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Shamali M, Vilmann P, Johansen NR, Konradsen H. Virtual reality interventions to reduce psychological distress during colonoscopy: a rapid review. Expert Rev Gastroenterol Hepatol 2023; 17:1149-1157. [PMID: 37929329 DOI: 10.1080/17474124.2023.2279177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Colonoscopy can cause psychological distress in patients, consequently discouraging patients from undergoing an unpleasant procedure or reducing compliance with follow-up examinations. This rapid review aimed to assess the feasibility and efficacy of Virtual Reality (VR) interventions during colonoscopy on patients' perceived psychological distress and procedure satisfaction. AREAS COVERED We searched PubMed, CINAHL, ProQuest/All Databases, and Cochrane Library databases on 1 December 2022, with a date limiter of 2002-2022 for articles that investigated the effect and feasibility of any type of immersive VR-based intervention on patients' pain, anxiety, discomfort, and procedure satisfaction immediately before, during, and/or post-procedure of colonoscopy. EXPERT OPINION Initially, 118 articles were identified, of which seven were eligible and included in this rapid review. Our findings demonstrate that VR interventions during colonoscopy were feasible, significantly reduced participant pain and anxiety, and significantly increased participant satisfaction with the procedure. VR interventions appear to be an effective alternative for patients who prefer to avoid analgetic medications or as an adjunct to routine sedation during colonoscopy. Directions of research design should focus on an optimized blinding process, using the high-end technology of 3-dimensional devices, considering an audiovisual distracting intervention, and designing multicenter and high-quality Randomized Controlled Trials.
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Affiliation(s)
- Mahdi Shamali
- Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Peter Vilmann
- Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels René Johansen
- Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Hanne Konradsen
- Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of NVS, Karolinska Institute, Stockholm, Sweden
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Găină MA, Szalontay AS, Ștefănescu G, Bălan GG, Ghiciuc CM, Boloș A, Găină AM, Ștefănescu C. State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain. J Clin Med 2022; 11:jcm11061670. [PMID: 35329993 PMCID: PMC8949336 DOI: 10.3390/jcm11061670] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colonoscopy related fear impairs the current gold standard screening of colorectal cancer. Compared to other minimally invasive procedures for cancer screening, colonoscopy-induced anxiety exceeds the procedure through bowel preparation. Immersive virtual reality's (iVR) role in alleviating the complex stress-pain relationship encountered during medical procedures is directly proportional to the rising affordability of state-of-the-art Head-Mounted-Displays (HMDs). OBJECTIVE to assess the effect of iVR on patients' colonoscopy-induced anxiety and pain. MATERIALS AND METHODS A systematic search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and Scopus databases up to January 2022. Clinical trials evaluating anxiety as an outcome were included without language restriction. RESULTS Four clinical trials were included: three on the patients' intraprocedural anxiety and one on patient education. Intraprocedural iVR interventions for colonoscopy-induced anxiety and pain revealed a similar effect as conventional sedation, while a statistically significant reduction was reported for non-sedated patients. iVR patient education improved the quality of bowel preparation and reduced patient anxiety before colonoscopy. CONCLUSIONS The current research highlights the need to use high-end HMDs and appropriate interactive iVR software content for colonoscopy-induced anxiety. Methodological frameworks regarding the eligibility of participants, double-blinding and randomization of iVR studies can facilitate the development of iVR implementation for anxiety and pain management.
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Affiliation(s)
- Marcel-Alexandru Găină
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
- Correspondence:
| | - Andreea Silvana Szalontay
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Gabriela Ștefănescu
- Medical Semiology and Gastroenterology, Department of Medicine I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (G.Ș.); (G.G.B.)
- 2nd Gastroenterology Ward, Saint “Spiridon” County Hospital, Independence Bvd. No 1, 700111 Iasi, Romania
| | - Gheorghe Gh Bălan
- Medical Semiology and Gastroenterology, Department of Medicine I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (G.Ș.); (G.G.B.)
- 2nd Gastroenterology Ward, Saint “Spiridon” County Hospital, Independence Bvd. No 1, 700111 Iasi, Romania
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania;
| | - Alexandra Boloș
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Alexandra-Maria Găină
- 1st Neurology Ward, Hospital of Neurosurgery “Prof. Dr. Nicolae Oblu” Iasi, 2 Ateneului Street, 700309 Iasi, Romania;
| | - Cristinel Ștefănescu
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
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Qualitative Validation of a Novel VR Program for Irritable Bowel Syndrome: A VR1 Study. Am J Gastroenterol 2022; 117:495-500. [PMID: 35020674 DOI: 10.14309/ajg.0000000000001641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although gut-directed psychotherapies are effective for irritable bowel syndrome (IBS), they are rarely prescribed, given a paucity of trained clinicians. Virtual reality (VR) offers a solution by allowing patients to self-practice these techniques in a standardized manner. METHODS A multidisciplinary team developed IBS/VR, a program that transports users into immersive VR worlds that teach patients about the brain-gut axis, cognitive behavioral therapy, and gut-directed meditation. We tested IBS/VR in Rome IV IBS patients and used inductive analysis to evaluate perceptions and identify recommendations. RESULTS We achieved thematic saturation after 9 interviews; 3 additional interviews revealed no emergent themes. After making 23 software changes based on patient feedback, we conducted 3 additional interviews which confirmed thematic saturation (N = 15 total). DISCUSSION This study offers initial validation of the first VR program designed for IBS.
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