scholarly journals Analyzing the Efficacy and Design Considerations of VR Environments to Manage Anxiety & Depression in AYA Cancer Patients

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3441-3441
Author(s):  
Elizabeth H. Cull ◽  
Aniket Saha ◽  
Laura Michelle Stanley ◽  
Vishnunarayan Prabhu ◽  
Joshua Biro
Keyword(s):  
Heart Rate ◽  
Virtual Reality ◽  
Virtual Environments ◽  
Cancer Patients ◽  
Rating Scale ◽  
Depression Scale ◽  
Adolescent And Young Adult ◽  
Objective Measures ◽  
Anxiety And Depression ◽  
Design Consideration

Prior studies have reported that adolescent and young adult (AYA) patients are specifically vulnerable to distress because of the intersection of disease and age. Compared to older cancer patients, AYA cancer patients indicate a more negative psychosocial outcome. Recent studies have focused on improving the quality of life of AYA patients by providing adjunctive non-pharmacological interventions. Popular methods adopted include cognitive behavioral therapy, hypnosis, video games and virtual reality (VR) exposure. Although VR has been tested among other cancer populations, to our knowledge, no studies have focused on the efficacy of VR for mitigating mental distress in the AYA population. Additionally, no studies have focused on what specific virtual-based experiences are efficacious without causing cybersickness in cancer patients. Research has found that up to 25% of healthy patients exposed to VR experience some form of cybersickness. This longitudinal study analyzed the efficacy of VR in the AYA population and sought to understand their preferences in virtual environments. The study included eight AYA cancer patients admitted to our institution receiving inpatient chemotherapy. Seven patients had acute leukemia and the 8th patient had medulloblastoma. Patients were offered the VR intervention every other day during the hospital stay. On average, patients were enlisted in the study for 19 days, and were provided with 27 different virtual environments to choose from. Subject scores were collected using validated survey instruments, including the Numeric Rating Scale (NRS) for pain, State Trait Anxiety Inventory (STAI) for anxiety, and Hospital Anxiety and Depression Scale (HADS-D) for depression. Objective measures were also collected including heart rate and electrodermal response. Additional qualitative data were collected via patient interviews to better understand the patient's attitudes and behaviors regarding their virtual reality experience. Responses collected from patients using HADS-D, STAI showed that, on average, there was a 15% decrease in depression and 13% decrease in general anxiety after receiving the VR intervention. Additionally, the response from the NRS showed that their perception of pain decreased by 18%. Moreover, these results were supported by the objective measures, where the frequency domain metric of heart rate variability, LF/HF (Low frequency to High Frequency power) ratio decreased by 42% displaying a high parasympathetic nervous system activity during the intervention and decrease in the number of bursts in skin conductance response by 7%. It was also observed from the survey that AYA patients preferred environments with more interaction and presence rather than simply exploring. Although no participants reported significant cybersickness, it was observed that 50% of the population reported fatigue at least once during the period of study. Hence, the design consideration of the VR environment is a crucial factor, especially while providing intervention for cancer patients. This proof of concept study affirms the capability of VR to be used as an adjunct therapy to help manage pain, anxiety and depression in AYA patients and provides design consideration for VR environments to be used in AYAs. Future work includes the development and testing of adaptive environments using affective computing techniques where the virtual environment changes according to the patient's mood. Disclosures Cull: Celgene: Speakers Bureau; ADC Therapeutics: Research Funding.

Study on the clinical application of pain treatment efficacy evaluation and the nursing of patients with non-cancer pain

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Han Qian ◽  
Yuping Liu ◽  
Wen Shen ◽  
Jie Chen
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cancer Pain ◽  
Rating Scale ◽  
Evaluation Model ◽  
Depression Scale ◽  
Nursing Intervention ◽  
Anxiety And Depression

Objective: To evaluate the pain degree of the patients with chronic non-cancer pain by using the evaluation model constituted by heart rate variability, anxiety and depression scale and quality of life rating scale, and to evaluate the efficacy after treatment and nursing intervention. Methods: 100 patients with chronic non-cancer pain treated in our hospital from February 2016 to April 2017 were selected to compare their heart rate variability, score of anxiety and depression, score of quality of life and NRS score before and after treatment and nursing intervention. Results: After treatment and nursing intervention, the heart rate variability time domain SDNN increased and the difference is significant (P ＜ 0.05); the score of anxiety and depression was lower than that before intervention (P ＜ 0.05); the scores of various dimensions of quality of life were higher than those before intervention (P ＜ 0.05); the NRS score was lower than that before intervention (P ＜ 0.05). Conclusion: The evaluation model constituted by heart rate variability, anxiety and depression scale and quality of life rating scale can be used to evaluate the pain degree of the patients with chronic non-cancer pain and to evaluate the efficacy after treatment and nursing intervention, which is worthy of clinic application.

scholarly journals Study on the Clinical Application of Pain Treatment Efficacy Evaluation and the Nursing of Patients with Chronic Non-cancer Pain

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Qian Han
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cancer Pain ◽  
Rating Scale ◽  
Evaluation Model ◽  
Depression Scale ◽  
Nursing Intervention ◽  
Anxiety And Depression

Objective: To evaluate the pain degree of the patients with chronic non-cancer pain by using the evaluation model constituted by heart rate variability, anxiety and depression scale and quality of life rating scale. This study also aims toevaluate the efficacy after treatment and nursing intervention. Methods: 100 patients with chronic non-cancer pain treated in the hospital from February 2016 to April 2017 were selected to compare their heart rate variability, score of anxiety and depression, score of quality of life and NRS score before and after treatment and nursing intervention. Results: After treatment and nursing intervention, the heart rate variability time domain SDNN significantly increased (P ＜ 0.05). The score of anxiety and depression was lower than that before intervention (P ＜ 0.05) while the scores of various dimensions of quality of life were higher than those before intervention (P ＜ 0.05). The results also showed that NRS score was lower than that before intervention (P ＜ 0.05). Conclusion: These findings suggest that the measurement combination of heart rate variability, anxiety and depression scale and quality of life rating scale can be used as an evaluation model to evaluate the pain degree of the patients with chronic non-cancer pain the efficacy after treatment and nursing intervention, which is worthy of clinic application.

scholarly journals Informal Caregiving in Amyotrophic Lateral Sclerosis (ALS): A High Caregiver Burden and Drastic Consequences on Caregivers’ Lives

2021 ◽  
Vol 11 (6) ◽  
pp. 748
Author(s):  
Pavel Schischlevskij ◽  
Isabell Cordts ◽  
René Günther ◽  
Benjamin Stolte ◽  
Daniel Zeller ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Functional Status ◽  
Disease Severity ◽  
Caregiver Burden ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Daily Routine ◽  
Work Lives ◽  
Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that causes progressive autonomy loss and need for care. This does not only affect patients themselves, but also the patients’ informal caregivers (CGs) in their health, personal and professional lives. The big efforts of this multi-center study were not only to evaluate the caregivers’ burden and to identify its predictors, but it also should provide a specific understanding of the needs of ALS patients’ CGs and fill the gap of knowledge on their personal and work lives. Using standardized questionnaires, primary data from patients and their main informal CGs (n = 249) were collected. Patients’ functional status and disease severity were evaluated using the Barthel Index, the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and the King’s Stages for ALS. The caregivers’ burden was recorded by the Zarit Burden Interview (ZBI). Comorbid anxiety and depression of caregivers were assessed by the Hospital Anxiety and Depression Scale. Additionally, the EuroQol Five Dimension Five Level Scale evaluated their health-related quality of life. The caregivers’ burden was high (mean ZBI = 26/88, 0 = no burden, ≥24 = highly burdened) and correlated with patients’ functional status (rp = −0.555, p < 0.001, n = 242). It was influenced by the CGs’ own mental health issues due to caregiving (+11.36, 95% CI [6.84; 15.87], p < 0.001), patients’ wheelchair dependency (+9.30, 95% CI [5.94; 12.66], p < 0.001) and was interrelated with the CGs’ depression (rp = 0.627, p < 0.001, n = 234), anxiety (rp = 0.550, p < 0.001, n = 234), and poorer physical condition (rp = −0.362, p < 0.001, n = 237). Moreover, female CGs showed symptoms of anxiety more often, which also correlated with the patients’ impairment in daily routine (rs = −0.280, p < 0.001, n = 169). As increasing disease severity, along with decreasing autonomy, was the main predictor of caregiver burden and showed to create relevant (negative) implications on CGs’ lives, patient care and supportive therapies should address this issue. Moreover, in order to preserve the mental and physical health of the CGs, new concepts of care have to focus on both, on not only patients but also their CGs and gender-associated specific issues. As caregiving in ALS also significantly influences the socioeconomic status by restrictions in CGs’ work lives and income, and the main reported needs being lack of psychological support and a high bureaucracy, the situation of CGs needs more attention. Apart from their own multi-disciplinary medical and psychological care, more support in care and patient management issues is required.

Effect of Virtual Reality Graded Exposure on Heart Rate and Self-Reported Anxiety Levels of Performing Saxophonists

2003 ◽  
Vol 51 (4) ◽  
pp. 302-315 ◽  
Author(s):  
Evelyn K. Orman
Keyword(s):  
Heart Rate ◽  
Virtual Reality ◽  
Virtual Environments ◽  
Exposure Period ◽  
Sense Of Presence ◽  
Graded Exposure ◽  
Subjective Measurements ◽  
Anxiety Levels ◽  
Exposure Sessions ◽  
Virtual Reality Exposure

This study is an examination of the effect of computer-generated virtual reality graded exposure on the physiological and psychological responses of performing musicians. Eight university saxophone majors, five men and three women, participated in twelve 15- to 20-minute weekly practice sessions during which they were immersed in one of four different virtual environments designed to elicit various anxiety levels. Baseline heart rates and subjective measurements were taken prior to immersion and continued throughout the exposure period. In addition, heart rate and subjective measurements were recorded for three live performances given by each subject before beginning the virtual reality exposure and after completion of the sixth and the twelfth exposure sessions. Findings indicated that the virtual environments did elicit a sense of presence and may have provided the means for desensitization. Heart-rate readings and psychological indications of anxiety did not always correspond.

scholarly journals Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Mental Wellbeing ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.

scholarly journals Prevalence and Influencing Factors of Anxiety and Depression Symptoms Amongst Surgical Nurses During COVID-19 Pandemic: A Large-Scale Cross-Sectional Study

2020 ◽  
Author(s):  
Chun-Xia Ren ◽  
De-Cun Zhou ◽  
Yin-Guang Fan ◽  
Bao-Zhu Li ◽  
Wan-Fei Zhang ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Influencing Factors ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
Self Rating ◽  
Surgical Nurses

Abstract BackgroundThe outbreak of novel 2019 coronavirus disease (COVID-19) has imposed an enormous physical and psychological pressure on people across the world. This study focused on evaluating the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the epidemic in China. MethodA cross-sectional, multicenter quantitative study was conducted in Anhui province (China) from March 3, 2020 to March 19, 2020, with a questionnaire package which consisted of general information questionnaire，Zung's self-rating anxiety scale (SAS), Zung's self-rating Depression Scale (SDS) and social support rating scale (SSRS). A total of 3600 surgical nurses participated in the survey by Wechat and QQ. Data were analysed using multiple linear regression models. ResultsA total of 3492 surgical nurses from 12tertiary hospitals and 12 secondary hospitals in one province of mainland China completed the survey. The prevalence rates of anxiety symptoms and depressive symptoms were 24.83% and 22.39%, respectively. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm (P< 0.05).Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety (r = -0.630, P < 0.001) and depression (r = -0.578, P < 0.001). Fertility status (β = 1.469, P = 0.003), hospital (β = -0.611, P < 0.001), participation in care for COVID-19 patients (β = 2.229, P < 0.001), likelihood of being infected with COVID-19 (β = 1.146, P < 0.001), social support (β = -0.623, P < 0.001) were significantly influencing surgical nurses’ anxiety degree. Similarly, these characteristics were significantly associated with the odds of experiencing depression symptoms in surgical nurses. Divorce and widowed surgical nurses (β = -2.654, P < 0.001) were significantly more likely to experience depressive symptoms than single nurses. ConclusionIn this survey, we found that the surgical nurses had high anxiety and depression symptoms during the COVID-19 outbreak in China. The findings suggest that targeted psychological interventions to promote the mental health of surgical nurses with psychological problems need to be immediately implemented.

Psychometric properties of the Revised Child Anxiety and Depression Scale in Greek Adolescents

2021 ◽  
pp. 135910452110565
Author(s):  
Ioanna Giannopoulou ◽  
Evdokia Pasalari ◽  
Paraskevi Bali ◽  
Dimitra Grammatikaki ◽  
Panagiotis Ferentinos
Keyword(s):  
Psychometric Properties ◽  
Measurement Invariance ◽  
Emotional Disorders ◽  
Rating Scale ◽  
Child Anxiety ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Divergent Validity ◽  
Convergent And Divergent Validity

The psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS-47) are established cross-culturally but lacking for the Greek population. The present study examined RCADS internal consistency and validity (structural and concurrent) in Greek adolescents, and tested measurement invariance across sex and age groups. We recruited 619 secondary school students ( n = 321 females), aged 12–18 years ( n = 318, 12–14-year-olds). Besides RCADS, all students completed Strengths and Difficulties Questionnaire (SDQ), a subsample ( n = 300) completed Screen for Child Anxiety-Related Emotional Disorders (SCARED), whereas a non-overlapping subsample ( n = 219) completed Depression Self-Rating Scale (DSRS). Structural validity was examined with Confirmatory Factor Analysis and measurement invariance was assessed with Multiple Indicators Multiple Causes (MIMIC) modeling. Convergent and divergent validity were examined using Spearman correlations between RCADS subscales and DSRS, SCARED, and SDQ validators. The six-factor model fitted the data best, validating the originally proposed RCADS structure. Three items displayed differential item functioning for sex, another three for age group, and one item for both, albeit with trivial effect sizes ( d < 0.2). Cronbach’s alpha was .94. Convergent and divergent validity were also established. In conclusion, the RCADS is a valid and reliable instrument for assessing anxiety and depression symptoms in Greek adolescents.

Stress-protective effects of micronized progesterone in treatment of anxiety disorders in pregnant women after in vitro fertilisation

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 346-353
Author(s):  
Natalya I. Tapilskaya ◽  
Mikhail S. Nekrasov ◽  
Inna O. Krikheli ◽  
Ksenia V. Ob'edkova ◽  
Alexander M. Gzgzyan ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Pregnant Women ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
In Vitro Fertilisation ◽  
Group 3 ◽  
The Mean ◽  
Micronized Progesterone

Aim. To study a stress-protective efficacy of micronized progesterone (MP) in pregnant women with anxiety disorders after in vitro fertilisation (IVF). Materials and methods. We conducted a prospective, comparative open-label randomized trial in two IVF-clinics. A total of 98 pregnant women after IVF with anxiety disorders were recruited at the 9th week of pregnancy. Progesterone supplementation after IVF for luteal phase support was administered out until 9 weeks gestation. Then, after randomization, group 1 (n=35) received 400 mg per day of MP vaginally, group 2 (n=33) received 400 mg of MP orally, group 3 (n=30) was comparative for the other groups. The duration of progesterone treatment was 12 weeks. The Spielberger State Trait Anxiety Inventory (STAI), the Montgomerysberg depression rating scale (MADRS), Hospital Anxiety and Depression Scale (HADS), and the Epworth Sleepiness Questionnaires (ESQ) were used to compare maternal mood at 9 weeks (day of randomization) after delivery and at 283, 565, 847 days after randomization. Results. The mean STAI sumscore in MP-groups was significantly lower than in group 3 starting from day 565 and continued until the end of the study. There were no significant differences between vaginal and oral administration of progesterone. There were no significant differences between the mean sumscores when questioning on the HADS, MADRS and ESQ. Conclusion. Prolonged use of MP in pregnant women with anxiety disorders led to the prevention of manifestations of an increase in anxiety and depression. The stress-protective and neuromodulating properties of MP can determine additional indications for its prolonged administration in women with anxiety disorders and/or premorbid history.

Hospital Anxiety and Depression Scale (HADS) accuracy in cancer patients

2019 ◽  
Vol 28 (8) ◽  
pp. 3921-3926 ◽  
Author(s):  
Maria Antonietta Annunziata ◽  
Barbara Muzzatti ◽  
Ettore Bidoli ◽  
Cristiana Flaiban ◽  
Francesca Bomben ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety
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