Abstract
OBJECTIVES: To explore the efficacy and safety of virtual reality (VR) in relieving negative emotions in patients with breast cancer with different personalities. METHODS: A randomized controlled trial was conducted. Between April 2023 and October 2023, we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province. The patients were randomly divided into an intervention group (n = 118) and a control group (n = 119) using block randomization. The intervention group received the VR intervention 3 - 5 times over 5 ± 2 weeks using natural landscapes with music or relaxation guidance, and the duration of each VR intervention was 15 ± 3 min. The control group received routine nursing care, including disease education and psychological counseling. Patients were assessed using the Type D Scale, Positive and Negative Affect Scale, and Distress Thermometer, and adverse events during the intervention were recorded. RESULTS: Overall, 85 patients completed the study (44 in the intervention group and 41 in the control group). Patients with Type D personalities showed more negative emotions [25.0 (21.5, 27.5) vs. 19.0 (16.0, 24.0), P = 0.001] and distressed attitudes [4.0 (2.0, 5.0) vs. 3.0 (1.0, 4.0), P = 0.020] with fewer positive emotions (27.2 ± 5.6 vs. 31.0 ± 5.9, P = 0.014) than those with non-Type D personalities. Total population analysis revealed no significant differences between the groups. However, in the subgroup analysis, patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group [median difference, -5.0 (-9.0, -2.5) vs. -2.0 (-4.0, 2.0), P = 0.046]. No significant differences were found between groups of patients with non-Type D personality traits. The proportion of adverse events was not significantly different between groups (P = 0.110). CONCLUSIONS: Breast cancer patients with Type D personalities suffer more severe negative emotions and distress, and more attention should be paid to them. VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.