Distraction-Based Interventions During Implanted Venous Port Catheter Needle Entry: Virtual Reality Application

This study is a randomized controlled experimental study planned to examine the effect of a virtual reality application during implanted venous port catheter needle insertion on patient satisfaction, comfort level, and time perception in cancer patients. Distraction-based interventions used in symptom management of cancer patients are simple, effective, and cost-effective. Distraction applications such as virtual reality glasses, listening to music, painting, and daydreaming aim to focus attention on another stimulus. Virtual reality application uses human-machine interfaces to focus the patient on a world other than their current environment with a three-dimensional virtual video, chaning teir perception of space and time. It has been shown that virtul reality applications reduce pain and anxiety, increase patient satisfaction, provide relief, and positively affect vital parameters during procedural procedures such as bone marrow aspiration, fine needle aspiration breast biopsy, colonoscopy, and transrectal prostate biopsy in cancer patients receiving chemotherapy.

Virtual reality is a new technique developed thanks to the advancement of computer technology and started to be used in the field of health as a cognitive-behavioral method to relieve pain and relax the patient. This method uses human-machine interfaces to give people the feeling of being in an interactive environment with virtual video in the forest, ocean or space. Virtual reality glasses are an application that is used to isolate the patient from his/her environment and includes a distraction method that allows the patient to focus on another world in three dimensions. It is usually applied with glasses or headgear. In addition, the patient is prevented from perceiving the surrounding sounds by wearing headphones. The most important feature that distinguishes virtual reality from other technological products such as television and video games is that it gives users the feeling of being in a different place. The use of virtual reality glasses provides a positive environment for patients and provides a calming experience by changing their perception of time. Virtual reality applications, a new technology, can make a positive difference in cancer care and increase the comfort and satisfaction levels of cancer patients. This innovative method can be used as a complementary nursing approach in addition to standard care during implantable venous port catheter needle intervention. The widespread use of virtual reality applications in cancer care contributes to qualified nursing care. This study will be presented as an innovative method showing that virtual reality technologies can be incorporated into nursing practices.

Study Design and Setting This single-center, single-blind, randomized controlledarasında conducted between July 2023 and July 2024 in the outpatient chemotherapy unit of a tertiary education and research hospital in Western Türkiye. Participants were randomly assigned to either a control group (CG=46) receiving routine care or a VR group (VRG=46) receiving routine care plus a distraction intervention. The VR group received a visual and auditory distraction intervention via VR by watching audio and video clips during the port catheter needle insertion procedure. The control group did not receive any distraction method. Outcome measures were: perceived procedure time, overall comfort level and sublevels, and patient satisfaction. Study Sample The study population consisted of 1,000 cancer paarasındapitalized between January 2022 and January 2023. The effect size of a similar studyby Başak et al. (2020) examining patient satisfaction with distraction-based intervention during peripheral intravenous access was used as a reference for determining the sample size. Power analysis resulted in a total sample size of 70 patients with an α = 0.05 and a power of 0.99. However, due to the risk of data loss during the stdy, the sample size was increased. Therefore, the final sample consisted of 92 cancer patients; 46 in the VR group and 46 in the control group.

Inclusion criteria were being at least açısıylars old, actively undergoing chemotherapy, having stage I, II, or III cancer, having a port catheter, and being willing to participate in the study.

Exclusion criteria included the preseKriterleriastasis, previous virtual reality experience, communication difficulties, and a diagnosed psychiatric disorder.