Symptom Self-Management Across Settings Emphasizing Virtual Reality

Abstract

Symptom management is a cornerstone of nursing practice. Symptoms are of clinical and research importance because they are the most common reason for which individuals seek healthcare. Rapid innovations in technology have made it possible to deliver interventions to alleviate a number of symptoms, providing safe, non-invasive alternatives to traditional pharmacologic treatments. One platform for delivering such interventions is via immersive technologies like virtual reality (VR). The purpose of this dissertation is to examine symptom self-management across various settings with an emphasis on virtual reality interventions. A three-paper format was used.In the first paper, we performed a systematic review of VR for acute pain management that clarified the heterogeneity of available content and need for intentional presentation and pairing of interventions to appropriate populations in order to ensure efficacy. Following this, to better understand factors of symptom self-management, we interviewed inpatient LKDs and found that careful consideration of the patient population and psychosocial factors that impact patients’ symptom experience is required for successful implementation of symptom management interventions. Findings are reported in the second paper Lastly, a feasibility study was performed using VR meditation for fatigue management. This study discovered that remote-based VR deployment is feasible and acceptable to patients, but it is vital to provide clear instructions and parameters for VR content and hardware use to promote participant adherence, especially when using a novel therapeutic technology without direct supervision. Overall, VR is a viable platform for deployment, but further development of content is currently required. Future research is needed to explore the efficacy of VR interventions for symptom self-management using various therapies over time and across different populations. Due to current limitations in hardware, clinicians should carefully evaluate the context of patient need – and openness to use – prior to utilizing VR and ensure viable matching of content and individual devices to patient needs at home. Research on how VR content and hardware can meet the individual constraints of home environments is needed. Cross-discipline collaboration between researchers with backgrounds in patient care, design, and engineering that is informed by input from patients is key to ensuring development of efficacious and safe VR therapeutics. Additionally, researchers must collaborate with industry partners to ensure translation of these findings into broad clinical use. In the post-COVID-19 world, VR has the capacity to encourage health and healing on a scale previously unimaginable. The scope of VR’s impact will largely depend on the level of collaboration between these key stakeholders. Only by working together can we usher in a new era of healthcare delivery through immersive VR symptom self-management.