Jennifer Byrne , 2025-04-21 18:27:00
April 21, 2025
4 min read
Key takeaways:
- A 12-minute virtual reality session during chemotherapy reduced heart rate, stress and pain compared with standard care.
- Most patients reported high satisfaction and no cybersickness with the intervention.
A virtual reality intervention administered during chemotherapy infusion yielded statistically significant reductions in stress, pain and heart rate among patients, according to a study published in Clinical Journal of Oncology Nursing.
Most patients assigned to the distraction therapy reported high satisfaction with the experience and had no feelings of cybersickness.
The 12-minute intervention guided patients on narrated “tours” of the Taj Mahal in Agra, India; the Amazon in Ecuador; and the canals of Venice, Italy.
“Virtual reality is something of a ‘hot topic’ in health care right now,” Cody C. Stansel, MSN, RN, NE-BC, OCN, CMSRN, administrative director of nursing at Vanderbilt-Ingram Cancer Center, told Healio. “Much of the research is looking at it from an educational perspective — how we can use this as a tool for doctors, nurses and other health care professionals.
“However, there’s so much utility for virtual reality as a patient intervention, and I don’t think there’s enough research going on about that,” he added. “I’m hoping our study will help spur on further research and, hopefully, make this a common tool to help patients with stress and pain.”
A positive impact
The potential for virtual reality to benefit people with cancer has received increased attention in the research community.
In 2024, Healio reported results from a randomized trial published in Cancer that showed a 10-minute session conferred significant reductions in pain among patients, with sustained effects for up to 24 hours.
Stansel and colleagues conducted a randomized controlled study to examine the effect of virtual reality on pain, stress and affect levels during chemotherapy.
The analysis included 90 adults (median age, 57.2 years; 57.7% men) who received chemotherapy at a 45-chair outpatient infusion clinic from November 2021 to December 2023.
The researchers randomly assigned participants to standard care alone (n = 45) or with a 12-minute virtual reality session during chemotherapy infusion (n = 45).
Participants completed surveys that assessed stress, pain, affect levels and cybersickness before and after the intervention, as well as satisfaction with the experience. The researchers evaluated heart rate before and halfway through the intervention.
“One of the things we noticed about the existing research was that not many of them used a control group, so they didn’t have something they were measuring the virtual reality intervention against,” Stansel said. “We had a control group that just went about their normal infusion routines. Whatever they were doing previously — watching TV, reading a book or visiting with a family member — we had them continue that activity.”
Results showed statistically significant reductions in stress and pain in the intervention group, with estimated adjusted mean differences of –1.5 points (95% CI, –2.1 to –0.9) for stress and –0.7 points (95% CI, –1.3 to –0.1) for pain.
Similarly, the adjusted mean difference for positive affect was 3.5 points higher in the intervention group vs. the control group, with an estimated mean difference for negative affect of 4.9 points lower (P < .001). Participants in the intervention group also demonstrated significantly reduced postevaluation heart rate (estimated adjusted mean difference = –6.6 beats/minute; 95% CI, –9.7 to –3.5).
Most patients (n = 35) in the intervention group reported no cybersickness. Four patients reported a score of 3 to 6 on the 20-point Fast Motion Sickness Scale.
More than half (n = 26) of patients in the intervention group reported a score of 9 or 10 on a 10-point scale for satisfaction.
“Basically, across the board, we saw that the virtual reality intervention made a positive impact,” Stansel said.
‘It’s like being teleported’
Earlier iterations of virtual reality technology have been studied for reducing pain and anxiety; however, major improvements have been made over the years, Stansel said.
“There have been some other research studies looking at this in the context of patients with cancer undergoing infusion, but not a lot of them,” Stansel said. “At the time we were doing our literature review, we found that several of these studies were older. Virtual reality technology has changed so much in just the last 10 to 20 years.”
The “guided tours” of popular travel destinations used in this study’s virtual reality experience aimed to create a feeling of immersion while also providing a voiceover description of the sites.
“It’s like they were being teleported to these locations,” Stansel said. “We were careful to choose media that had a lower risk for motion sickness, because we know that is one of the potential complications of virtual reality.”
Stansel could not definitively say why the virtual reality intervention led to such notable improvements, but he theorized that the “diversionary aspect” of the experience played a role.
“Virtual technology has gotten so good and is so immersive that [patients] feel like they’ve been transported to a different place,” he said. “The media we showed them was so engaging that they forget where they are and just enjoy their virtual surroundings.”
Future research could help determine which types of virtual reality interventions provide optimal results, Stansel said.
“One of the opportunities is to figure out whether there are specific types of media that would work best for this kind of intervention,” he said. “We didn’t have any validated tools or videos to show the patients. We basically got on the marketplace and found some material we thought might be useful, and got permission to use it.”
In fact, the researchers did not receive financial support for this study. Vanderbilt University loaned the headsets, and student volunteers guided the experience with patients. Stansel pointed out that the intervention could easily be delivered by nurses without exorbitant cost.
“I’d love to highlight our student volunteers, who did a lot of work for us and helped make this study successful,” he said. “It also shows that you can provide these kinds of interventions to your patients without spending a gazillion dollars, or tying up provider resources to make it happen.”
For more information:
Cody C. Stansel, MSN, RN, NE-BC, can be reached at cody.c.stansel@vumc.org.
