Context: Pain management in palliative care remains inadequate; the development of innovative therapeutic options is needed.
Objectives: To determine the feasibility and preliminary effectiveness for larger randomised controlled trials of 3D head-mounted (HMD) virtual reality (VR) for managing cancer pain (CP) in adults.
Methods: Thirteen people receiving palliative care participated in a single-session randomised cross-over trial, after which they completed a qualitative semi-structured interview. We also compared the effects of 3D HMD VR and 2D screen applications on CP intensity and levels of perceived presence. Feasibility was assessed with recruitment, completion rates and time required to recruit target sample.
Results: Although recruitment was slow, completion rate was high (93%). Participants reported that the intervention was acceptable and caused few side effects. Although participants reported significantly reduced CP intensity after 3D HMD VR (1.9 ± 1.8, P = .003) and 2D screen applications (1.5 ± 1.6, P = .007), no significant differences were found between interventions (-.38 ± 1.2, 95% CI: -1.1-.29, P = .23). Participants reported significantly higher levels of presence with the 3D HMD VR compared to 2D screen (60.7 ± SD 12.4 versus 34.3 ± SD 17.1, mean 95% CI: 16.4-40.7, P = .001). Increased presence was associated with significantly lower pain intensity (mean 95% CI: -.04--0.01, P = 0.02).
Conclusions: Our preliminary findings support growing evidence that both 3D and 2D virtual applications provide pain relief for people receiving palliative care. Given the relative lack of cybersickness and increasing access to portable VR, we suggest that larger clinical studies are warranted.
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http://dx.doi.org/10.1007/s00520-022-06824-x | DOI Listing |
Health Sociol Rev
December 2024
Department of Anthropology, University of Amsterdam, Amsterdam, Netherlands.
Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team.
View Article and Find Full Text PDFHead Neck
December 2024
Department of Pediatric Hematology & Oncology, Klinik für Kinder- Und Jugendmedizin, Universitätsmedizin Rostock, Rostock, Germany.
Background: Infantile fibrosarcoma (IFS) is a rare pediatric tumor of intermediate malignancy with high local aggressiveness that typically presents in young infants. Its occurrence in the head and neck region is rare. Complete non-mutilating surgical resection is often not possible, requiring multimodal treatment.
View Article and Find Full Text PDFCureus
November 2024
Nephrology, Colchester Hospital, Colchester, GBR.
Calciphylaxis is a rare and serious disorder almost exclusively seen in patients on dialysis or those with advanced chronic kidney disease (CKD) not on dialysis and is associated with very high mortality. We present the case of a 50-year-old male with a background of end-stage renal disease (ESRD) compliant with dialysis, parathyroid adenoma, secondary hyperparathyroidism, and high body mass index (BMI). Whilst receiving 31 doses of intravenous sodium thiosulphate (STS) over an 11-week period, the patient underwent surgical debridement of multiple painful ulcerative lesions in his lower abdomen and left thigh and then subsequently a subtotal parathyroidectomy at 70 days from admission.
View Article and Find Full Text PDFFront Med (Lausanne)
December 2024
Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Aim: Transitional care in the emergency department (ED) has the potential to improve outcomes for older patients, but the specific population benefits from it and impact in Taiwan remain unclear. Therefore, we conducted this study.
Methods: An interdisciplinary team comprising emergency physicians, dedicated transitional care nurse (TCN), nurse practitioners, nurses, geriatricians, and social workers was established at a tertiary medical center.
Front Pain Res (Lausanne)
December 2024
Department of Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, White Plains, NY, United States.
Chronic pain is highly prevalent among older adults, is associated with cognitive deficits, and is commonly treated in primary care. We sought to document the extent of impairment across specific neurocognitive domains and its correlates among older adults with chronic pain in primary care. We analyzed baseline data from the Problem Adaptation Therapy for Pain trial, which examined a psychosocial intervention to improve emotion regulation in 100 adults ≥ 60 years with comorbid chronic pain and negative emotions, who did not have evidence of moderate-to-severe cognitive impairment.
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