Clinical trial NCT04030910: 'LIFEView' Audiovisual Technology: Virtual Travel to Support Wellbeing and Quality of Life at the End of Life
Official title: 'LIFEView' Audiovisual Technology: Virtual Travel to Support Wellbeing and Quality of Life at the End of Life
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Palliative Care
Terminal Illness
Quality of Life
Psychological Distress
Keywords: Life review
Reminiscence
Technology
Existential distress
Virtual travel
Well-being
Lead sponsor: Bruyere Research Institute
Sponsor class: OTHER
Collaborators: name: Bruyere Continuing Care
First posted: 2019-07-24
Enrollment: 38
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: All eligible patients will be recruited to receive the intervention ("LIFEView").
Primary purpose: SUPPORTIVE_CARE

Brief summary: This study is looking to assess the use of an audio-video technology called 'LIFEView' using a laptop and large-screen TV. This tool intends to support life review or reminiscence of past experiences, escape from current surroundings using virtual travel, or virtual visits to a location that one might have liked to visit in their lifetime but could not. We hope that by using this technology, we can support better wellbeing and quality of life for patients receiving palliative care services within the community and on an inpatient palliative care unit, or for patients at the end-of-life within Bruyère long-term care homes.

Due to the potential for disorientation and reduced physical mobility, patients receiving palliative and end-of-life care may be unable to fully enjoy an immersive experience using a virtual reality (VR) headset. To reduce the possibility of disorientation that may arise from using a VR headset with 'LIFEView', our research team will use the 'LIFEView' prototype software loaded on a laptop and connected to a mobile high-definition 50" TV for inpatient PCU and LTC facility use, or to a patient's personal TV within their residence in the community. This setup will also improve accessibility to 'LIFEView' as a result of its relatively low-tech requirements (i.e. TV + laptop), and allows for an opportunity for patients and their loved ones to share cherished memories and stories.

Detailed description: This project is designed to address the psychosocial and existential suffering commonly experienced by palliative care patients. Technology-based reminiscence and dignity therapy interventions have been demonstrated to improve well-being and quality of life in older adults (Lazar et al, 2014), although little evidence exists to support the use of these technology-based interventions in a palliative care context.

These technologies may require modification to meet the needs of PEOLC patients that are at risk for delirium, a neuropsychiatric condition characterized by fluctuating disruptions in awareness, focus and cognition (American Psychiatric Association, 2013). Delirium can be experienced by up to 88% of patients at the end of life (Hosie et al., 2013). Moreover, patients in PEOLC settings may also have limited mobility or may be bedbound. Due to the potential for disorientation and reduced physical mobility, patients receiving PEOLC may be unable to fully enjoy an immersive experience using a virtual reality (VR) headset. To reduce the possibility of disorientation that may arise from using a VR headset with 'LIFEView', our research team plans to use the 'LIFEView' prototype software loaded on a laptop and connected to a mobile high-definition 40-42" TV for inpatient PCU and LTC facility use, or to a patient's personal TV within their residence in the community.

Eligibility criteria: Inclusion Criteria:

• Any patients who are able to complete the outcome measures (Section 5.0 Outcomes) and capable of consenting to participating in the research study will be included.

Exclusion Criteria:

Patients experiencing the following, as determined by the clinical care team:

* Delirium
* Severe cognitive impairment (as determined by the clinical care team)
* Known behavioural abnormalities (e.g. overtly aggressive behavior) that in the opinion of the clinical care team might impede any meaningful participation in the project
* A score of \<30% on the Palliative Performance Scale (PPS) (Anderson et al., 1996) at the time of consent
* Individuals who are already currently using Motiview paired with a exercise bicycle in the LTC setting
* Those who are in the opinion of attending physician or clinical team too unwell to participate in the project
* Unable to complete outcome measures indicated

Primary outcomes:
measure: Change in psychological and physical symptoms measured by the Edmonton Symptom Assessment System-revised (ESAS-r) (Bruera et al., 1991; Watanabe et al., 2011)
timeFrame: At least 24 hours before using 'LIFEView', and directly after and 48 hours after using 'LIFEView' (pre- and post-'LIFEView')
Secondary outcomes:
measure: Change in quality of life measured by the McGill Quality of Life-Revised questionnaire (Cohen et al., 2017)
timeFrame: At least 24 hours before using 'LIFEView', and 48 hours after using 'LIFEView' (pre- and post-'LIFEView')
measure: Psychosocial effects and aspects of quality of life as determined by semi-structured interviews for consenting participants and their consenting family member(s) or caregiver(s).
timeFrame: Within 24 hours of using 'LIFEView' (post-'LIFEView')
measure: Change in heart rate
timeFrame: At least 24 hours before using 'LIFEView', and directly after using 'LIFEView' (pre- and post-'LIFEView')
measure: Change in blood pressure
timeFrame: At least 24 hours before using 'LIFEView', and directly after using 'LIFEView' (pre- and post-'LIFEView')
Other outcomes:
measure: Aspects of participant's level of general well-being as per the Greater Cincinnati Chapter Well-Being Observation tool (Rentz, 2002; Kinney & Rentz, 2005) during the 'LIFEView' session, and other observable phenomena
timeFrame: From initiation of the 'LIFEView' session and directly after using 'LIFEView' (during and post-'LIFEView')
Locations:
city: Ottawa
country: Canada
facility: Bruyere Continuing Care
state: Ontario
Study officials:
affiliation: Bruyère Continuing Care
name: Rebekah Hackbusch
role: PRINCIPAL_INVESTIGATOR
affiliation: Bruyère Continuing Care
name: Jill Rice, MD, CCFP(PC)
role: PRINCIPAL_INVESTIGATOR
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