cancer in their homes; a pilot randomised trial. BMC cancer 2022; 22(1):360.
  43. Uslu A, Arslan S. The effect of using virtual reality glasses on anxiety and fatigue in women with breast cancer receiving adjuvant chemotherapy: a pretest-posttest randomized controlled study. InSeminars in oncology nursing 2023; 39(5):151503.
  44. Schneider SM, Hood LE. Virtual reality: a distraction intervention for chemotherapy. InOncology nursing forum 2007; 34(1):39.
  45. Von Ah DM, Kang DH, Carpenter JS. Predictors of cancer-related fatigue in women with breast cancer before, during, and after adjuvant therapy. Cancer Nursing 2008; 31(2):134-44.
  46. Kardan L, Latifi M, Delavar P. Review on position of midwives in the health system. National conference of midwifery and women's health, Article Code MIDWIFE01_019. 2019.
مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 10
دی 1404
صفحه 62-76