Background. Needle-related procedures (NRPs) in cancer care are often associated with significant pain and anxiety, contributing to psychological and physiological distress. This study aimed to assess the effectiveness of virtual reality (VR)-based interventions in reducing anxiety, pain, depression, fear, and physiological parameters (pulse rate and respiratory rate) in patients with cancer undergoing NRPs. Methods. A systematic search of 11 databases (CINAHL, Cochrane Library, Embase, IEEE Xplore, Medline, ProQuest, PsycINFO, PubMed, Scopus, Web of Science, and CNKI) was conducted from inception to 15 May 2025. Two independent reviewers selected and extracted studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using Cochrane RevMan 2024 software. Heterogeneity was assessed using Higgins’I2statistics and Cochran’s Q test. The GRADE framework was applied to evaluate the quality of evidence. Results. Fourteen randomized controlled trials (RCTs) with 1089 participants were included. VR interventions showed significant benefits compared to controls in reducing anxiety (standard mean difference [SMD] = −1.74, 95% confidence interval [CI]: −2.47 to −1.01,p< 0.001), pain (SMD = −1.30, 95% CI: −1.93 to −0.67,p< 0.001), depression (SMD = −0.73, 95% CI: −0.96 to −0.50,p< 0.001), fear (mean difference [MD] = −1.31, 95% CI: −1.56 to −1.06,p< 0.001), and respiratory rate (MD = −3.85, 95% CI: −6.18 to −1.52,p= 0.001). However, no significant difference was found in pulse rate (MD = 0.25, 95% CI: −14.32 to 14.81,p= 0.97). Conclusions. VR-based interventions are effective in alleviating psychological symptoms (anxiety, depression, fear) and physiological distress (pain, respiratory rate) in patients with cancer undergoing NRPs. However, they do not significantly impact pulse rate. Interpretation of findings should consider limitations such as the small number of studies, limited sample sizes, and high heterogeneity. Further high-quality RCTs with follow-up assessments are warranted. Customizing VR interventions to address demographic and procedural needs may further enhance their effectiveness.
背景：在癌症治疗中，与针头相关的操作常伴随显著的疼痛和焦虑，导致患者心理与生理上的双重困扰。本研究旨在评估基于虚拟现实（VR）的干预措施在减轻接受针头相关操作的癌症患者的焦虑、疼痛、抑郁、恐惧及生理参数（心率和呼吸频率）方面的效果。方法：系统检索了从建库至2025年5月15日期间11个数据库（CINAHL、Cochrane Library、Embase、IEEE Xplore、Medline、ProQuest、PsycINFO、PubMed、Scopus、Web of Science和CNKI）中的相关研究。两位独立评审员根据预设的纳入与排除标准筛选并提取研究数据。使用Cochrane RevMan 2024软件进行荟萃分析，采用Higgins I²统计量和Cochran Q检验评估异质性，并应用GRADE框架评价证据质量。结果：共纳入14项随机对照试验，涉及1089名参与者。与对照组相比，VR干预在减轻焦虑（标准化均数差[SMD] = −1.74，95%置信区间[CI]：−2.47至−1.01，p < 0.001）、疼痛（SMD = −1.30，95% CI：−1.93至−0.67，p < 0.001）、抑郁（SMD = −0.73，95% CI：−0.96至−0.50，p < 0.001）、恐惧（均数差[MD] = −1.31，95% CI：−1.56至−1.06，p < 0.001）以及呼吸频率（MD = −3.85，95% CI：−6.18至−1.52，p = 0.001）方面均显示出显著益处。然而，在心率方面未观察到显著差异（MD = 0.25，95% CI：−14.32至14.81，p = 0.97）。结论：基于VR的干预能有效缓解接受针头相关操作的癌症患者的心理症状（焦虑、抑郁、恐惧）和生理困扰（疼痛、呼吸频率），但对心率无显著影响。研究结果的解释需考虑相关局限性，如纳入研究数量较少、样本量有限及异质性较高。未来需要开展更多包含随访评估的高质量随机对照试验。针对人口学特征和操作需求定制VR干预方案，可能进一步提升其效果。
肿瘤(癌症)患者之家