ABSTRACT
OBJECTIVES: Virtual reality (VR) might improve symptom management, but there is limited evidence regarding VR in palliative care. We evaluated the feasibility of VR and impact on anxiety and pain for patients in a hospital palliative care consultation service. METHODS: Patients referred to a hospital specialist palliative care team, with anxiety or pain, were offered a VR intervention (a short audiovisual experience). Participants rated anxiety and pain on a 0-10 Likert severity scale pre intervention/post intervention and completed an evaluation form. Change in symptom scores was analysed by parametric statistics. RESULTS: 28 participants used VR a total of 42 times with no adverse events. Mean pain score reduced by 29% from 4.10 (SD=2.71) pre intervention to 2.93 (SD=2.45) post intervention (t(27)=5.150, p<0.001). Mean anxiety scores reduced by 40% from 4.43 (SD=2.56) to 2.65 (SD=2.24) (t(27)=5.058, p<0.001). Patients rated the experience on average 4.75/5 and all would recommend use to a friend. VR was described as absorbing and relaxing. CONCLUSION: VR may improve anxiety and pain and was acceptable in this setting. Large-scale evaluation will generate important data on feasibility and implementation.
ABSTRACT
As cancer diagnoses rise, and more treatment options become available, doctors, nurses and allied health professionals will increasingly encounter more patients with acute oncological emergencies in the emergency department (ED). Neutropenia (low levels of neutrophils in the blood) is a common side effect of systemic anti-cancer therapy, particularly chemotherapy, and has a negative effect on patients' immune system, leaving them vulnerable to infection. Patients who develop neutropenia are at increased risk of developing neutropenic sepsis, a potentially life-threatening condition that requires urgent assessment and treatment within an hour of presentation. This article describes the risk factors for and signs and symptoms of neutropenic sepsis and outlines assessment and management of patients who present to the ED with this condition.
