Case report: Therapeutic potential of Flourishing-Life-Of-Wish Virtual Reality Therapy on Relaxation (FLOW-VRT-Relaxation)—a novel personalized relaxation in palliative care

In view of the global aging population and growing need of palliative care, innovative intervention for effective symptom management is of urgent need. Flourishing-Life-Of-Wish Virtual Reality Therapy (FLOW-VRT) is a brief, structured, manualized, and personalized psychological intervention with theoretical foundations based on stress coping theory, self-determination theory, flow theory, and attention restoration theory. With a specific focus on relaxation, FLOW-VRT-Relaxation intends to facilitate adaptive end-of-life coping through delivering personalized relaxation. This paper reports a case study of the application of FLOW-VRT-Relaxation, and discusses its therapeutic potential as a cost-effective method for reducing palliative symptoms by addressing patient's unmet needs. The case study is a 51-year-old Chinese female, diagnosed with advanced cervix cancer, and presented with unmet psychological (i.e., unfulfilled wishes) and physical needs (i.e., pain and fatigue) before FLOW-VRT-Relaxation. To address her unmet needs, FLOW-VRT-Relaxation was delivered by a registered clinical psychologist specialized in palliative care. Need assessment was first conducted, followed by a 10-min VR travel of Japan as her own choice. Relaxation was verbally coached during VR. Right after VR, consolidation with psychological components including psychoeducation, cognitive and emotional processing, and reminiscence intervention were delivered. The patient showed improvement in physical and psychological symptoms, lower sense of loneliness and engulfment, as well as enhanced peace after FLOW-VRT-Relaxation. The current findings provide encouraging initial support for the feasibility, acceptability, and therapeutic potential of using FLOW-VRT-Relaxation as a cost-effective, scalable and personalized VR relaxation for patients under palliative care. It is hoped that with its optimal use, FLOW-VRT-Relaxation can serve as an alternative therapeutic tool that effectively improves the end-on-life care

VR in Nursing Facilities - A randomized controlled multicenter pilot study analyzing the changes in the state of mind of seniors in nursing facilities through the viewing of 360° videos

Context: VR as an application to enhance well-being is sparsely researched in the elderly population. The aim of the pilot study was to analyze the effect of 360° videos of different categories on the state of mind of seniors in nursing facilities. Furthermore, for the implementation in everyday life, the usability of the system and the experience for seniors should be evaluated. Methods: The VR experience was used as a supplement to existing care services in three facilities on eight subjects. Mood state was assessed using the Questionnaire for the Assessment of Happiness before and after the intervention. Demographic data and technology acceptance were collected beforehand. After the intervention, subjects were interviewed about confounding factors and side effects, and nursing home staff were interviewed about the usability of the system and the organizational concept of implementation. Results: There was a positive effect on state of mind. Gender and spatial mobility turned out to be influencing factors. Categories containing people, animals and action achieved the highest increases in the state of mind. Interest in using technical devices correlated negatively with the change in mood state. None of the subjects found the VR goggles distracting or reported motion sickness. Very good usability was indicated by the employees. Conclusion: A very high willingness to use this technology was found among nursing staff and residents. The tendencies of the positive effect of 360° videos on the state of mind, as well as differentiation based on the mentioned characteristics gender and spatial mobility, should be verified by a larger sample to empirically validate the use of this technology to increase the quality of life

SafeSpace: what is the feasibility and acceptability of a codesigned virtual reality intervention, incorporating compassionate mind training, to support people undergoing cancer treatment in a clinical setting?

Objectives: The SafeSpace study codesigned and tested a virtual reality (VR) intervention, incorporating relaxation and compassionate mind training to determine acceptability/feasibility in an oncology setting and evaluate impact on physical/psychological well-being and quality of life. Design: A two-phase study. Phase I determined key characteristics using an experienced-based codesign approach. Phase II evaluated the intervention using various measures and qualitative interviews in a mixed methods approach. Descriptive statistics were used to analyse measures data and framework analysis to analyse interviews. Setting: A specialist cancer centre, UK. Participants: 11 in phase I and 21 in phase II. Participants were in cancer treatment, recovery or palliative care. Primary and secondary outcome: Primary outcome: acceptability of the intervention, assessed by >60% uptake of three sessions. Secondary outcomes: impact on psychological well-being using EQ-5D/QLQ-C30, Profile of Mood Scale, Warwick and Edinburgh Mental Well-being Scale, Depression and Anxiety Severity Scale 21, Self-Compassion Scale, Acceptance and Action Questionnaire and a locally developed questionnaire to capture self-compassion post use. Physiological impact was assessed by change in heart rate (HR)/HR variability and electrodermal activity (EDA). Results: Twenty participants (mean age=48.7 years; SD=16.87); 65% (n=13) completed three sessions. Mental well-being improved following each use and from baseline to after session 3 (VR 1—z=2.846, p≤0.01; VR 2—z=2.501, p≤0.01; VR 3—z=2.492, p≤0.01). There was statistically significant difference in mean scores for EDA at mid-session and post session compared with pre session (F (1.658, 4.973)=13.364, p<0.05). There was statistically significant reduction in stress levels from baseline to post session 3. Participants found the intervention acceptable and highlighted areas for development. Conclusion: The intervention is acceptable and feasible and has shown positive effects on mental well-being/stress in the oncology setting. Larger studies are needed to confirm findings

La intervención psicológica en pacientes oncológicos: una revisión de la literatura (2000-2014)

Objective: The aim of this work has been to assess the use of the different psychological interventions related to the emotional, physical, functional state and quality of life of cancer patients in the different phases of the illness. Method: For this purpose, a bibliographic search between the years 2000 and 2014 in Medline and CancerLit databases was conducted. Results: A total of 122 experimental studies are described grouped according to the illness phases and the kind of psychological intervention employed. It is discussed about the methodological guaranties and the measures and the assessments of therapeutic efficiency to identify the interventions with the best prognostic. Conclusions: In general, the studies reviewed have achieved favorable results in relation to the improvement of the emotional, physical, functional state and the quality of life the patients. Nevertheless, their methodological limitations (little samples, difficulties of generalization, control group absence, etc.) and, sometimes, contradictory results suggest to be cautious when concluding about the effectiveness or not of the psychological intervention in cancer and the benefits of its application.Objetivo: Valorar la utilidad de las distin­tas intervenciones psicológicas en relación al estado emocional, físico, funcionalidad y la ca­lidad de vida de los pacientes oncológicos en las diferentes fases de la enfermedad. Método: Se realizó una búsqueda biblio­gráfica en las bases de datos Medline y Can­cerLit, entre el año 2000 y 2014. Resultados: Un total de 122 estudios expe­rimentales se describen agrupados según las fases de la enfermedad y los tipos de interven­ción psicológica aplicados. Se discute acerca de sus garantías metodológicas y se analizan las medidas y valoraciones de eficacia tera­péutica para identificar las intervenciones con mejores pronósticos. Conclusiones: En general, los trabajos revi­sados han logrado resultados favorables en re­lación a la mejora del estado emocional, físico, funcional y la calidad de vida de los pacientes. No obstante, sus limitaciones metodológicas (uso de muestras pequeñas, dificultades de ge­neralización, ausencia de grupo control, etc.) y, en ocasiones, resultados contradictorios se­ñalan cautela a la hora de concluir sobre la efectividad o no de la intervención psicológica en cáncer y los beneficios de su aplicación

Psychological intervention in oncological patients: a review (2000-2014)

Objective: The aim of this work has been to assess the use of the different psychological interventions related to the emotional, physical, functional state and quality of life of cancer patients in the different phases of the illness. Method: For this purpose, a bibliographic search between the years 2000 and 2014 in Medline and CancerLit databases was conducted. Results: A total of 122 experimental studies are described grouped according to the illness phases and the kind of psychological intervention employed. It is discussed about the methodological guaranties and the measures and the assessments of therapeutic efficiency to identify the interventions with the best prognostic. Conclusions: In general, the studies reviewed have achieved favorable results in relation to the improvement of the emotional, physical, functional state and the quality of life the patients. Nevertheless, their methodological limitations (little samples, difficulties of generalization, control group absence, etc.) and, sometimes, contradictory results suggest to be cautious when concluding about the effectiveness or not of the psychological intervention in cancer and the benefits of its application.</p

Promoting empathy through virtual reality experience: the case of sexual harassment

Introducción: En los últimos decenios, la realidad virtual (RV) se ha adoptado de manera exponencial en la psicología clínica para tratar varios trastornos psicológicos y promover el bienestar. La RV es una forma avanzada de interfaz humano-computadora que permite al usuario interactuar y estar presente en un entorno tridimensional de manera naturalista. El uso de la RV se ha ampliado para simular no sólo el mundo exterior, sino también la experiencia corporal, dando la ilusión de encarnar un cuerpo "virtual". Cuando esta ilusión se induce con éxito, el participante puede percibirse a sí mismo como otra persona y sentir las emociones del cuerpo encarnado. Este modelo se ha adoptado para estudiar la empatía, por ejemplo, en el contexto de la violencia sexual, para inducir un cambio en la perspectiva de los hombres, y la empatía. Objetivo: Esta tesis doctoral pretendía alcanzar tres objetivos generales: (1) revisar y meta analizar la literatura existente sobre la RV y la empatía; (2) investigar la eficacia de un sistema de RV basado en un vídeo de 360° para inducir la ilusión de intercambio corporal con (a) el mismo género, y (b) un género diferente; (3) generar un vídeo de 360° sobre el acoso sexual grabado desde la perspectiva de una mujer víctima de acoso, y comprobar si induce cambios positivos en la empatía, y disminuye las variables de actitud violenta. Método: El meta-análisis siguió el método de los Elementos de Información Preferidos para Revisiones Sistemáticas y Meta-análisis; el video de 360° fue grabado desde la perspectiva de una mujer víctima de acoso y comparado con un video no invasivo; un video de 360° fue grabado desde la perspectiva de una mujer víctima de acoso y comparado con una narrativa (diseño contrabalanceado). Principales resultados: El meta-análisis incluyó 7 artículos con un total de 335 participantes, el tamaño del efecto de la empatía fue d+ = .44 y de la toma de perspectiva fue d+=.51. El estudio de la encarnación: a) 42 participantes participaron en el estudio. El análisis mostró resultados significativos sobre el sentido de la encarnación para el mismo género: propiedad p = .003; agencia, p < .001; ubicación p = .013. b) 44 participantes masculinos participaron en el estudio. Los análisis mostraron resultados significativos para el sentido de ubicación p < .001, y de propiedad, p < .001, pero no para la agencia p = .222. Estudio sobre el acoso sexual: 44 participantes masculinos participaron en el estudio. Los resultados mostraron cambios positivos en la empatía para ambas condiciones (p < .001), además de que hubo un efecto de arrastre para el video de 360° (p = .030). Los resultados de la actitud violenta fueron significativos entre la línea de base y que los 360° (p = .007), y la narrativa (p = .006), no hubo efecto de arrastre (p = 1.00). El efecto de arrastre significativo se encontró en la variable de toma de perspectiva p = .012, que fue mayor cuando se presentó la condición de 360° antes de la narrativa. Discusión: Esta tesis doctoral demostró que la RV puede cambiar positivamente la empatía y, en particular, la RV basada en vídeo de 360° puede ser una herramienta eficaz para generar la ilusión del cuerpo y, por consiguiente, cambiar el sentido de la empatía.Introduction: In the past decades, Virtual Reality (VR) has been exponentially adopted in clinical psychology for treating several psychological disorders and promoting well-being. VR is an advanced form of human-computer interface that allows the user to interact with and be present into a 3-D environment in a naturalistic manner. The use of VR has expanded to simulate not only the external world, but also the body experience, giving the illusion to embody a “virtual” body. When this illusion is successfully induced, the participant can perceive themselves as another person and feel the emotions of the embodied body. This model has been adopted to study empathy such as in sexual violence context to induce a change in men's perspective, and empathy. Objective: This doctoral thesis aimed to achieve three general objectives: (1) to review and meta-analyze the existing literature on VR and empathy; (2) to investigate the effectiveness of a VR system based on a 360° video to induce the illusion of body swap with the (a) same gender, and (b) different gender; (3) to generate a 360° video on sexual harassment recorded from the perspective of a victim woman, and to test whether it induces positive changes in empathy, and decreases the violent attitude variables. Method: The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis method; the 360° video was recorded from the first-person perspective and compared with a non-invasive video; a 360° video was recorded from the perspective of a woman who was a victim of harassment, and compared with a narrative (counterbalanced design). Main results: The meta-analysis included 7 articles with a total of 335 participants, the effect size of empathy was d+ = .44 and of perspective-taking was d+=.51. The embodiment study: (a) 42 participants participated in the study. The analysis showed significant results on the sense of embodiment for the same gender: ownership p = .003; agency, p < .001; location p = .013. (b) 44 male participants participated in the study. The analyses showed significant results for the sense of location p < .001, and ownership, p < .001, but not for agency p = .222. Study on sexual harassment: 44 male participants participated in the study. The results showed positive changes in empathy for both conditions (p < .001), plus there was a carry.over effect for the 360° video (p = .030). The results of the violent attitude were significant between the baseline and than the 360° (p = .007), and the narrative (p = .006), there was no carry-over effect (p = 1.00). The significant carry-over effect was found in the perspective-taking variable p = .012, which was greater when the 360° condition was presented before the narrative. Discussion: This doctoral thesis showed that VR could positively change empathy, and in particular the 360° video based-VR can be an effective tool to generate the body's illusion, and consequently changing the sense of empathy