Engagement Projects Help Patients Manage Stress and Anxiety

Cody Stansel, MSN, RN, NE-BC, OCN^®, CMSRN, described a program developed at Vanderbilt Ingram Cancer Center Infusion Center in which patients watched virtual reality videos and then reported on their pain and stress levels. Following the activity, patients experienced a mean decrease of 0.9 points on the pain measure and 1.5 points on the stress measure.

Stansel defined virtual reality as using visual and auditory sensory input to create the illusion of being in a specific environment or experiencing an event through a 360-degree recording of a place or event or a completely computer-generated experience. The virtual reality activity in Vanderbilt’s program provided patients with headsets and gave them a choice of 5- to 10-minute videos. Nurses identified patients to participate in the activity based on treatment, patient status, and other factors, and participation was voluntary. Vanderbilt’s pilot project involved 13 patients, and Stansel reported that the nurses who led the program plan to accrue 100 patients and add a control group to evaluate the effectiveness of the intervention.

At Rush University, a multidisciplinary group implemented a virtual art therapy project for ambulatory patients during the COVID-19 coronavirus. Patients receiving chemotherapy or radiation with access to a device with a camera and microphone for video chat participated in four consecutive weekly art sessions. Supplies were delivered prior to the first session, and a certified art therapist provided guided 90-minute sessions. Each week used a different painting medium. Patients completed the Generalized Anxiety Disorder 7-item survey and the Visual Facial Anxiety Scale each week. Overall, participants reported a reduction in anxiety each week from pre- to post-session.

“These preliminary findings suggest that art therapy can be delivered virtually, and the activity is associated with decreased anxiety levels among this sample,” Abigail de la Rosa, RN, BSN, nurse navigator, said, adding that continued study enrollment is necessary before generalizing these preliminary findings.

Because of COVID-19, investigators pivoted from an in-person to virtual setting, which presented challenges such as coordinating delivery of art therapy supplies and fostering an interactive setting on a virtual platform. However, the promising results of the program indicate that the virtual setting can be effective in cases in which an in-person program is not feasible, de la Rosa said.