The Effect of Virtual Reality on Psychological Parameters in Patients Receiving Chemotherapy
Condition: Side Effect of Chemotherapy
Study type: Interventional

Summary: 
      It has been determined that after mastectomy, women have psychological problems such as
      deterioration of body image, fear of losing their feminine characteristics and sexual
      dysfunction. Chemotherapy treatment for the first time causes patients to feel hopeless, to
      experience uncertainty and anxiety, and to increase their stress level. Experiencing intense
      stress during this treatment process can lead to severe mental problems, which negatively
      affects the course of the disease and the response to treatment. Chemotherapy is a painful
      procedure. Pain and stress are symptoms that affect each other positively.

      Virtual reality glasses, which is one of the distraction methods used in the control of
      symptoms; It is widely used in clinical medical care to relieve symptoms by offering the
      possibility to create therapeutic environments in the evaluation and treatment of medical
      conditions. By affecting the emotional, cognitive, behavioral and sociocultural dimensions of
      the individual, it increases the sense of control, activity level and work capacity, reduces
      stress, pain, anxiety level, feeling of powerlessness and side effects of pharmacological
      methods.
    

Detailed description: 
      Breast cancer, which is common among women all over the world, draws attention in terms of
      mental and psychosocial aspects among cancer types because of the fear and anxiety of being
      cancer, as well as the loss of the breast, which appears as a symbol of femininity and
      sexuality, provides the nourishment of the baby, expresses love and motherhood feelings. type
      has been. Especially since it is a disease that evokes death, it creates more stress and
      anxiety in the individual compared to other diseases. In patients receiving chemotherapy
      after mastectomy, the side effects of the treatment, the treatment process, the fear of
      recurrence of the disease further increase the level of stress and anxiety. Nielsen, Zhang,
      Kristesen, and Schnohr, in their study examining the relationship between stress intensity
      and frequency, and breast cancer incidence, stated that women with high stress levels had a
      higher risk for breast cancer than women with low stress levels. Alacacioglu et al. The
      anxiety levels of female patients were found to be higher than male patients in their study
      with patients who were treated with chemotherapy. Karabulutlu et al., in their study with
      cancer patients, determined that 81.3% of cancer patients had depression and 61.5% had
      anxiety. In the study conducted by Aydoğan et al., the anxiety levels of cancer patients and
      healthy individuals were compared. found to be high. Non-pharmacological methods such as
      relaxation techniques, distraction, therapeutic touch, massage, hot-cold application, skin
      stimulation are used to reduce anxiety. In recent years, virtual reality as a distraction
      application has been widely used in clinical medical care to relieve pain. There are studies
      showing its effectiveness in pain and stress management in procedures such as injection
      applications, wound care, endoscopy procedure, phantom and chronic pain, chemotherapy
      applications. Schneider et al. During the chemotherapy treatment, videos were watched with
      virtual reality glasses to the patient with breast, lung and colon cancer who received
      chemotherapy treatment. It was determined that the anxiety and fatigue levels of the patients
      in the experimental group decreased and the time passed faster during the treatment process.
      Espinoza et al. Parks and nature walks were watched with virtual reality glasses in half-hour
      sessions consisting of four sessions for one week in 33 patients aged 41-85 years who were
      hospitalized in the oncology service and received chemotherapy treatment for metastatic
      cancer. After the application of virtual reality glasses, it was observed that the anxiety
      and depression levels of the patients decreased and the level of happiness increased.

      According to the researchers' hypotheses, virtual reality acts as a non-pharmacological
      method, using cognitive and attentional processes on the body's complex pain modulation
      system. Although its neurobiological mechanisms have not been fully elucidated, studies have
      interestingly reported positive results in pain management. When patients feel that they are
      in the image, their attention is effectively distracted from the pain. Thus, the perception
      of pain is reduced. At the same time, distraction technique increases the patient's tolerance
      to pain, raises the pain threshold and causes him to feel less pain. This method, which is
      one of the independent practices of the nurse; It is a method frequently used in the current
      literature, as it is not an invasive procedure, is reliable, and has no known side effects.
      Although virtual reality is a potential and important technology in reducing the stress, pain
      and anxiety experienced during chemotherapy after mastectomy, there are limited or
      insufficient number of studies on this subject in our country. In the study of Toru, it was
      determined that virtual reality glasses applied during chemotherapy treatment in breast
      cancer patients reduced anxiety. In Karaman's study to determine the effect of virtual
      reality application on pain and anxiety during breast biopsy, found that virtual reality is
      effective on pain and anxiety.

      However, unlike the studies conducted in this study, the stress level will be examined with
      saliva analysis and its relations with other parameters will be evaluated. There is no study
      directly related to this subject and it has been seen that a comprehensive study is needed.
      This research will be carried out to determine the effect of virtual reality on some
      physiological and psychological parameters in patients receiving chemotherapy after breast
      surgery. It is thought that the result of the research will contribute to the literature as
      an evidence-based non-pharmacological method in reducing the stress, pain and anxiety
      experienced during chemotherapy after mastectomy.
    

Intervention name(s): Virtually reality
Intervention type(s): Other
Intervention description(s): Before chemotherapy, saliva samples will be taken from the control group, Personal Information Form, State Anxiety Scale and Visual Analogue Scale (VAS) pre-test questionnaires will be applied to the patients who accepted to participate in the study, vital signs measurements will be made and post-test questionnaires will be applied at the 30th minute of chemotherapy, vital signs measurements will be made, and A saliva sample will be taken. In the experimental group, a saliva sample will be taken before chemotherapy.
Other intervention name(s): experimental-control group
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The research will be carried out by applying an experimental research design with a control group, pre-test-post-test applied, repetitive measurement.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: anxiety; pain; tension; oxygen saturation