Introduction: Virtual reality (VR) has garnered increasing attention in oncology due to its potential to enhance patient care by alleviating anxiety and emotional distress. The present work evaluates the hypothesis proposed by a recent theoretical model that engagement and the sense of presence are key mediators that impact the degree of beneficial effects that VR may have on the emotional well-being of breast cancer patients. Methods: This study draws on data from three previous studies comprising 156 breast cancer patients. The psychological variables of well-being studied included emotional dimensions measured before and after exposure to a virtual environment, as well as factors related to immersive qualities. Correlation and mediation analyses were conducted to explore relationships among said variables, namely, one’s tendency to be immersed in an activity, engagement, spatial presence, and emotional well-being (i.e., valence and arousal) of the patients. Results: Engagement plays a crucial mediating role between tendency of immersion, spatial presence, and positive emotional responses. Patients with a greater tendency toward immersion and higher engagement in the virtual environment showed significant emotional improvements. However, tendency of immersion and spatial presence alone did not directly lead to more positive emotional experiences; their influence was primarily exerted through engagement. Conclusions: Engagement emerges as a fundamental lever for maximizing the psychological benefits of VR in oncology. Clinical interventions using VR should prioritize optimizing engagement in immersive environments to improve patients’ emotional state throughout their cancer treatment journey.
引言：虚拟现实（VR）因其在缓解患者焦虑与情绪困扰方面的潜力，在肿瘤学领域日益受到关注。本研究基于近期理论模型提出的假设，探讨参与度和临场感是否作为关键中介变量，影响VR对乳腺癌患者情绪健康的改善程度。方法：本研究整合了三项前期研究数据，共纳入156名乳腺癌患者。分析的心理健康变量包括暴露于虚拟环境前后的情绪维度指标及沉浸体验相关因素。通过相关性分析与中介效应检验，探究患者的活动沉浸倾向、参与度、空间临场感与情绪健康（效价与唤醒度）之间的关联机制。结果：参与度在沉浸倾向、空间临场感与积极情绪反应之间发挥关键中介作用。具有较高沉浸倾向且在虚拟环境中参与度更强的患者表现出显著的情绪改善。然而，单纯的沉浸倾向与空间临场感并不能直接引发更积极的情绪体验，其影响主要通过参与度实现。结论：参与度是最大化VR在肿瘤学中心理干预效益的核心杠杆。临床VR干预应着重优化患者在沉浸环境中的参与度，从而在癌症治疗全程中改善其情绪状态。
肿瘤(癌症)患者之家