ABSTRACT
Background: Malignancy patients who need long-term hospitalization can feel loneliness affecting their quality of life. The global COVID-19 pandemic has caused visiting restrictions that could mean patients who might be missing out on family support and palliative care, therefore, need to adapt and change. We used virtual reality (VR) technology with the aim of reducing feelings of loneliness among these patients. Objectives: In a small cohort setting, we aimed to clarify the usefulness of VR viewing for this purpose by text mining interviews with the patients in palliative care after their VR experience, and to clarify the feasibility of this program. Design and Setting/Subjects: Four consecutive Japanese patients in the palliative care unit viewed personalized familiar persons or places through VR goggles, while communicating by telephone. After the VR experience, text mining of the patients' interviews was used to extract the words for the frequency count and co-occurrence analysis. Results: Four clusters were extracted: "relief from the pain of hospitalization by feeling safe and secure with family members nearby," "using VR to regain daily life," "immersive feeling of being in the same space as family," and "loneliness due to the realistic feeling of separation from the family through VR experience." There were no cases of VR sickness. Conclusion: Our results attained by text mining suggest the promising potential of VR imaging of familiar surroundings for patients in palliative care.
ABSTRACT
OBJECTIVES: In recent years, efforts made by cancer patients to balance their work schedules and treatment regimens have gained increasing attention. Such workers tend to resign when diagnosed with cancer. A particularly prominent issue is that many of these employees resign immediately after diagnosis. This study aimed to clarify factors influencing continuation of employment from the period immediately after diagnosis up to the first treatment. METHODS: Study aims were explained to 68 employees, who were 20â64 years and had received a definitive diagnosis of cancer in the last two years. After obtaining informed consent, structured interviews were conducted. RESULT: Informed consent was obtained from 61 patients, of which 60 (98.4%) wished to continue working after diagnosis. Of these 60 patients, 15 (25.0%) had not been working (including those on leave) and 45 (75.0%) had continued employment. The latter comprised the continuation group. There were no significant differences in attributes, company type and size, nor in employment status between the two groups. Subjects in the continuation group sought significantly more consultation for the questionnaire item "Disease, treatment, and symptoms," whereas significantly less consultation was sought for the item "Concerning expenses such as medical bills and living costs." The number of those who had disclosed their illness to colleagues was significantly higher in the continuation group, while the number of those hoping for a "Probationary period for returning to work" and complaining of "Prejudice and misunderstanding of cancer patient's continuation of work" was significantly smaller in the continuation group. The number of those who had undergone surgery and who received a score of 0 to 1 (light work acceptable) on the Eastern Cooperative Oncology Group performance status was significantly higher in the continuation group. As for other factors that had influenced subjects' decision to continue working or not, subjects described two situational attitudes: first, "Gratitude for understanding, consideration, and encouragement of superiors and colleagues" and second, "Impossibility of thinking about work immediately after diagnosis." CONCLUSION: Results revealed that continuation of work immediately after diagnosis was related to the stage of the patient's cancer, their general condition, and whether they had undergone surgery or not. Support from superiors and/or colleagues at the workplace was also beneficial. Medical staff should therefore provide patients with support in overcoming the crisis in which they feel the continuation of work immediately after diagnosis to be an impossibility, and to assist them in making an informed choice regarding their employment status.
