4 | DISCUSSION
This paper evaluates the effectiveness of IVR technology-based
intervention for breast cancer patients through meta-analysis, and the
results show that the study participants’ symptoms of anxiety,
depression, pain, and fatigue were alleviated, and their quality of life
was improved, and the difference was statistically significant.
With the transformation of the biopsychosocial medical model, the impact
of negative emotions on breast cancer patients has attracted more and
more attention. Postoperative breast loss, wound pain, worry about
disease prognosis, nausea and vomiting due to chemotherapy, hair loss,
etc. can cause anxiety, depression and other adverse psychological
symptoms, which can seriously affect the prognosis and regression of
patients20. The results of this study showed that
Reynolds et al.17 study concluded that the
intervention effect of IVR technology on anxiety in breast cancer
patients was not significant, probably because the study subjects
reported lower levels of anxiety before the intervention, resulting in
no significant difference between before and after the intervention; the
rest of the studies reported that IVR had a significant improvement in
anxiety and depression symptoms in breast cancer patients, which was
consistent with the meta-analysis of the effect of the relevant VR
interventions on breast cancer.21 The results are
consistent with the fact that the principle of action may be to utilize
the distraction mechanism. In the study included in this paper, the
researchers based on IVR technology, immersed patients in wonderful
natural scenery such as the sea, forests, waterfalls, etc., and
cooperated with breathing and movements to stretch the body and mind and
achieve a state of relaxation, to achieve the purpose of alleviating
anxiety in breast cancer patients by distracting attention from the
disease and the medical environment in which they live. And Zeng et
al.22 ’s meta-analysis of cancer patients showed that
VR-based interventions did not have a significant effect on anxiety
relief. The reason for this may be that although non-immersive VR
technology uses virtual scenes, it is mainly connected to the virtual
environment through the computer screen, and the patients are not
detached from the real world and are not in it, so the authenticity and
fun are not as good as immersive virtual reality technology, and may be
affected by the hospital environment and other factors, so the patients
cannot completely relax their bodies and minds to achieve the effect of
relieving anxiety.
It has been found that fatigue, with a prevalence of about 90% in
breast cancer patients, is one of the most common and serious
complications in breast cancer patients and is often not effectively
treated23 , which may be affected by adverse reactions
such as nausea, vomiting, loss of appetite and bone marrow suppression
produced by chemotherapy; and fatigue will aggravate patients’ negative
emotions such as anxiety and depression, which will aggravate their
physical and mental burdens and further affect their quality of life.
Some studies have observed postoperative breast cancer patients and
found that sleep deprivation aggravates pain, while good sleep promotes
wound healing and tissue repair24 . The results of
this study showed that interventions based on IVR technology can improve
fatigue symptoms in breast cancer patients, which is consistent with
Cheng et al.25 class experimental study results, but
different from Burrai et al.11 The results of
meta-analysis of IVR-based interventions for cancer chemotherapy
patients, the reasons for this difference may be (1) the small sample
size of the included studies; (2) due to the nature of the virtual
reality, blinding could not be implemented for all interventions, so it
may lead to bias, and the limited number of the included studies did not
allow for the analysis of the source of the bias through the funnel
plot; and (3) the period and frequency of the interventions in the
included studies, varied greatly between control groups.
Postoperative pain is one of the most common complications of breast
cancer, and studies have shown that about 25% to 60% of patients will
develop chronic pain that lasts for 7-12 years, which can cause the body
to produce autonomic responses, such as increased heart rate, increased
blood pressure, nausea and vomiting, which seriously affects the quality
of life of breast cancer patients.26 Currently,
non-pharmacological interventions to control pain through IVR technology
are receiving increasing attention, and its mechanism of action may be
focus shifting, when the patient is immersed in the virtual environment,
the attention will be shifted away from the painful stimuli, and in this
way, weakening its responsiveness to injurious neural signals, and thus
pain perception decreases.27 Of the studies included
in this paper, Mohammad et al.19 intervened in breast
cancer chemotherapy patients through immersive virtual environments,
such as deep-sea diving in the Ocean Rift Valley, combined with morphine
medication for pain relief, and after 4 months of intervention, the
results showed that compared to medication alone for pain relief, the
IVR-based intervention combined with medication was more effective in
relieving pain, and the side effects of the medication, such as nausea,
vomiting, and constipation, were significantly reduced; Reynolds et
al.17 An at-home IVR intervention that allowed
patients to pile rocks on a waterfall, jump in a mountain range, and
write on a beach showed significant pain reduction after four weeks of
intervention, with pain relief lasting for at least 48 hours
post-intervention. Although evidence suggests that IVR is effective in
relieving immediate or short-term pain, the long-term effects have not
been proven, and more high-quality studies need to be included in the
future to determine the long-term efficacy of IVR techniques for breast
cancer pain.