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Virtual Reality Education Program to Reduce Anxiety During Radiation Therapy

Primary Purpose

Anxiety, Stress, Satisfaction, Patient

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Video Education
VR-based Education
Sponsored by
Medical College of Wisconsin
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Anxiety focused on measuring Patient education, Virtual reality

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient is 18 years of age or older
  2. Patient is female
  3. Patient has been diagnosed with breast cancer
  4. Patient will be receiving whole breast radiation therapy without supraclavicular nodal irradiation
  5. Patient is scheduled for an outpatient radiation oncology visit
  6. Patient has the ability to understand a written informed consent document, and the willingness to sign it
  7. Patient has the ability to complete a series of self-reported questionnaires

Exclusion Criteria:

  1. Non-English-speaking patients (as the VR education program includes English narration)
  2. Patients with visual defects that affect their ability to watch a movie
  3. Patients with auditory defects that affect their ability to listen with headphones
  4. Patients who have worked in the field of radiation oncology as they would have previously undergone treatment-related education
  5. Patients who have been treated previously with radiation oncology as they would have previously undergone treatment-related education
  6. Patients that have been diagnosed with epilepsy, conditions causing seizures, or have any previous history of seizures because a very minute number of head-mounted display (HMD) users have experienced a seizure as a result of using the device
  7. Patients with a reported history of cognitive disability as their ability to understand educational content may be impaired
  8. Patients with a history of severe motion sickness because a side effect of using a HMD in a very small number of users is motion sickness symptoms
  9. Patients with a pacemaker, hearing aid(s), and/or defibrillator, while patients with other types of electronic medical devices / implants will be assessed for eligibility on a case-by-case basis because there could be potential interference with the HMD

Sites / Locations

  • Froedtert & the Medical College of Wisconsin

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Video Education

VR-based Education

Arm Description

Participants will receive video education on radiation therapy.

Participants will receive VR-based education on radiation therapy.

Outcomes

Primary Outcome Measures

Intra- and Inter-arm Differences in Pre-post Intervention Changes in Anxiety Using the State Trait Anxiety Inventory (STAI) for Adults Scores
The STAI was administered as a self-evaluation questionnaire at three time points. The STAI consists of two scales: one for measuring trait anxiety and one for measuring state anxiety. Both of the scales have ranges from 20 - 80, with higher scores representing higher anxiety.
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Stress Using the Visual Analog Scale for Stress Scores
The Visual Analog Scale for Stress was administered as a self-evaluation questionnaire at three time points. Participants indicated where they fell in terms of stress level from 0 (no stress at all) to 100 (most stressed ever).
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Preparedness Using the Visual Analog Scale for Preparedness Scores
The Visual Analog Scale for Preparedness was administered as a self-evaluation questionnaire at three time points. Participants indicated where they fell in terms of preparedness for their RT treatment from 0 (not prepared at all) to 100 (completely prepared).
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Satisfaction Using the Visual Analog Scale for Satisfaction Scores
The Visual Analog Scale for Satisfaction was administered at three time points. Participants indicated where they fell in terms of satisfaction from their experience with the radiation oncology department from 0 (not satisfied at all) to 100 (completely satisfied).
Proportional Differences in Pre-post Intervention Changes in the "Met" Need Count Per Arm of Information Need Topics Related to Radiation Therapy Treatment Using the Information Needs Scale Scores
The Information Needs Scale was administered as a self-evaluation questionnaire at three time points. Participants were asked to indicate how important it was for them to have information on a set of items related to radiation therapy treatment from 1 (not important) to 9 (very important). Participants were also asked to indicate whether they felt their needed level of information for each item was met, partially met, or unmet at the time of questionnaire completion, which is reported here.

Secondary Outcome Measures

Full Information

First Posted
July 15, 2019
Last Updated
April 14, 2021
Sponsor
Medical College of Wisconsin
Collaborators
Marquette University, Froedtert Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04029961
Brief Title
Virtual Reality Education Program to Reduce Anxiety During Radiation Therapy
Official Title
Pilot Study for the Development and Implementation of a Virtual Reality-based Radiation Therapy Education and Anxiety Mitigation Program
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Terminated
Why Stopped
The study was suspended due to the COVID-19 pandemic. The study was then terminated to prevent inconsistencies in baseline anxiety for patients enrolled before vs after the COVID-19 pandemic.
Study Start Date
August 12, 2019 (Actual)
Primary Completion Date
April 14, 2020 (Actual)
Study Completion Date
April 14, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical College of Wisconsin
Collaborators
Marquette University, Froedtert Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare the efficacy of an immersive virtual reality (VR)-based education program with a form of patient education commonly provided by clinics (e.g., an educational video) at delivering education to breast cancer patients as they prepare for radiation therapy treatment. Self-evaluation questionnaires completed by participants will be used to measure changes in information needs and anxiety, stress, preparedness and satisfaction levels pre/post education between the VR-based education and video education groups in this study. Expanded access to the current VR-based education program will depend on licensing status for associated assets by interested parties.
Detailed Description
Breast cancer patients experience anxiety, potentially reaching levels that are considered clinically-relevant. Prior research in this area has described the information needs of breast cancer patients at different time points as they proceed through the radiotherapy treatment process. Of high importance seems to be addressing patients' information needs through sensory and procedural information as a mechanism of anxiety reduction. The study team created an immersive VR-based education program that enables breast cancer patients to experience the procedure and emotions associated with radiation therapy prior to their actual treatment by offering controlled virtual exposure to the clinical environments involved in the treatment process. An educational video on the process of receiving radiation therapy is considered standard education at the majority of the clinical sites involved in this study. Participants enrolled in this study will be randomly assigned to either the VR-based education group or the video education group. Participation in this project will provide insight into aspects of patient education that are most effective at reducing anxiety and stress levels and meeting patients' information needs when undergoing radiation therapy treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anxiety, Stress, Satisfaction, Patient, Preparedness, Information Needs
Keywords
Patient education, Virtual reality

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Video Education
Arm Type
Active Comparator
Arm Description
Participants will receive video education on radiation therapy.
Arm Title
VR-based Education
Arm Type
Experimental
Arm Description
Participants will receive VR-based education on radiation therapy.
Intervention Type
Other
Intervention Name(s)
Video Education
Intervention Description
Prior to their CT simulation, participants will receive education on radiation therapy in the form of a video.
Intervention Type
Other
Intervention Name(s)
VR-based Education
Intervention Description
Prior to their CT simulation, participants will receive education on radiation therapy in the form of an immersive VR program delivered through a head-mounted display (HMD).
Primary Outcome Measure Information:
Title
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Anxiety Using the State Trait Anxiety Inventory (STAI) for Adults Scores
Description
The STAI was administered as a self-evaluation questionnaire at three time points. The STAI consists of two scales: one for measuring trait anxiety and one for measuring state anxiety. Both of the scales have ranges from 20 - 80, with higher scores representing higher anxiety.
Time Frame
Directly pre/post education (education appointment), directly following first radiation therapy (RT) treatment (first RT session)
Title
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Stress Using the Visual Analog Scale for Stress Scores
Description
The Visual Analog Scale for Stress was administered as a self-evaluation questionnaire at three time points. Participants indicated where they fell in terms of stress level from 0 (no stress at all) to 100 (most stressed ever).
Time Frame
Directly pre/post education (education appointment), directly following first radiation therapy (RT) treatment (first RT session)
Title
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Preparedness Using the Visual Analog Scale for Preparedness Scores
Description
The Visual Analog Scale for Preparedness was administered as a self-evaluation questionnaire at three time points. Participants indicated where they fell in terms of preparedness for their RT treatment from 0 (not prepared at all) to 100 (completely prepared).
Time Frame
Directly pre/post education (education appointment), directly following first radiation therapy (RT) treatment (first RT session)
Title
Intra- and Inter-arm Differences in Pre-post Intervention Changes in Satisfaction Using the Visual Analog Scale for Satisfaction Scores
Description
The Visual Analog Scale for Satisfaction was administered at three time points. Participants indicated where they fell in terms of satisfaction from their experience with the radiation oncology department from 0 (not satisfied at all) to 100 (completely satisfied).
Time Frame
Directly pre/post education (education appointment), directly following first radiation therapy (RT) treatment (first RT session)
Title
Proportional Differences in Pre-post Intervention Changes in the "Met" Need Count Per Arm of Information Need Topics Related to Radiation Therapy Treatment Using the Information Needs Scale Scores
Description
The Information Needs Scale was administered as a self-evaluation questionnaire at three time points. Participants were asked to indicate how important it was for them to have information on a set of items related to radiation therapy treatment from 1 (not important) to 9 (very important). Participants were also asked to indicate whether they felt their needed level of information for each item was met, partially met, or unmet at the time of questionnaire completion, which is reported here.
Time Frame
Directly pre/post education (education appointment), directly following first radiation therapy (RT) treatment (first RT session)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is 18 years of age or older Patient is female Patient has been diagnosed with breast cancer Patient will be receiving whole breast radiation therapy without supraclavicular nodal irradiation Patient is scheduled for an outpatient radiation oncology visit Patient has the ability to understand a written informed consent document, and the willingness to sign it Patient has the ability to complete a series of self-reported questionnaires Exclusion Criteria: Non-English-speaking patients (as the VR education program includes English narration) Patients with visual defects that affect their ability to watch a movie Patients with auditory defects that affect their ability to listen with headphones Patients who have worked in the field of radiation oncology as they would have previously undergone treatment-related education Patients who have been treated previously with radiation oncology as they would have previously undergone treatment-related education Patients that have been diagnosed with epilepsy, conditions causing seizures, or have any previous history of seizures because a very minute number of head-mounted display (HMD) users have experienced a seizure as a result of using the device Patients with a reported history of cognitive disability as their ability to understand educational content may be impaired Patients with a history of severe motion sickness because a side effect of using a HMD in a very small number of users is motion sickness symptoms Patients with a pacemaker, hearing aid(s), and/or defibrillator, while patients with other types of electronic medical devices / implants will be assessed for eligibility on a case-by-case basis because there could be potential interference with the HMD
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John LaDisa, PhD
Organizational Affiliation
Medical College of Wisconsin
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Monica Shukla, MD
Organizational Affiliation
Medical College of Wisconsin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Froedtert & the Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
21664788
Citation
Halkett GK, Kristjanson LJ, Lobb E, Little J, Shaw T, Taylor M, Spry N. Information needs and preferences of women as they proceed through radiotherapy for breast cancer. Patient Educ Couns. 2012 Mar;86(3):396-404. doi: 10.1016/j.pec.2011.05.010. Epub 2011 Jun 12.
Results Reference
background
PubMed Identifier
27906757
Citation
Bekelis K, Calnan D, Simmons N, MacKenzie TA, Kakoulides G. Effect of an Immersive Preoperative Virtual Reality Experience on Patient Reported Outcomes: A Randomized Controlled Trial. Ann Surg. 2017 Jun;265(6):1068-1073. doi: 10.1097/SLA.0000000000002094.
Results Reference
background
PubMed Identifier
18036247
Citation
Halkett GK, Kristjanson LJ. Validity and reliability testing of two instruments to measure breast cancer patients' concerns and information needs relating to radiation therapy. Radiat Oncol. 2007 Nov 25;2:43. doi: 10.1186/1748-717X-2-43.
Results Reference
background
Citation
Spielberger, C. State-Trait Anxiety Inventory for Adults - Manual, Instrument and Scoring Guide. 2015 Consulting Psychologists Press, Inc. Mind Garden, Inc.
Results Reference
background
Links:
URL
https://www.rtanswers.org/What-is-Radiation-Therapy/What-to-Expect
Description
Patient Video by the American Society for Therapeutic Radiation Oncology (ASTRO)

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Virtual Reality Education Program to Reduce Anxiety During Radiation Therapy

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